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1.
Helminthologia ; 61(1): 85-98, 2024 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-38659464

RESUMEN

A general limitation of ecological investigations based on nematodes is related to the difficult and time-consuming taxonomic identification of species. Therefore, nematologists are investing many efforts to develop alternative approaches as proxies applicable in biomonitoring assessment. Recently, an alternative method that combines morpho-functional traits was proposed for detecting assemblage changes of marine nematodes. In view of the promising results, it was tested the same approach to document taxonomic structure changes of soil free-living and plant parasitic nematodes. Specifically, this attempt was carried out using three data sets that include studies from various European regions and different types of ecosystems: forests, grasslands and maize crops. Multivariate statistical analysis revealed that the simple combination of the four traits (i.e., buccal cavity cuticularization occurrence, amphideal fovea size and shape, morphology of the cuticle and pharynx) in a single code number perfectly mirrors the taxonomic structure trends of the nematode assemblage at genus level. Therefore, we predict that similar results can be also obtained by directly encoding nematode specimens with the selected traits and we point to new important advances if this procedure can be coupled with advanced machine learning.

2.
Drug Alcohol Depend ; 225: 108847, 2021 08 01.
Artículo en Inglés | MEDLINE | ID: mdl-34182375

RESUMEN

BACKGROUND: Alcohol consumption is responsible for a significant number of road fatalities. To contrast this phenomenon, a more responsible attitude to the wine consumption, especially among young, inexperienced drivers prone to risky behaviour on the road must be promoted. METHOD: This is a simplified single-blind, placebo-controlled experiment aimed at evaluating 44 young drivers monitored during a driving simulation following the consumption of natural and conventional wines, with a reference blood alcohol concentration (BAC) of 0.5 g/l. Two hypotheses are tested: (1) the legal consumption of wine has no significant impact on young drivers' performance in both ordinary and unusual road events; (2) natural and conventional wines are expected to produce negligible and acceptable impairments in young drivers the same BAC. Two reference groups (BAC = 0 g/l), one a placebo-controlled group with drivers treated with a dealcoholized wine, were included. RESULTS AND CONCLUSIONS: Significant differences between the groups in terms of perception and reaction times (PRT) to visual and auditory stimuli, and to speeding were observed, with young drivers treated with conventional wine displaying more aggressive behaviours. In contrast, participants treated with natural wine showed PRT which were not significantly different from those belonging to control groups. The gaze attention levels of wine treated drivers were found to be dose dependant, with young drivers of the two control groups and those of the treated ones with BAC < 0.3 g/l able to focus on wider area ahead and, thereby, collect more information from the road environment.


Asunto(s)
Conducción de Automóvil , Vino , Accidentes de Tránsito/prevención & control , Consumo de Bebidas Alcohólicas/epidemiología , Nivel de Alcohol en Sangre , Humanos , Método Simple Ciego
3.
Accid Anal Prev ; 139: 105487, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32135336

RESUMEN

A passing maneuver allows drivers to maintain their desired speed on two-lane highways. However, it entails a high risk of collision with vehicles travelling in the opposite direction. Investigating drivers' behavior while performing passing maneuvers could provide helpful information on the factors that influence this process. Driving simulators have become important tools for driving behavior research studies as they are safe, facilitate the controlled use of experimental variables, and generate detailed output data. It remains to be seen whether simulator results can be considered representative of real-life driving conditions. With respect to passing maneuvers, no study has made a comprehensive and direct comparison between drivers' passing behavior in the field and driver behavior observed in a simulated environment. In this validation study, a fixed-base interactive simulator was used to collect data from fifty-four participants (eighteen Iranians and thirty-six Italians) involved in several traffic scenarios on a two-lane rural highway segment (obtained by varying the speed of opposing vehicles, lead vehicles and headways in the opposite direction). A 3D model and its environmental characteristics were realized from the real segment which had previously been surveyed with drones to collect videos and derive data on real passing maneuvers. The results for the two-sided K-S test revealed no statistically significant difference in the accepted gap, effective accepted gap, perception reaction time, and time to collision variables between the field and the simulator at the 95 % confidence level. However, when conducting a one-sided K-S test, some statistical directional differences were found in the cases of the accepted gap and perception reaction time variables, which exhibited lower values in the field compared to the simulator again at the 95 % confidence level. Although the passing duration was statistically higher in the simulator than in the field, the shape of the two distributions was not statistically different. Analysis showed that differences in the passing duration are due to the lower passing vehicle speed and lower speed difference with the simulator than in the field, which are caused by truncating headways in the subject direction in the simulator. The cultural background of participants did not result in any discernible difference in passing behavior. The results would support a more extensive use of driving simulators in future passing behavior studies.


Asunto(s)
Conducción de Automóvil/psicología , Simulación por Computador/normas , Accidentes de Tránsito/prevención & control , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Tiempo de Reacción/fisiología , Medición de Riesgo , Adulto Joven
4.
Accid Anal Prev ; 131: 200-212, 2019 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-31306834

RESUMEN

The available sight distance (ASD) is the maximum length of the roadway ahead visible to the driver. It is a fundamental factor in road geometry principles and is used by road designers to ensure safe driving conditions. However, designers do not know how a specific ASD may affect the longitudinal and transversal behavior of drivers engaged in negotiating curves. This paper focuses on analyzing driver longitudinal behavior along rural highways curves with limited visibility. A number of virtual sight condition scenarios were recreated and tested in the driving simulator. Three tracks were designed with various combinations of radii and sight obstructions (a continuous wall) along the roadside located at various offsets from the lane centerline, combinations which resulted with a minimum ASD of 56.6 m. Roadside factors capable of influencing the risk perception of drivers (e.g., traffic barriers, posted speed limit signs, vegetation) were all excluded from the simulations. Results indicate that speed and trajectory dispersion from the lane centerline depend linearly on ASD in the investigated range of curve radii (from 120 to 430 m). In general, when ASD increases, so does speed and the trajectories tend to be less dispersed around the lane centerline. As a result, in safety terms, any variation in ASD will have the polar opposite effect on safety related parameters. Furthermore, different curves with similar ASD values resulted in different speed and lateral control behaviors. Analysis from ANOVA support the same findings; in addition, radius, curve direction, and distance from trajectory to sight obstruction have been identified as significant independent parameters. Road designers should adjust the ASD and these parameters when seeking to encourage drivers to adopt appropriate behaviors. To optimize safe driving conditions, ASD should be designed so that it is slightly greater than the required sight distance, since excessive ASD values may encourage drivers to drive at inappropriate speeds.


Asunto(s)
Conducción de Automóvil , Entorno Construido , Tiempo de Reacción/fisiología , Accidentes de Tránsito/prevención & control , Simulación por Computador , Femenino , Humanos , Masculino , Población Rural , Percepción Visual/fisiología
6.
Leukemia ; 29(6): 1344-9, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25801912

RESUMEN

We investigated the influence of molecular status on disease characteristics and clinical outcome in young patients (⩽ 40 years) with World Health Organization (WHO)-defined essential thrombocythemia (ET) or early/prefibrotic primary myelofibrosis (early-PMF). Overall, 217 patients with ET (number 197) and early-PMF (number 20) were included in the analysis. Median follow-up time was 10.2 years. The cumulative incidence of thrombosis, hemorrhages and disease evolution into myelofibrosis/acute leukemia were 16.6%, 8.6% and 3% at 15 years, respectively. No differences were detectable between ET and early-PMF patients, although the latter cohort showed a trend for worse combined-event free survival (EFS). Mutation frequency were 61% for JAK2V617F, 25% for CALR and 1% for MPLW515K, and were comparable across WHO diagnosis; however, JAK2V617F allele burden was higher in the early-PMF group. Compared with JAK2V617F-positive patients, CALR-mutated patients displayed higher platelet count and lower hemoglobin level. CALR mutations significantly correlated with lower thrombotic risk (9.1% versus 21.7%, P = 0.04), longer survival (100% versus 96%, P = 0.05) and better combined-EFS (86% versus 71%, P = 0.02). However, non-type 1/type 2 CALR mutations ('minor' mutations) and abnormal karyotype were found to correlate with increased risk of disease evolution. At last contact, six patients had died; in five cases, the causes of death were related to the hematological disease and occurred at a median age of 64 years (range: 53-68 years). Twenty-eight patients (13%) were unmutated for JAK2, CALR and MPL: no event was registered in these 'triple-negative' patients.


Asunto(s)
Calreticulina/genética , Janus Quinasa 2/genética , Mutación/genética , Mielofibrosis Primaria/genética , Mielofibrosis Primaria/mortalidad , Receptores de Trombopoyetina/genética , Trombocitemia Esencial/genética , Trombocitemia Esencial/mortalidad , Adolescente , Adulto , Anciano , Estudios de Cohortes , Análisis Citogenético , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Pronóstico , Tasa de Supervivencia , Adulto Joven
7.
Rev Sci Instrum ; 84(2): 022703, 2013 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-23464185

RESUMEN

The linac driven coherent THz radiation source at the SPARC-LAB test facility is able to deliver broadband THz pulses with femtosecond shaping. In addition, high peak power, narrow spectral bandwidth THz radiation can be also generated, taking advantage of advanced electron beam manipulation techniques, able to generate an adjustable train of electron bunches with a sub-picosecond length and with sub-picosecond spacing. The paper reports on the manipulation, characterization, and transport of the electron beam in the bending line transporting the beam down to the THz station, where different coherent transition radiation spectra have been measured and studied with the aim to optimize the THz radiation performances.

10.
Aliment Pharmacol Ther ; 27(10): 932-9, 2008 May.
Artículo en Inglés | MEDLINE | ID: mdl-18315586

RESUMEN

BACKGROUND: Bone marrow-derived stem cells (BMSC) and granulocyte colony-stimulating factor (G-CSF) have been proved to contribute to tissue regeneration after liver injury. AIMS: To test the safety of G-CSF and define the exact dose capable of mobilizing BMSC in the majority of patients with liver cirrhosis; and to assess the feasibility of leukapheresis to collect BMSC from peripheral blood. METHODS: In this study, we treated 18 patients affected by liver cirrhosis with increasing doses of G-CSF to mobilize CD34(+) and CD133(+) BMSC into the peripheral blood. RESULTS: The dose-finding phase demonstrated that 15 microg/kg/day of G-CSF is the optimal dose to mobilize both CD34(+) and CD133(+) stem cells. Circulating BMSC were collected by a single step leukapheresis in three patients and the mean number of CD34(+) and CD133(+) cells cryopreserved was 1.3 +/- 0.7 and 1.2 +/- 0.5 x 10(6)/kg, respectively. No severe adverse events were observed during the drug administration and stem cell collection. Noteworthy is, none of the patients showed a significant modification of liver function. CONCLUSIONS: Our study demonstrates that G-CSF administration and BMSC collection from the peripheral blood is possible and safe in patients with liver cirrhosis. The optimal dose to mobilize BMSC in cirrhotics is 15 microg/kg/day. At this dose, G-CSF does not seem to modify the residual liver function in cirrhotic patients.


Asunto(s)
Factor Estimulante de Colonias de Granulocitos/administración & dosificación , Movilización de Célula Madre Hematopoyética/métodos , Leucaféresis/métodos , Cirrosis Hepática/terapia , Trasplante de Células Madre de Sangre Periférica/métodos , Antígeno AC133 , Adulto , Anciano , Antígenos CD , Antígenos CD34 , Relación Dosis-Respuesta a Droga , Estudios de Factibilidad , Femenino , Glicoproteínas , Factor Estimulante de Colonias de Granulocitos/efectos adversos , Humanos , Masculino , Persona de Mediana Edad , Péptidos , Resultado del Tratamiento
11.
Dig Liver Dis ; 39(10): 943-51, 2007 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-17692581

RESUMEN

BACKGROUND/AIM: Controversial experimental observations suggest that granulocyte colony stimulating-factor may promote hepatic regeneration after hepatectomy and chemical injury either by directly stimulating adult liver cells or facilitating the mobilization of bone marrow cells and their homing to the liver. We investigated whether different schedules of granulocyte colony stimulating-factor administration protect against experimental acute liver injury. METHODS: Acute liver injury was induced in Sprague-Dawley fed rats by injecting a single intraperitoneal dose of carbon tetrachloride. Recombinant human granulocyte colony stimulating-factor or vehicle was given daily after intoxication (4 days) or before (7 days) and after carbon tetrachloride administration. Liver injury and regeneration were assessed 2 and 4 days after damage. Bone marrow cells mobilization was evaluated by the white blood cell count and the assessment of circulating clonogenic haematopoietic progenitors (colony forming unit-cells). RESULTS: In this experimental model, although granulocyte colony stimulating-factor induced the significant mobilization of colony forming unit-cells, the study cytokine had no effect on liver injury (serum alanine amino transaminase level and necrotic index) and liver regeneration (mitotic index and bromodeoxyuridine incorporation), regardless of the administration schedule. CONCLUSIONS: This study does not support the conclusion that: (1) granulocyte colony stimulating-factor exerts a protective effect against toxic-induced, non-lethal acute liver injury and (2) promotes hepatocyte regeneration.


Asunto(s)
Factores Estimulantes de Colonias/uso terapéutico , Fallo Hepático Agudo/tratamiento farmacológico , Animales , Tetracloruro de Carbono/toxicidad , Modelos Animales de Enfermedad , Citometría de Imagen , Inmunohistoquímica , Recuento de Leucocitos , Fallo Hepático Agudo/inducido químicamente , Fallo Hepático Agudo/patología , Regeneración Hepática/efectos de los fármacos , Masculino , Ratas , Ratas Sprague-Dawley , Proteínas Recombinantes , Resultado del Tratamiento
12.
Phys Rev Lett ; 99(23): 234801, 2007 Dec 07.
Artículo en Inglés | MEDLINE | ID: mdl-18233375

RESUMEN

In this Letter we report the first experimental observation of the double emittance minimum effect in the beam dynamics of high-brightness electron beam generation by photoinjectors; this effect, as predicted by the theory, is crucial in achieving minimum emittance in photoinjectors aiming at producing electron beams for short wavelength single-pass free electron lasers. The experiment described in this Letter was performed at the SPARC photoinjector site, during the first stage of commissioning of the SPARC project. The experiment was made possible by a newly conceived device, called an emittance meter, which allows a detailed and unprecedented study of the emittance compensation process as the beam propagates along the beam pipe.

13.
Phys Rev E Stat Nonlin Soft Matter Phys ; 67(1 Pt 2): 015501, 2003 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-12636555

RESUMEN

Results of the first experimental search for the effect of the prewave zone in near-infrared transition radiation are presented. A substantial difference in the spatial distribution of transition relation for two different wavelengths (450 nm and 1600 nm) was observed. Experimental data are in a good, though not complete, agreement with the theory.

14.
Leukemia ; 16(9): 1773-81, 2002 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-12200693

RESUMEN

Although the transcription factor nuclear factor-erythroid 2 (NF-E2) is known to be functionally linked to the megakaryocytic lineage, little is known about its role in malignant megakaryocytes. We used real-time RT-PCR and Western blotting to investigate expression of NF-E2 and its partner, MafG, in CD34-derived normal (five cases) and malignant megakaryocytes from essential thrombocythemia (ET) patients (eight cases) and in megakaryoblastic cell lines. We also quantitated the mRNA of the thromboxane synthase (TXS) gene, which is directly regulated by NF-E2. Although real-time RT-PCR showed that both a and f NF-E2 isoforms were significantly reduced with respect to the normal counterpart both in ET megakaryocytes and in cell lines (P < or = 0.01), western blotting revealed decreased NF-E2 protein expression only in the latter. However, both the NF-E2a/MafG mRNA ratio (P < or = 0.01) and TXS (P< or = 0.01) mRNA expression were significantly reduced in megakaryocytes from ET patients and cell lines with respect to healthy subjects. These two findings provide strong indirect evidence of altered activity of the a isoform of NF-E2 in malignant megakaryocytes, raising the possibility that NF-E2 could play a role in megakaryocyte transformation.


Asunto(s)
Proteínas de Unión al ADN/genética , Proteínas de Unión al ADN/metabolismo , Megacariocitos/metabolismo , Trombocitopenia/metabolismo , Trombocitosis/metabolismo , Factores de Transcripción/genética , Factores de Transcripción/metabolismo , Adulto , Antígenos CD34/metabolismo , Western Blotting , Médula Ósea/química , Estudios de Casos y Controles , Cartilla de ADN/química , Factores de Unión al ADN Específico de las Células Eritroides , Eritropoyesis , Femenino , Citometría de Flujo , Humanos , Factor de Transcripción MafG , Masculino , Persona de Mediana Edad , Factor de Transcripción NF-E2 , Subunidad p45 del Factor de Transcripción NF-E2 , Proteínas Nucleares/genética , Proteínas Nucleares/metabolismo , ARN Mensajero/metabolismo , Proteínas Represoras/genética , Proteínas Represoras/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Trombocitopenia/genética , Trombocitopenia/patología , Tromboxano-A Sintasa/genética , Tromboxano-A Sintasa/metabolismo , Células Tumorales Cultivadas
15.
Phys Rev Lett ; 88(10): 104802, 2002 Mar 11.
Artículo en Inglés | MEDLINE | ID: mdl-11909361

RESUMEN

Experimental results are presented from vacuum-ultraviolet free-electron laser (FEL) operating in the self-amplified spontaneous emission (SASE) mode. The generation of ultrashort radiation pulses became possible due to specific tailoring of the bunch charge distribution. A complete characterization of the linear and nonlinear modes of the SASE FEL operation was performed. At saturation the FEL produces ultrashort pulses (30-100 fs FWHM) with a peak radiation power in the GW level and with full transverse coherence. The wavelength was tuned in the range of 95-105 nm.

16.
Stem Cells ; 19(4): 339-47, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11463954

RESUMEN

The transcriptional factor nuclear factor-erythroid 2 (NF-E2) is one of the few transcription factors known to be functionally linked to the megakaryocytic lineage, where it regulates terminal megakaryocyte maturation and platelet formation. However, the regulation of NF-E2 expression in megakaryocytic cells has not been extensively evaluated. In particular, no data have been reported on the effect of negative regulators of megakaryocytopoiesis on NF-E2 expression. This study investigated the in vitro effects of two negative regulators of megakaryocytopoiesis, such as interleukin-4 (IL-4) and transforming growth factor-beta1 (TGF-beta1) on the expression of NF-E2 transcription factor in megakaryoblastic cell lines (Hel and MK1) and in normal CD34-derived megakaryocytic cells. For this purpose, we used quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR) to detect mRNA NF-E2 isoforms (a and f) and flow-cytometry analysis to evaluate NF-E2 protein expression. Our results demonstrated that TGF-beta1 did not inhibit NF-E2 mRNA and protein expression of either maturating or fully mature normal megakaryocytic cells as well as that of the two cell lines. By contrast, IL-4 downmodulates the expression of NF-E2 transcription factor at both mRNA and protein levels in normal maturating megakaryocytic cells and in the megakaryoblastic cell lines. NF-E2 expression of normal mature megakaryocytes was not affected by IL-4. Thus, the results of the present investigation demonstrate that NF-E2 transcription factor is involved not only in terminal megakaryocyte maturation but also in the negative regulation of the early phase of megakaryocyte development.


Asunto(s)
Proteínas de Unión al ADN/metabolismo , Interleucina-4/farmacología , Megacariocitos/efectos de los fármacos , Factores de Transcripción/metabolismo , División Celular/efectos de los fármacos , División Celular/fisiología , Separación Celular , Células Cultivadas , Factores de Unión al ADN Específico de las Células Eritroides , Citometría de Flujo , Humanos , Megacariocitos/citología , Megacariocitos/metabolismo , Factor de Transcripción NF-E2 , Subunidad p45 del Factor de Transcripción NF-E2 , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Factores de Tiempo , Factor de Crecimiento Transformador beta/farmacología , Factor de Crecimiento Transformador beta1 , Células Tumorales Cultivadas
17.
Phys Rev E Stat Nonlin Soft Matter Phys ; 63(5 Pt 2): 056501, 2001 May.
Artículo en Inglés | MEDLINE | ID: mdl-11415022

RESUMEN

Measurements of coherent diffraction radiation from a slit of variable width generated by short electron bunches were performed in millimeter and submillimeter ranges. Experimental data are compared with the transition radiation case and theoretical predictions. A more realistic description than the conventional theory is necessary to account for the data correctly. No noticeable difference in the estimated bunch length was observed using diffraction radiation in a wide range of slit widths and transition radiation.

18.
Haematologica ; 86(5): 504-9, 2001 May.
Artículo en Inglés | MEDLINE | ID: mdl-11410414

RESUMEN

BACKGROUND AND OBJECTIVES: Idiopathic thrombocytopenic purpura (ITP) induces thrombocytopenia by means of an autoimmune mechanism. Despite the available therapies a subset of patients develop chronic refractory severe thrombocytopenia (i.e. a platelet count consistently lower than 20 to 30x10(9)/L), and life-threatening bleeding can occasionally occur. It has been suggested that the risk of major bleeding is higher in elderly patients and in patients with bleeding at diagnosis. However, since clear data on the influence of clinical and/or laboratory parameters on outcome are lacking, some patients may be receiving unnecessary treatment. DESIGN AND METHODS: We made a retrospective analysis of a series of 310 patients with chronic ITP (108 males and 202 females), with a median age at diagnosis of 40 years (range 8-87 years). The median follow-up time was 121 months, (range 7-434 months). Therapy was most often started in the presence of hemorrhagic complications and/or a platelet count <30x10(9)/L either at diagnosis or during follow-up. RESULTS: Our findings confirmed that patients who were symptomatic at diagnosis were more likely to have bleeding during their follow-up. Moreover, all the patients who suffered major bleeding during their follow-up had median platelet counts of 10x10(9)/L (range 1-20) at that time. Only one patient, aged 43 years, died of hemorrhage following prolonged severe thrombocytopenia. Age >60 years was not associated with any significant differences in incidence of bleeding at diagnosis or during follow-up. INTERPRETATION AND CONCLUSIONS: We conclude that prospective studies are required to evaluate whether it may be reasonable to treat only symptomatic patients, independently of age.


Asunto(s)
Hemorragia/etiología , Púrpura Trombocitopénica Idiopática/complicaciones , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pronóstico , Púrpura Trombocitopénica Idiopática/diagnóstico , Púrpura Trombocitopénica Idiopática/mortalidad , Estudios Retrospectivos , Factores de Riesgo
19.
Mech Ageing Dev ; 122(8): 823-33, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11337011

RESUMEN

We have investigated the mitochondrial energy state in human platelets of young (19-30 years old) and aged individuals (65-87 years old) exploiting the Pasteur effect, i.e. stimulation of lactate production by incubation of the purified platelets with the mitochondrial respiratory chain inhibitor, antimycin A. This assay allows the determination of mitochondrial function with respect to glycolysis, and the ratio of mitochondrial adenosine triphosphate (ATP) to glycolytic ATP. A significant increase of basal, non-stimulated lactate production and decrease of the stimulation by antimycin A were observed in the older individuals, suggesting that the impairment of oxidative phosphorylation detectable in post-mitotic tissues of aged individuals can be observed also in easily collectable blood cells.


Asunto(s)
Envejecimiento/fisiología , Plaquetas/fisiología , Mitocondrias/fisiología , Adenosina Trifosfato/metabolismo , Adulto , Anciano , Anciano de 80 o más Años , Envejecimiento/sangre , Antimicina A/farmacología , Plaquetas/citología , Plaquetas/efectos de los fármacos , Células Cultivadas , Femenino , Glucosa/metabolismo , Humanos , Ácido Láctico/biosíntesis , Masculino
20.
Eur J Haematol ; 64(3): 139-44, 2000 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10997878

RESUMEN

Early hemorrhagic death (within the first 10 d of treatment [EHD]) is reported as the main cause of death during induction therapy for acute promyelocytic leukemia (APL). In order to evaluate possible differences in the incidence of EHD during induction regimens based on all-trans retinoic acid (ATRA), we retrospectively analyzed a consecutive series of 86 APL patients, diagnosed and treated at our Institution from 1982. Forty-three patients received combination chemotherapy with anthracyclines and cytosine arabinoside (January 1982 to December 1991), while induction of the remaining 43 was based on ATRA alone or on a combination of ATRA and anthracyclines (January 1992 to October 1996). There were significantly less induction deaths in the ATRA group [9 (chemotherapy group-CT) vs. 2 (ATRA group-RA) overall and 8(CT) vs. 1(RA) of EHD; p = 0.01]. Hemostatic evaluations showed an earlier reduction of D-dimer in the ATRA group. No cases of morphological resistance were observed in the ATRA group after induction. In addition, the number of relapses occurring in the first 24 months from the achievement of complete remission (CR) was significantly lower in the ATRA group (15 vs. 7; p = 0.01), with a disease free survival at 2 yr of 67% vs. 31%. In conclusion, ATRA appears to be able to significantly reduce the incidence of EHD, increasing the number of possible long-term remissions.


Asunto(s)
Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Hemorragia/inducido químicamente , Hemorragia/mortalidad , Leucemia Promielocítica Aguda/tratamiento farmacológico , Tretinoina/uso terapéutico , Trasplante de Médula Ósea , Citarabina/administración & dosificación , Daunorrubicina/administración & dosificación , Hemorragia/prevención & control , Humanos , Mercaptopurina/administración & dosificación , Metotrexato/administración & dosificación , Inducción de Remisión , Estudios Retrospectivos , Tretinoina/administración & dosificación
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