527 resultados para Anorexia nervosa


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PURPOSE: We assessed the safety of the multikinase inhibitor regorafenib in patients with hepatocellular carcinoma (HCC) that had progressed following first-line sorafenib. PATIENTS AND METHODS: Thirty-six patients with Barcelona Clinic Liver Cancer stage B or C HCC and preserved to mildly impaired liver function (Child-Pugh class A) received regorafenib 160 mg once daily in cycles of 3 weeks on/1 week off treatment until disease progression, unacceptable toxicity, death or patient/physician decision to discontinue. The primary end-point was safety; secondary end-points included efficacy (including time to progression and overall survival). RESULTS: The median treatment duration was 19.5 weeks (range 2-103). At data cutoff, three patients remained on treatment. Reasons for discontinuation were adverse events (n=20), disease progression (n=10), consent withdrawal (n=2) and death (n=1). Seventeen patients required dose reductions (mostly for adverse events [n=15]); 35 patients had treatment interruption (mostly for adverse events [n=32] or patient error [n=11]). The most frequent treatment-related adverse events were hand-foot skin reaction (any grade n=19; grade ≥3 n=5), diarrhoea (n=19; n=2), fatigue (n=19; n=6), hypothyroidism (n=15; n=0), anorexia (n=13; n=0), hypertension (n=13; n=1), nausea (n=12; n=0) and voice changes (n=10; n=0). Disease control was achieved in 26 patients (partial response n=1; stable disease n=25). Median time to progression was 4.3 months. Median overall survival was 13.8 months. CONCLUSION: Regorafenib had acceptable tolerability and evidence of antitumour activity in patients with intermediate or advanced HCC that progressed following first-line sorafenib.

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The importance of the cerebellum for non‐motor functions is becoming more and more evident. The influence on cognitive functions from acquired cerebellar lesions during childhood, however, is not well known. We present follow‐up data from 24 patients, who were operated upon during childhood for benign cerebellar tumours. The benign histology of these tumours required neither radiotherapy nor chemotherapy. Post‐operatively, these children were of normal intelligence with a mean IQ of 99.1, performance intelligence quotient (PIQ) of 101.3 and verbal intelligence quotient (VIQ) of 96.8. However, 57% of patients showed abnormalities in subtesting. In addition, more extensive neuropsychological testing revealed significant problems for attention, memory, processing speed and interference. Visuo‐constructive problems were marked for copying the Rey figure, but less pronounced for recall of the figure. Verbal fluency was more affected than design fluency. Behavioural deficits could be detected in 33% of patients. Attention deficit problems were marked in 12.5%, whereas others demonstrated psychiatric symptoms such as mutism, addiction problems, anorexia, uncontrolled temper tantrums and phobia. Age at tumour operation and size of tumour had no influence on outcome. Vermis involvement was related to an increase in neuropsychological and psychiatric problems. The observation that patients with left‐sided cerebellar tumours were more affected than patients with right‐sided tumours is probably also influenced by a more pronounced vermian involvement in the former group. In summary, this study confirms the importance of the cerebellum for cognitive development and points to the necessity of careful follow‐up for these children to provide them with the necessary help to achieve full integration into professional life.

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A 7-year-old male intact Rottweiler was presented with a 1-week history of lethargy, anorexia, vomiting and multiple syncopal events. The results of the clinical examination and electrocardiography were consistent with a third degree atrioventricular block and an intermittent accelerated idioventricular rhythm. Haematology, serum biochemistry, serology for Borrelia burgdorferi, blood culture, total T4, thoracic radiography and echocardiography did not reveal the cause of the arrhythmia. Response to medical treatment with isoproterenol was poor. Pacemaker placement was declined by the owners and the dog was euthanized at their request. Histopathological examination of the heart revealed a chemodectoma at the base of the heart. There was no neoplastic infiltration of the conduction tissue. Potential mechanisms explaining the association of the arrhythmias and the tumour, such as vagal stimulation and neuroendocrine factors are discussed.

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A 12-month-old beagle presented for anorexia, pyrexia and vomiting. The dog had been treated intermittently with antibiotics and corticosteroids for inappetence and lethargy since five months of age. Previous laboratory abnormalities included macrocytosis and neutropenia. At presentation, the dog was lethargic, febrile and thin. Laboratory examination findings included anaemia, a left shift, thrombocytopenia, hypoglycaemia and hyperbilirubinaemia. Multiple, small, hypoechoic, round hepatic lesions were observed on abdominal ultrasound. Cytological examination of hepatic fine needle aspirates revealed a fungal infection and associated pyogranulomatous inflammation. The dog's general condition deteriorated despite supportive measures and treatment with fluconazole, and owners opted for euthanasia before hypocobalaminaemia was identified. Subsequent genomic analysis revealed a CUBN:c.786delC mutation in a homozygous state, confirming hereditary cobalamin malabsorption (Imerslund-Gräsbeck syndrome). Similar to human infants, dogs with Imerslund-Gräsbeck syndrome may rarely be presented for infectious diseases, distracting focus from the underlying primary disorder.

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Canine granulocytic anaplasmosis (CGA) is caused by the rickettsial microorganism Anaplasma phagocytophilum. CGA is typically characterized by fever, thrombocytopenia, lethargy, anorexia, arthropy, and other nonspecific clinical signs. Skin lesions have been described in naturally infected lambs and humans. The pathophysiology of CGA is not entirely clear, and the persistence of the organism after the resolution of clinical signs has been described. The aim of the study was to investigate if A. phagocytophilum can be detected in canine lesional skin biopsies from A. phagocytophilum-seropositive dogs with etiologically unclear skin lesions that improved after the treatment with doxycycline. Paraffin-embedded lesional skin biopsies were allocated into separate groups: biopsies from A. phagocytophilum-seropositive dogs responsive to treatment with doxycycline (n=12), biopsies from A. phagocytophilum-seronegative dogs (n=2), and biopsies in which skin lesions histopathologically resembled a tick bite (n=10). The serological status of the latter group was unknown. Histology of the seropositive and seronegative dog skin lesions did not indicate an etiology. DNA was extracted, and a conventional PCR for partial 16S rRNA gene was performed. Anaplasma phagocytophilum DNA was amplified from 4/12 seropositive dogs' skin biopsies. All sequences were 100% identical to the prototype A. phagocytophilum human strain (GenBank accession number U02521). Anaplasma phagocytophilum was not amplified from the 2 seronegative and 10 suspected tick bite dogs. Serum antibody titers of the PCR-positive dogs ranged from 1:200 to 1:2048. Histopathologically, a mild-to-moderate perivascular to interstitial dermatitis composed of a mixed cellular infiltrate and mild-to-moderate edema was seen in all seropositive dogs. In 8/12 seropositive dogs, vascular changes as vasculopathy, fibrinoid necrosis of the vessel walls, and leukocytoclastic changes were observed. In summary, our results support the hypothesis that the persistence of A. phagocytophilum in the skin may be causative for otherwise unexplained skin lesions in seropositive dogs.

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An 8-yr-old male leopard (Panthera pardus) was presented with a 4-day history of lethargy, vomiting, and anorexia. Thoracic and abdominal radiographs revealed a soft-tissue mass cranial to the diaphragm and atypical appearance of the gastric fundus. Esophagoscopy revealed gastric mucosa in the lumen of the esophagus, which confirmed gastroesophageal intussusception. An exploratory celiotomy with manual reduction of the intussusception was performed. Reduction was verified by intraoperative esophagoscopy and gastroscopy. An incisional fundic gastropexy to the left abdominal wall was performed to reduce the chance of a recurrence of the intussusception. No postoperative complications related to the surgery were observed, and the animal resumed eating within 48 hr of surgery. A subsequent recurrence of clinical signs was not noted by the owner.

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Hiatal hernia was diagnosed in three exotic felines-lynx (Lynx lynx), cougar (Puma concolore), and lion (Panthera leo). All cats had a history of anorexia. Thoracic and abdominal radiographs showed evidence of a soft tissue mass within the caudal mediastinum suggestive of a hiatal hernia in all animals. A barium esophagram was performed in one case. All animals underwent thoracic or abdominal surgery for hernia reduction. Surgical procedures included: intercostal thoracotomy with herniorrhaphy and esophagopexy (lynx and cougar), and incisional gastropexy (lion). Concurrent surgical procedures performed were gastrotomy for gastric foreign body removal and jejunostomy tube placement. Clinical signs related to the hiatal hernia disappeared after surgery and recurrence of signs was not reported for the time of follow-up.

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Introduction. Cancer is the second most common cause of death in the USA (2). Studies have shown a coexistence of cancer and hypogonadism (9,31,13). The majority of patients with cancer develop cachexia, which cannot be solely explained by anorexia seen in these patients. Testosterone is a male sex hormone which is known to increase muscle mass and strength, maintain cancellous bone mass, and increase cortical bone mass, in addition to improving libido, sexual desire, and fantasy (14). If a high prevalence of hypogonadism is detected in male cancer patients, and a significant difference exists in testosterone levels in cancer patients with cachexia versus those without cachexia, testosterone may be administered in future randomized trials to help alleviate cachexia. Study group and design The study group consisted of male cancer patients and non-cancer controls aged between 40 and 70 years. The primary study design was cross-sectional with a sample size of 135. The present data analysis is done on a subset convenience sample of 72 patients recruited between November 2006 and January 2010. ^ Methods. Patients aged 40-70 years with or without a diagnosis of cancer were recruited into the study. All patients with a BMI over 35, significant edema, non-melanomatous skin cancer, current alcohol or illicit drug abuse, concomitant usage of medications interfering with gonadal axis, and anabolic agents, patients on tube feeds or parenteral nutrition within 3 months prior to enrollment were excluded from the study. The study was approved by the Institutional Review Board of Baylor College of Medicine and is being conducted at the Michael E. DeBakey Veterans Affairs Medical Center at Houston. My thesis is a pilot data analysis that employs a smaller subset convenience sample of 72 patients determined by using the data available for the 72 patients (of the intended sample of 135 patients) recruited between November 2006 and January 2010. The primary aim of this analysis is to compare the proportion of patients with hypogonadism in the male cancer and non-cancer control groups, and to evaluate if a significant difference exists with respect to testosterone levels in male cancer patients with cachexia versus those without cachexia. The procedures of the study relevant to the current data analysis included blood collection to measure levels of testosterone and measurement of body weight to categorize cancer patients into cancer cachexia and cancer non-cachexia sub-groups. ^ Results. After logarithmic transformation of data of cancer and control groups, the unpaired t test with unequal variances was done. The proportion of patients with hypogonadism in the male cancer and non-cancer control groups was 47.5% and 22.7% with a Pearson chi2 statistic of 1.6036 and a p value of 0.205. Comparing the mean calculated Bioavailable testosterone in male cancer patients and non-cancer controls resulted in a t statistic of 21.83 and a p value less than 0.001. When the cancer group alone was taken, the mean free testosterone, calculated bioavailable testosterone and total testosterone levels in the cancer non-cachexia sub-group were 3.93, 5.09, 103.51 respectively and in the cancer cachexia sub-group were 3.58, 4.17, 84.08 respectively. The unpaired t test with equal variances showed that the two sub-groups had p values of 0.2015, 0.1842, and 0.4894 with respect to calculated bioavailable testosterone, free testosterone, and total testosterone respectively. ^ Conclusions. The small sample size of this exploratory study, resulting in a small power, does not allow us to draw definitive conclusions. For the given sub-sample, the proportion of patients with hypogonadism in the cancer group was not significantly different from that of patients with hypogonadism in the control group. Inferences on prevalence of hypogonadism in male cancer patients could not be made in this paper as the sub-sample is small and therefore not representative of the general population. However, there was a statistically significant difference in calculated Bioavailable testosterone levels in male cancer patients versus non-cancer controls. Analysis of cachectic and non-cachectic patients within the male cancer group showed no significant difference in testosterone levels (total, free, and calculated bioavailable testosterone) between both sub-groups. However, to re-iterate, this study is exploratory and the results may change once the complete dataset is obtained and analyzed. It however serves as a good template to guide further research and analysis.^

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La paciente C.J., asistió a la carrera de Especialización en Prostodoncia recomendada para iniciar, dado su diagnóstico de bulimia y anorexia nerviosa purgativa, un tratamiento rehabilitador integral que le permita recomponer su salud bucal, para de esta manera, estimularla a mantener su condición de paciente estable en lo que se refiere a su enfermedad. Se transitaron los pasos de la historia clínica para llegar a un diagnóstico ajustado y de esta manera poder determinar un buen pronóstico y desarrollar un adecuado plan de tratamiento y tratamiento final que colmó las expectativas de la paciente.

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En tanto el Trabajo Social tiene como principios básicos los Derechos Humanos y la Justicia Social, toda problemática relacionada a ello se torna en un tema de investigación para la profesión, incluyendo aquellas asociadas a la corporalidad. Actualmente, el cuerpo adquiere algunos significados asociados a la estética, idealización y eterna juventud y tienen un importante peso especialmente en los colectivos de mujeres, en los cuales las representaciones sociales se inscriben en los cuerpos buscando satisfacer ciertos patrones y estereotipos de mujer ideal. Estas prácticas suelen derivar en una serie de problemáticas asociadas a la discriminación y exclusión de aquellas personas que no respondan a los mismos y a situaciones extremas que ponen el peligro la salud y el bienestar integral de las mujeres, incluyendo realidades que van desde la trata de personas hasta la anorexia, bulimia, entre otras. La Investigación de Tesis que estoy llevando a cabo apunta a comprender las formas en que las representaciones sociales del cuerpo femenino influyen en la vida cotidiana de las mujeres y la relación de sus prácticas con los mecanismos de poder buscando así contribuir, desde el Trabajo Social, al logro de una sociedad más igualitaria, integradora y con pleno ejercicio de ciudadanía

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El presente proyecto tiene como objetivo continuar indagando uno de los aspectos tratados en Textos especializados: comprensión y traducción por profesionales del área científico-técnica y por traductores, trabajo desarrollado por la misma unidad ejecutora. Se trata de la evaluación de la traducción de un texto especializado, tomando como eje central su microestructura, para lo cual se afinarán ciertos parámetros de evaluación de los resultados obtenidos en el trabajo citado, a fin de obtener un modelo de aplicación posterior. El corpus está formado por un máximo de sesenta producciones, repartidas equitativamente en las siguientes especialidades: psicología (bulimia y anorexia); medicina (traumatología) e ingeniería (hidráulica). Las conclusiones podrán servir de referencia para posibles modificaciones metodológicas en la carrera de Traductorado como así también en los cursos de Capacitación en Idioma Francés destinados a estudiantes universitarios y profesionales de la comunidad

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El presente proyecto tiene como objetivo continuar indagando uno de los aspectos tratados en Textos especializados: comprensión y traducción por profesionales del área científico-técnica y por traductores, trabajo desarrollado por la misma unidad ejecutora. Se trata de la evaluación de la traducción de un texto especializado, tomando como eje central su microestructura, para lo cual se afinarán ciertos parámetros de evaluación de los resultados obtenidos en el trabajo citado, a fin de obtener un modelo de aplicación posterior. El corpus está formado por un máximo de sesenta producciones, repartidas equitativamente en las siguientes especialidades: psicología (bulimia y anorexia); medicina (traumatología) e ingeniería (hidráulica). Las conclusiones podrán servir de referencia para posibles modificaciones metodológicas en la carrera de Traductorado como así también en los cursos de Capacitación en Idioma Francés destinados a estudiantes universitarios y profesionales de la comunidad

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El presente proyecto tiene como objetivo continuar indagando uno de los aspectos tratados en Textos especializados: comprensión y traducción por profesionales del área científico-técnica y por traductores, trabajo desarrollado por la misma unidad ejecutora. Se trata de la evaluación de la traducción de un texto especializado, tomando como eje central su microestructura, para lo cual se afinarán ciertos parámetros de evaluación de los resultados obtenidos en el trabajo citado, a fin de obtener un modelo de aplicación posterior. El corpus está formado por un máximo de sesenta producciones, repartidas equitativamente en las siguientes especialidades: psicología (bulimia y anorexia); medicina (traumatología) e ingeniería (hidráulica). Las conclusiones podrán servir de referencia para posibles modificaciones metodológicas en la carrera de Traductorado como así también en los cursos de Capacitación en Idioma Francés destinados a estudiantes universitarios y profesionales de la comunidad

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En tanto el Trabajo Social tiene como principios básicos los Derechos Humanos y la Justicia Social, toda problemática relacionada a ello se torna en un tema de investigación para la profesión, incluyendo aquellas asociadas a la corporalidad. Actualmente, el cuerpo adquiere algunos significados asociados a la estética, idealización y eterna juventud y tienen un importante peso especialmente en los colectivos de mujeres, en los cuales las representaciones sociales se inscriben en los cuerpos buscando satisfacer ciertos patrones y estereotipos de mujer ideal. Estas prácticas suelen derivar en una serie de problemáticas asociadas a la discriminación y exclusión de aquellas personas que no respondan a los mismos y a situaciones extremas que ponen el peligro la salud y el bienestar integral de las mujeres, incluyendo realidades que van desde la trata de personas hasta la anorexia, bulimia, entre otras. La Investigación de Tesis que estoy llevando a cabo apunta a comprender las formas en que las representaciones sociales del cuerpo femenino influyen en la vida cotidiana de las mujeres y la relación de sus prácticas con los mecanismos de poder buscando así contribuir, desde el Trabajo Social, al logro de una sociedad más igualitaria, integradora y con pleno ejercicio de ciudadanía

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En tanto el Trabajo Social tiene como principios básicos los Derechos Humanos y la Justicia Social, toda problemática relacionada a ello se torna en un tema de investigación para la profesión, incluyendo aquellas asociadas a la corporalidad. Actualmente, el cuerpo adquiere algunos significados asociados a la estética, idealización y eterna juventud y tienen un importante peso especialmente en los colectivos de mujeres, en los cuales las representaciones sociales se inscriben en los cuerpos buscando satisfacer ciertos patrones y estereotipos de mujer ideal. Estas prácticas suelen derivar en una serie de problemáticas asociadas a la discriminación y exclusión de aquellas personas que no respondan a los mismos y a situaciones extremas que ponen el peligro la salud y el bienestar integral de las mujeres, incluyendo realidades que van desde la trata de personas hasta la anorexia, bulimia, entre otras. La Investigación de Tesis que estoy llevando a cabo apunta a comprender las formas en que las representaciones sociales del cuerpo femenino influyen en la vida cotidiana de las mujeres y la relación de sus prácticas con los mecanismos de poder buscando así contribuir, desde el Trabajo Social, al logro de una sociedad más igualitaria, integradora y con pleno ejercicio de ciudadanía