Navegando por Palavras-chave "Graves' ophthalmopathy"
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- ItemSomente MetadadadosCorrelation between clinical and histological analyses in retroocular connective tissues and extraocular muscles from patients with Graves' ophthalmopathy(Humana Press Inc, 2000-06-01) Matos, K.; Nose, V; Manso, P. G.; Furlane, R.; Marback, E.; Nakanami, C.; Nakanami, D.; Pares, L.; Stamato, F.; Universidade Federal de São Paulo (UNIFESP)Twenty-two patients with Graves' ophthalmopathy underwent biopsy, and two patients had both eyes biopsied. the samples for the control group (n = 4) were obtained during routine non-thyroid-related corrective strabismus surgery. Ophthalmological evaluation with clinical activity score (CAS), endocrinological evaluation, and ultrasound were used in our study. Correlation between clinical and histological analyses in connective tissues and extraocular muscles from patients with Graves' ophthalmopathy was done. the echography results disclosed an enlargement in all extraocular recti muscles with the exception of one patient. Periodic acid-Schiff and Giemsa stains revealed a moderate number of mast cells in the endomysial connective tissue, none of which displayed significant degranulation. There were no signs of muscle cell damage. Fifteen of the biopsies showed weak cellular reactions with only scattered inflammatory cells. Furthermore, the inflammatory process may be localized and not equally distributed throughout the muscle. Thus, the biopsies might not be representative for the whole muscle. Statistical significance analysis was found when sex and CAS were compared (p = 0.001683) using the Fisher test.In conclusion, our investigation indicates a pleomorphic pattern of histologic findings in connective tissue and extraocular muscles in Graves' ophthalmopathy.
- ItemSomente MetadadadosPentoxifylline (PTX) - An alternative treatment in Graves' ophthalmopathy (inactive phase): Assessment by a disease specific quality of life questionnaire and by exophthalmometry in a prospective randomized trial(Wichtig Editore, 2004-07-01) Finamor Junior, Francisco Estivallet [UNIFESP]; Martins, João Roberto Maciel [UNIFESP]; Nakanami, Deise Mitsuko [UNIFESP]; Paiva, Elias Rodrigues de [UNIFESP]; Manso, Paulo Gois [UNIFESP]; Furlanetto, Reinaldo Perrone [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)PURPOSE. To investigate the effect of pentoxifylline (PTX) in subjects with inactive Graves' ophthalmopathy (GO) through a specific quality of life (QOL) questionnaire and exophthalmometry readings.METHODS. Eighteen females were randomly divided in two groups. Group A (n=9) was treated with PTX 1200 mg orally/day for 6 months. Group B (n=9) received placebo during the initial 6 months and then PTX for another 6 months. Proptosis measurements were carried out every 3 months and a questionnaire graded from 0 to 10 according to the severity of the symptoms was performed at baseline and after placebo and PTX administration.RESULTS. At baseline, Group A questionnaire score values were 5.5 (median; range 3.5 to 8.0), and 5.0 after 6 months (3.0 to 6.0; p=0.01). In Group B, baseline values were not significantly different after 6 months of placebo: 6.0 (4.5 to 7.0) and 5.5 (4.5 to 7.0), respectively. However, a significant change was observed 6 months after PTX: 4.0 (2.0 to 5.0; p<0.001). Patients in Group A had a progressive improvement of proptosis during PTX: at baseline, 23 mm (median; range 20 to 32); after 3 months, 23 mm (18 to 30; p=0.02); and after 6 months, 23 mm (18 to 30; p=0.005). In Group B, proptosis remained stable during placebo: at baseline, 23 mm (21 to 25); after 3 months, 23 mm (20 to 25); and after 6 months, 23.5 mm (20 to 25). A significant change was observed after 3 and 6 months of PTX: 22 mm (19 to 24; p=0.0006) and 20.8 mm (17 to 25; p=0.0003), respectively.CONCLUSIONS. Pentoxifylline seems to improve the QOL of patients in the inactive phase of GO. The objective findings of the proptosis readings corroborate to suggest that PTX may be an effective and promising drug in the inactive phase of GO. 14: )
- ItemAcesso aberto (Open Access)Protein expression of VEGF, IGF-1 and FGF in retroocular connective tissues and clinical correlation in Graves' ophthalmopathy(Conselho Brasileiro de Oftalmologia, 2008-08-01) Matos, Kimble [UNIFESP]; Manso, Paulo Gois [UNIFESP]; Marback, Eduardo [UNIFESP]; Furlanetto, Reinaldo [UNIFESP]; Alberti, Gustave Nosé; Nosé, Vania [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Universidade Federal da Bahia; Tufts University Medical Center; Brigham and Women's Hospital Department of PathologyPURPOSE: To investigate the immunohistochemical expression (IGF-1, EGFr, EGF, c-erbB-2/HER-2/neu, PDGF-A, PDGF-B, FGF and VEGF) in patients with Graves' ophthalmopathy. METHODS: Twenty-four samples (Graves' ophthalmopathy patients) underwent lateral rectus muscle and surrounding fibrous and adipose tissue biopsy. The control group was obtained by strabismus surgery. Correlation between clinical- ophthalmologic, endocrinological, ultrasonographic findings, and immunohistochemical expression was performed. RESULTS: IGF-1: There were 7 positive cases (29.2%). There was a direct relation with higher CAS (clinical activity score) in all of them and if only CAS equal or higher than 5 was considered, this was 54.5%. FGF: There was expression in 5 cases (20.8%) with a direct relation in all those with higher CAS (>5) (45.4%). VEGF: There were two positive cases (8.3%) for VEGF in endothelial cells, in these cases the patients also presented CAS higher than 5. There was no expressions of all growth factors in the control group. CONCLUSIONS: All patients, except one, with positive expression of FGF, IGF-1 and VEGF showed CAS greater than 5, suggesting in this way an important role of these growth factors in the pathogenesis and severity of Graves' ophthalmopathy. However, statistical analysis revealed only significant association between IGF-1 and male sex (P=0.034). Low ultrasound reflectivity and endocrine status may not correlate directly with disease activity or with immunoexpression of growth factors and c-erbB-2/HER-2/neu.
- ItemSomente MetadadadosProtracted hypofractionated radiotherapy for graves' ophthalmopathy: a pilot study of clinical and radiologic response(Elsevier B.V., 2012-03-01) Cardoso, Cejana Casimiro de Deus [UNIFESP]; Giordani, Adelmo José [UNIFESP]; Borri Wolosker, Angela Maria [UNIFESP]; Souhami, Luis; Manso, Paulo Gois [UNIFESP]; Dias, Rodrigo Souza [UNIFESP]; Comodo Segreto, Helena Regina [UNIFESP]; Segreto, Roberto Araujo [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); McGill UnivPurpose: To evaluate the clinical and radiologic response of patients with Graves' ophthalmopathy given low-dose orbital radiotherapy (RT) with a protracted fractionation.Methods and Materials: Eighteen patients (36 orbits) received orbital RT with a total dose of 10 Gy, fractionated in 1 Gy once a week over 10 weeks. of these, 9 patients received steroid therapy as well. Patients were evaluated clinically and radiologically at 6 months after treatment. Clinical response assessment was carried out using three criteria: by physical examination, by a modified clinical activity score, and by a verbal questionnaire considering the 10 most common signs and symptoms of the disease. Radiologic response was assessed by magnetic resonance imaging.Results: Improvement in ocular pain, palpebral edema, visual acuity, and ocular motility was observed in all patients. Significant decrease in symptoms such as tearing (p < 0.001) diplopia (p = 0.008), conjunctival hyperemia (p = 0.002), and ocular grittiness (p = 0.031) also occurred. Magnetic resonance imaging showed decrease in ocular muscle thickness and in the intensity of the T2 sequence signal in the majority of patients. Treatments were well tolerated, and to date no complications from treatment have been observed. There was no statistical difference in clinical and radiologic response between patients receiving RT alone and those receiving RT plus steroid therapy.Conclusion: RT delivered in at a low dose and in a protracted scheme should be considered as a useful therapeutic option for patients with Graves' ophthalmopathy. (C) 2012 Elsevier Inc.