#511
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Ñòàòèñòèêà....
×òî ìîæåò îáîçíà÷àòüñÿ "Ref" ïðèìåíèòåëüíî ê Îòíîøåíèþ ðèñêîâ?
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#512
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Ref çíà÷èò OR=1.0 èëè ðåôåðåíòíàÿ ãðóïïà ñðàâíåíèÿ, â êîòîðîé ðèñê âçÿò çà óñëîâíóþ åäèíèöó
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#513
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Ñïàñèáî!
Ìûñëè ïðî reference êîíå÷íî áûëè, íî ðàíåå êàê-òî íå âñòðå÷àë... |
#514
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Óâàæàåìûå êîëëåãè!
Ñìîòðþ êíèãó William F. Young Jr. MD MSc, "The Netter Collection of Medical Illustrations: The Endocrine System: Volume 2, 2 edition" 256 pages 2011. 1. Íà ñòð 43 â ðàçäåëå "GRAVES DISEASE" ó ðèñóíêà ïàöèåíòà ïåðå÷èñëÿþòñÿ ïðèçíàêè çàáîëåâàíèé, â òîì ÷èñëå íàïèñàíî: "Muscle wasting". Êàê ïåðåâåñòè ýòî "Muscle wasting" (ñòðåëêà íà ïðåäïëå÷üå) ? Îñîáåííî ñ ó÷¸òîì òîãî, ÷òî ðÿäîì íàïèñàíî: "Muscular weakness, fatigability" (ñòðåëêà íèæå êîëåííîãî ñóñòàâà) ... 2. Íà ñòðàíèöå 159 â òàáëèöå "DIFFERENTIAL DIAGNOSIS OF HYPERCALCEMIC STATES" â ñòðîêå "Humoral hypercalcemia of malignancy" â êîëîíêå "Associated findings" íàïèñàíî: "Solid malignancy usually evident". Êàê ïåðåâåñòè ýòî "Solid malignancy usually evident"? Çàðàíåå áëàãîäàðåí |
#515
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Muscle wasting - ìûøå÷íàÿ àòðîôèÿ;
Solid malignancy usually evident - íàëè÷èå óæå äèàãíîñòèðîâàííîãî îïóõîëåâîãî ïðîöåññà â îðãàíàõ è òêàíÿõ (èñêëþ÷àÿ ëåéêåìèè)
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#516
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#517
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Óâàæàåìûå êîëëåãè!
Careful patient selection- NPSA TTR>60% Ðå÷ü î ïîäáîðå èíãèáèòîðîâ 10à. Ïîìîãèòå, ïîæàëóéñòà. ![]() |
#518
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íå çíàþ, êàê ýòî áóäåò â êîíòåêñòå, no (NPSA) National Patient Safety Agency âûïóñòèëî ñïåö. áðîøþðó-ðåêîìåíäàöèè äëÿ ïàöèåíòîâ îá èõ îöåíêå çíàíèé è ïîäãîòîâëåííîñòè ê ëå÷åíèþ ÎÀÊ, ïîäðîáíåå çäåñü (ñòð. 2)
[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ] TTR - âðåìÿ, ïðîâåäåííîå â òåðàïåâòè÷åñêîì äèàïàçîíå ÌÍÎ; TTR>60% - ãîâîðèò î òîì, ÷òî ó ïàöèåíòîâ â òå÷åíèå 6 ìåñ. èëè ïîñëåäíåãî ãîäà öèôðû òåðàïåâòè÷åñêîãî ÌÍÎ áûëè â áîëåå 60%, à ÌÍÎ<2 èëè ÌÍÎ>3.0 âñåãî â ìåíåå 40% îò îáùåãî êîëè÷åñòâà èçìåðåíèé çà ýòîò ïåðèîä.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
#519
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Áîëüøîå ñïàñèáî!
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#520
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Íå ìîãó ñïðàâèòüñÿ ñ êîëîêîëüíûì çâîíîì. Êàê ïåðåâåñòè "toll-like receptor"?
Îòñþäà: Additionally, a variety of agonists and antagonists of the innate immune responses, including CD-14 and factors that modulate toll-like receptor (TLR) signaling, have been identified
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Èñðàôèëîâà Øàõëà Þñèôîâíà. Òåðàïåâò, ïóëüìîíîëîã. |
#521
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Âèêèïåäèÿ (íå î÷åíü íàäåæíûé èñòî÷íèê, íî âñå æå) ñ÷èòàåò, ÷òî ýòî íè áîëüøå íè ìåíüøå, êàê "[Ññûëêè äîñòóïíû òîëüêî çàðåãèñòðèðîâàííûì ïîëüçîâàòåëÿì ]".
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#522
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Øàõëà Þñèôîâíà, ÿ, êîíå÷íî, íå âèêèïåäèÿ, íî òî÷íî çíàþ, ÷òî ýòî äåéñòâèòåëüíî òîëë-ïîäîáíûå ðåöåïòîðû.
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#523
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Àíòèòåëà ê ðåöåïòîðàì òèðåîòðîïèíà...
Óâàæàåìûå êîëëåãè!
Ñîâñåì ïëîõî ïîíèìàþ ïîñëåäíþþ ôðàçó ðåçþìå, ïîýòîìó ïðèâîæó ïîñëåäíåå öåëèêîì âìåñòå ñ ìîèì ïåðåâîäîì. Ïîêðèòèêóéòå, ïîæàëóéñòà. Thyrotrophin receptor antibodies (TRAb) exist as stimulating or blocking antibodies in the serum (neutral TRAb have been identified recently). The clinical features of GD occur when stimulating TRAb predominate. But the relationship of TRAb to clinical phenotype and outcome is not clear when current assay methods are used. Therefore no consensus exists about its utility in diagnosing and predicting outcome in GD. The most commonly used TRAb assays, measure thyroid binding inhibiting immunoglobulins (TBII or “receptor assays”) and don’t differentiate between stimulating and blocking antibodies. However, the more expensive, technically demanding and less freely available “biological assays” differentiate between them by their ability to stimulate cyclic AMP or failure to do so. Failure to differentiate between TRAb types and its heterogeneous molecular and functional properties has limited TBII use to GD diagnosis and differentiating from other forms of thyrotoxicosis. The current 2nd-3rd generation receptor assays are highly sensitive and specific when used for this purpose. TRAb assays should also be done in appropriate pregnant women. Current data do not support its use in outcome prediction as there is a significant variability of assay methodology, population characteristics and study design in published data, resulting in a lack of consensus. Àíòèòåëà ê ðåöåïòîðàì òèðåîòðîïèíà (TRAb) ñóùåñòâóþò â âèäå ñòèìóëèðóþùèõ èëè áëîêèðóþùèõ àíòèòåë â ñûâîðîòêå (íåäàâíî áûëè âûÿâëåíû è íåéòðàëüíûå TRAb) . Êëèíè÷åñêèå ïðèçíàêè ÄÒÇ ïðîèñõîäÿò, êîãäà ïðåîáëàäàþò ñòèìóëèðóþùèå TRAb. Íî ïðè èñïîëüçîâàíèè íûíåøíèõ ìåòîäîâ àíàëèçà íåò ÷¸òêîé ñâÿçè ìåæäó óðîâíÿìè TRAb è êëèíè÷åñêèìè ïðîÿâëåíèÿìè è èñõîäàìè ÄÒÇ. Ïîýòîìó ñðåäè êëèíèöèñòîâ íå ñóùåñòâóåò åäèíîãî ìíåíèÿ î ïîëåçíîñòè îïðåäåëåíèÿ TRAb äëÿ äèàãíîñòèêè è ïðîãíîçèðîâàíèè èñõîäà ÄÒÇ. Áîëüøèíñòâî ñîâðåìåííûõ òåñò-ñèñòåì äëÿ îïðåäåëåíèÿ óðîâíÿ TRAb, èçìåðÿÿ êîëè÷åñòâî òèðîèäíûõ èíãèáèðóþùèõ èììóíîãëîáóëèíîâ (TBII or “receptor assays”), íå äåëàþò ðàçëè÷èÿ ìåæäó ñòèìóëèðóþùèìè è áëîêèðóþùèìè àíòèòåëàìè. Îäíàêî, áîëåå äîðîãèå, òåõíè÷åñêè áîëåå ñîâåðøåííûå è ïîêà ìåíåå äîñòóïíûå "áèîëîãè÷åñêèå òåñò-ñèñòåìû" ìîãóò ðàçëè÷àòü àíòèòåëà ïî èõ ñïîñîáíîñòè ñòèìóëèðîâàòü öèêëè÷åñêèé ÀÌÔ. Íåñïîñîáíîñòü òåñò-ñèñòåì ðàçëè÷àòü òèïû TRAb ïî èõ ðàçëè÷èþ â ìîëåêóëÿðíîì ñòðîåíèè è ôóíêöèîíàëüíûì ñâîéñòâàì ïðèâîäèò ê îãðàíè÷åíèþ ïðèìåíåíèÿ òàêèõ ñèñòåì äëÿ äèàãíîñòèêè ÄÒÇ è äèôôåðåíöèàöèè åãî îò äðóãèõ ôîðì òèðåîòîêñèêîçà. Ñîâðåìåííûå òåñò-ñèñòåìû âòîðîãî è òðåòüåãî ïîêîëåíèÿ äëÿ îïðåäåëåíèÿ TRAb èìåþò áîëåå âûñîêóþ ÷óâñòâèòåëüíîñòü è ñïåöèôè÷íîñòü äëÿ ýòîé öåëè.  ïåðâóþ î÷åðåäü îïðåäåëåíèå TRAb äîëæíî áûòü ñäåëàíî áåðåìåííûì æåíùèíàì ïðè ñîîòâåòñòâóþùèõ ïîêàçàíèÿõ.* Èç-çà çíà÷èòåëüíûå ðàçëè÷èé â òåñò-ñèñòåìàõ, ðàçëè÷èé â õàðàêòåðèñòèêàõ èçó÷åííûõ ãðóïï íàñåëåíèÿ è ðàçëè÷èé â äèçàéíå îïóáëèêîâàííûõ ðàáîò ñîâðåìåííûå íàó÷íûå ïóáëèêàöèè íå äàþò åäèíîãî ìíåíèÿ – ìîæíî ëè èñïîëüçîâàòü óðîâíè TRAb â ïðåäñêàçàíèè èñõîäà ÄÒÇ. _______________ * Òàê êàê áåðåìåííûì íåëüçÿ ïðîâîäèòü ñöèíòèãðàôèþ (Ïðèì. ïåðåâîä÷èêà) |
#524
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Äàííûå, íàêîïëåííûå ê ñåãîäíÿøíåìó äíþ, íå ïîçâîëÿþò èñïîëüçîâàòü òåñò íàáîðû äëÿ ýòèõ àíòèòåë â ïðîãíîçå/èñõîäå ÄÒÇ èç-çà çíà÷èòåëüíîé âàðèàáåëüíîñòè êàê òåñò íàáîðîâ, òàê è ïðîòåñòèðîâàííîãî íàñåëåíèÿ/ïàöèåíòîâ, èëè äèçàéíà èññëåäîâàíèé, ïðèâîäÿ ê îòñóòñòâèþ åäèíîãî êîíñåíñóñà ïî äàííîìó âîïðîñó.
ÏÑ. Ñìûñë â ñëåäóþùåì - åñëè êàêèå-òî àíòèòåëà (êîíêðåòíàÿ òåñò-ñèñòåìà) áûëè ïîêàçàíû ïðîãíîñòè÷åñêè çíà÷èìûìè ó áåðåìåííûõ ïðè ðåòðîñïåêòèâíîì èññëåäîâàíèè, òî ýòî íå çíà÷èò ÷òî ëþáûå àíòèòåëà ëþáîé -åñò-ñèñòåìû áóäóò òàêæå ïðåäñêàçàòåëüíû ó ïîæèëûõ ëþäåé (ëþäåé ëþáîãî âîçðàñòà) ïðîñïåêòèâíî. Èëè åñëè äàííàÿ ðåíòãåí-ìåòîäèêà ñ äàííûì êîíòðàñòèðîâàíèåì ïîçâîëÿåò âèçóàëèçèðîâàòü äàííóþ îïóõîëåâóþ ïàòîëîãèþ, òî àâòîìàòè÷åñêè íå çíà÷èò ÷òî ëþáîå êîíòðàñòíîå Ð-èññëåäîâàíèå ìîæåò âûÿâèòü ëþáóþ îïóõîëü â îðãàíèçìå.
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Èñêðåííå, Âàäèì Âàëåðüåâè÷. |
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Öèòàòà:
êîãäà áûë îòêðûò ãåí, êîäèðóþùèé ýòè ðåöåïòîðû, èññëåäîâàòåëü -Christiane Nüsslein-Volhard - âîñêëèêíóëà "Das ist ja toll!"- "That's amazing!" Ñîáñòâåííî îòñþäà è ïîøëî íàçâàíèå ðåöåïòîðîâ.
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Ñ óâàæåíèåì, Þñèô Àëõàçîâ. |