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Paper-based village registers were introduced 5 years ago in Malawi as a tool to measure vital statistics of births and deaths at the population level. However, usage, completeness and accuracy of their content have never been formally evaluated. In Traditional Authority Mwambo, Zomba district, Malawi, we assessed 280 of the 325 village registers with respect to (i) characteristics of village headmen who used village registers, (ii) use and content of village registers, and (iii) whether village registers provided accurate information on births and deaths. All village headpersons used registers. There were 185 (66%) registers that were regarded as 95% completed, and according to the registers, there were 115 840 people living in the villages in the catchment area. In 2011, there were 1753 births recorded in village registers, while 6397 births were recorded in health centre registers in the same catchment area. For the same year, 199 deaths were recorded in village registers, giving crude death rates per 100 000 population of 189 for males and 153 for females. These could not be compared with death rates in health centre registers due to poor and inconsistent recording in these registers, but they were compared with death rates obtained from the 2010 Malawi Demographic Health Survey that reported 880 and 840 per 100 000 for males and females, respectively. In conclusion, this study shows that village registers are a potential source for vital statistics. However, considerable inputs are needed to improve accuracy of births and deaths, and there are no functional systems for the collation and analysis of data at the traditional authority level. Innovative ways to address these challenges are discussed, including the use of solar-powered electronic village registers and mobile phones, connected with each other and the health facilities and the District Commissioner's office through the cellular network and wireless coverage.
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Sistema de Registros/estadística & datos numéricos , Población Rural/estadística & datos numéricos , Estadísticas Vitales , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Malaui/epidemiología , Masculino , Persona de Mediana Edad , Investigación Operativa , Sistema de Registros/normas , Estudios Retrospectivos , Adulto JovenRESUMEN
The dynamics of excited states in α,ω-dinaphthylpolyyne, a class of linear sp-carbon chains, has been investigated by ultrafast transient absorption spectroscopy and DFT//TDDFT calculations. We show that the role of molecular conformers, in which end-capped naphthalene rings are planar or perpendicular to the polyyne plane, is fundamental for understanding both the steady state properties, such as UV-Vis absorption spectra and vibronic transitions, and the ultrafast transient absorption features. In particular, we observed in one of the conformers the ultrafast formation of a narrow photo-induced absorption band rising within 30 ps. This band can be assigned to an inter-system crossing event leading to the formation of triplet excited states.
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Acquired haemophilia (AH) is an autoimmune syndrome characterized by acute bleeding in patients with negative family and personal history, and factor VIII depletion. Its incidence is 1.6 x 106 population per year. AH is associated with autoimmune diseases, solid tumours, lymphoprolipherative diseases, pregnancy; 50% of the cases idiopathic. Spontaneous or after minor trauma severe bleeding associated with a prolonged activated partial thromboplastin time, not corrected by incubation with normal plasma, with a normal prothrombin time are the diagnostic hallmarks. The goals of management are the control of bleeding and the suppression of inhibitor. First-line haemostatic treatment includes recombinant factor VIIa and activated prothrombin complex concentrate. Prednisone +/- cyclophosphamide and other immunosuppressive agents are the standard intervention for inhibitor eradication.
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Factores de Coagulación Sanguínea/uso terapéutico , Factor VIII/uso terapéutico , Factor VIIa/uso terapéutico , Hemofilia A/diagnóstico , Hemofilia A/terapia , Inmunosupresores/uso terapéutico , Adulto , Anciano , Anciano de 80 o más Años , Inhibidores de Factor de Coagulación Sanguínea/análisis , Factores de Coagulación Sanguínea/administración & dosificación , Factor VIII/administración & dosificación , Factor VIIa/administración & dosificación , Femenino , Hemorragia/prevención & control , Humanos , Inmunosupresores/administración & dosificación , Masculino , Persona de Mediana Edad , Tiempo de Tromboplastina Parcial , Proteínas Recombinantes/administración & dosificación , Proteínas Recombinantes/uso terapéuticoRESUMEN
In the olive oil extraction process, 20% olive oil is obtained. About 80% corresponds to waste, mainly alperujo and orujo. When these residues are stored in open reservoirs for later stabilization or potential reuse, odorous Volatile Organic Compounds (VOCs) are generated as products of waste decomposition. In this work, these emissions were studied by means of TD-GC/MS in relation to the changes in the physical-chemical (ashes, moisture, total phenols, pH, proteins, fibers, oils, fats) and biological parameters (bacterial and fungal diversity in Illumina platform) of waste for 6â¯months. The dynamics of these parameters were statistically related to the evolution of environmental variables (temperature, relative humidity, precipitation) and their effects on the most relevant physical-chemical parameters in order to evaluate their incidence in odorant VOCs emissions over time. The results showed a progressive increase in the diversity of both fungi and bacteria that were related, mainly, to a progressive decrease in the concentration of fatty acid methyl esters and the concentration of alkenes in the emissions; and to an increase of odorous compounds, mainly aldehydes, ketones and carboxylic acids, which were responsible for the unpleasant odors of waste. No significant differences were observed between the evolution of orujo characteristics compared to those of alperujo.
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Compuestos Orgánicos Volátiles , Cromatografía de Gases y Espectrometría de Masas , Odorantes , Aceite de Oliva , FenolesRESUMEN
CAPNS1 is essential for the stability and function of ubiquitous CAPN1 and CAPN2. Calpain modulates by proteolytic cleavage many cellular substrates and its activity is often deregulated in cancer cells, therefore calpain inhibition has been proposed as a therapeutical strategy for a number of malignancies. Here we show that CAPNS1 depletion is coupled to impairment of MCF7 and MCF10AT cell lines growth on plate and defective architecture of mammary acini derived from MCF10A cells. In soft agar CAPNS1 depletion leads to cell growth increase in MCF7, and decrease in MCF10AT cells. In both MCF7 and MCF10AT, CAPNS1 depletion leads to the enlargement of the stem cell compartment, as demonstrated by mammosphere formation assays and evaluation of stem cell markers by means of FACS and western blot analysis. Accordingly, activation of calpain by thapsigargin treatment leads to a decrease in the stem cell reservoir. The expansion of the cancer stem cell population in CAPNS1 depleted cells is coupled to a defective shift from symmetric to asymmetric division during mammosphere growth coupled to a decrease in NUMB protein level.
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Neoplasias de la Mama/metabolismo , Calpaína/deficiencia , Células Madre Neoplásicas/metabolismo , Animales , Neoplasias de la Mama/patología , Proliferación Celular/fisiología , Células Cultivadas , Femenino , Humanos , Células MCF-7 , Ratones , Células Madre Neoplásicas/patologíaRESUMEN
BACKGROUND: Coeliac disease is associated with DQ2 and DQ8 alleles, but other genes also confer an additional genetic risk. AIMS: Defining whether the genetic profiles of interleukin-10, tumour necrosis factor alpha and interferon gamma are associated with an increased coeliac disease risk. PATIENTS AND METHODS: The functionally gene polymorphisms of tumour necrosis factor alpha (-308G/A), interferon gamma (+874T/A) and interleukin-10 (-1082G/A) were typed using sequence specific primer-polymerase chain reaction in 110 Sicilian coeliac disease patients and in 220 Sicilian healthy controls. RESULTS: No differences in genotype frequencies of interleukin-10 polymorphisms were found between coeliac disease patients and healthy controls. A significant increase of -308A (p<0.033; OR: 1.72; CI: 1.27-2.33) and of +874T (p: 0.0045; OR: 3.02; CI: 1.47-6.21) allele frequencies, both in hetero- and homozygosis, was observed in coeliac patients in comparison with healthy controls. In addition, simultaneous significant higher percentages of -308A and +874T alleles (p: 0.0066; OR: 2.33; CI: 1.42-3.82) as well as simultaneous significant lower percentages of -308A and +874T alleles (p: 0.003; OR: 0.23; CI: 0.10-0.60) were observed in coeliac patients compared with healthy controls. CONCLUSIONS: Genetically determined higher frequencies of -308A tumour necrosis factor alpha and +874T interferon gamma alleles, both in hetero and in homozygosis and mostly whether simultaneous, may play a role in predisposing to gluten intolerance. Subjects positive for -308A tumour necrosis factor alpha and +874T interferon gamma alleles have an increased risk for coeliac disease.
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Enfermedad Celíaca/genética , Interferón gamma/genética , Interleucina-10/genética , Polimorfismo Genético , Factor de Necrosis Tumoral alfa/genética , Adolescente , Adulto , Estudios de Casos y Controles , Enfermedad Celíaca/epidemiología , Niño , Preescolar , Femenino , Frecuencia de los Genes , Predisposición Genética a la Enfermedad , Genotipo , Humanos , Lactante , Masculino , Persona de Mediana Edad , Sicilia/epidemiologíaRESUMEN
BACKGROUND: In Down syndrome there is an increased prevalence of coeliac disease, but the reasons for this association are yet unknown. AIMS: To evaluate a possible correlation between TNFalpha, IFNgamma and IL-10 genotype polymorphisms with the susceptibility to coeliac disease in Down syndrome patients. METHODS: Single nucleotide polymorphisms of TNFalpha (-308G-->A promoter region), IFNgamma (+874T-->A promoter region) and IL-10 (-1082G-->A promoter region) have been studied in 10 Down patients with coeliac disease, in 40 Down patients without coeliac disease and in 220 healthy controls. Clinical features were also studied in coeliac disease-Down syndrome patients. RESULTS: The 10 coeliac disease-Down syndrome patients had a biopsy proven coeliac disease afterward a serological testing positive to antigliadin, antiendomysium and antitransglutaminase antibodies. Intestinal biopsy showed total atrophy in 6/10 and partial villous atrophy in 4/10 of them. All coeliac disease-Down syndrome patients had silent forms of coeliac disease and classical trisomy 21. No significant differences were observed for the IFNgamma and IL-10 polymorphisms in the studied groups. A significant trend for increase of TNFalpha -308A positive frequency was observed in coeliac disease-Down syndrome patients compared to healthy controls (p=0.043). CONCLUSIONS: Single nucleotide polymorphisms of IFNgamma and IL-10 do not play a role in predisposing Down syndrome patients to coeliac disease, while the TNFalpha -308 allele could be an additional genetic risk factor for coeliac disease in trisomy 21.
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Enfermedad Celíaca/genética , Síndrome de Down/genética , Interferón gamma/genética , Interleucina-10/genética , Factor de Necrosis Tumoral alfa/genética , Adolescente , Enfermedad Celíaca/complicaciones , Niño , Preescolar , Citocinas/genética , Síndrome de Down/complicaciones , Predisposición Genética a la Enfermedad , Humanos , Lactante , Polimorfismo Genético , Polimorfismo de Nucleótido SimpleRESUMEN
To compare the antileukemic efficacy of idarubicin and mitoxantrone in elderly patients with acute myeloid leukemia (AML) and to evaluate the feasibility of autologous transplantation using PBSC after consolidation in those with a good performance status, 160 patients (median age 69 years), with AML at diagnosis, 118 of them with de novo AML and 42 with AML secondary to myelodysplastic syndrome or toxic exposure (sAML), received induction treatment with idarubicin, 8 mg/m2/day or mitoxantrone, 7 mg/m2/day, on days 1, 3, and 5, both combined with VP-16, 100 mg/m2/day on days 1 to 3 and cytarabine (araC), 100 mg/m2/day, on days 1 to 7. G-CSF, 5 microg/kg/day, was administered after chemotherapy in patients aged more than 70 years. Patients in complete remission (CR) received one course of consolidation using the same schedule as for induction except the araC administration was shortened to 5 days. Some patients younger than 70 years were then scheduled for autologous stem cell harvest on days 5 to 7 of G-CSF, 5 microg/kg/day, initiated after hematopoietic recovery from consolidation. Autologous transplantation was performed following an additional chemotherapy conditioning. Ninety-five patients (59%) achieved CR, without significant difference between the idarubicin (56% CR) and mitoxantrone (63% CR) group. There was also no significant difference in CR rate between de novo AML (63%) and secondary AML (55%) (P = 0.12). Patients aged < 70 years had 67% CR, while patients aged > or = 70 years had 49% (P = 0.02). There was no significant difference in the duration of aplasia between the two arms. Median time to neutrophil recovery was 22 days in patients who received G-CSF following induction and 27 days in patients who did not (P = 0.006). Severe extrahematologic toxicities of induction did not differ between the two arms and included sepsis (39%), diarrhea (13%), hyperbilirubinemia (8%), hemorrhage (6%) and vomiting (6%). Overall, 14 patients (9%), died from toxicity of induction. First consolidation was administered in 74 patients of whom seven (9%) died from toxicity. Nineteen patients have received transplantation. Median time to recovery of neutrophils > 0.5 x 10(9)/l was 13 days and of platelets > 50 x 10(9)/l 43 days following consolidation. There were two toxic deaths. Median disease-free survival and survival from time of achieving CR of non transplanted patients are 6 and 7 months respectively without difference between the two arms. Fourteen transplanted patients relapsed at a median of 5 months post-transplant. We conclude that this regimen is well tolerated and has a good efficacy to induce CR, without a significant difference in efficacy and toxicity between idarubicin and mitoxantrone. Intensive postinduction, including transplantation, is feasible; however, this procedure did not seem to prevent early relapse in the majority of patients. Neither the high rate of CR nor consolidation nor transplant procedure in a selected group of patients did translate into improved DFS and/or survival.
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Antibióticos Antineoplásicos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Idarrubicina/uso terapéutico , Leucemia Mieloide/tratamiento farmacológico , Mitoxantrona/uso terapéutico , Enfermedad Aguda , Anciano , Anciano de 80 o más Años , Antibióticos Antineoplásicos/administración & dosificación , Terapia Combinada , Citarabina/administración & dosificación , Supervivencia sin Enfermedad , Método Doble Ciego , Etopósido/administración & dosificación , Estudios de Factibilidad , Femenino , Trasplante de Células Madre Hematopoyéticas , Humanos , Idarrubicina/administración & dosificación , Leucemia Mieloide/terapia , Masculino , Persona de Mediana Edad , Mitoxantrona/administración & dosificación , Proyectos Piloto , Trasplante AutólogoRESUMEN
Severe thrombocytopenia (TP) accounted for 5.3% of cases in a consecutive series of 380 HIV-infected intravenous drug users (IVDUs) at presentation. Forty-one of 53 subjects with severe TP showed haemorrhages and were treated as follows: ten were splenectomized, 17 were given high-dose intravenous immunoglobulins (HDIg), and 10 received anti-Rh(D) immunoglobulins (anti-Rh Ig). Splenectomy induced a complete clinical response in all cases: four out of 10 patients maintained platelet counts greater than 100 x 10(9)/l. HDlg gave a good clinical response in all patients, but eight out of 17 suffered haemorrhages during the follow-up and recall treatments were necessary. Six out of 10 patients treated with anti-Rh lg maintained platelet counts greater than 30 x 10(9)/l, but in two cases the treatment was interrupted because of severe haemolysis. No patient progressed to overt AIDS during the follow-up. Splenectomized patients in particular did not show adjunctive risks of worsening of the HIV-related clinical picture. A platelet kinetic study performed in 20 patients with severe HIV-related TP suggests a possible role for platelet sequestration in TP of HIV-infected IVDUs, in which a liver involvement is very frequent.
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Infecciones por VIH/complicaciones , Inmunoglobulina G/uso terapéutico , Inmunoglobulinas/administración & dosificación , Abuso de Sustancias por Vía Intravenosa/complicaciones , Trombocitopenia/etiología , Trombocitopenia/terapia , Adulto , Femenino , Estudios de Seguimiento , Humanos , Inmunoglobulina G/administración & dosificación , Infusiones Intravenosas , Masculino , Recuento de Plaquetas , Prevalencia , Globulina Inmune rho(D) , Esplenectomía , Trombocitopenia/sangre , Trombocitopenia/epidemiologíaRESUMEN
Within this phase II trial of the European Organization for Research and Treatment of Cancer, we have investigated the safety and efficacy of pentostatin (Nipent; SuperGen, San Ramon, CA) in refractory lymphoid malignancies. Pentostatin was administered at a dosage of 4 mg/m2 every week for the first 3 weeks, then every 14 days, followed by maintenance therapy of 4 mg/m2 monthly for a maximum of 6 months. We have previously reported the results in T- and B-cell prolymphocytic leukemia, B-cell chronic lymphocytic leukemia, and hairy cell leukemia This report focuses on the outcome in T-cell malignancies: T-cell chronic lymphocytic leukemia, Sézary syndrome, mycosis fungoides, and T-zone lymphoma. Of 92 patients with these diagnoses enrolled, 76 were evaluable for response and toxicity, ie, 25 of 28 with T-cell chronic lymphocytic leukemia, 21 of 26 with Sézary syndrome, 22 of 26 with mycosis fungoides, and eight of 12 with T-zone lymphoma. All patients had progressive and advanced disease. Sixteen patients (21%) died during the first 9 weeks of treatment: 12 of progressive disease, two of infectious complications thought to be unrelated to treatment, one of myocardial infarction, and one of renal failure related to administration of intravenous contrast. Major toxicity (grades 3 and 4) included infection in 10.5% of patients, nausea/vomiting in 5%, and hepatotoxicity in 3%. One patient (1.3%) achieved a complete remission and 15 (19.7%) a partial remission. Better results were achieved in patients with Sézary syndrome or mycosis fungoides (complete remission + partial remission = 33.4% and 22.7%, respectively) than in patients with T-cell chronic lymphocytic leukemia (8%) or T-zone lymphoma (25%). We conclude that pentostatin is active in low-grade T-cell malignancies. Toxicities are mild to moderate at the dose schedule administered. Severe hematologic toxicity has not been observed. The efficacy at the present dose level is moderate. A higher dose might be necessary for some T-cell malignancies.
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Antibióticos Antineoplásicos/uso terapéutico , Inmunosupresores/uso terapéutico , Leucemia de Células T/tratamiento farmacológico , Linfoma de Células T/tratamiento farmacológico , Pentostatina/uso terapéutico , Adulto , Anciano , Antibióticos Antineoplásicos/administración & dosificación , Antibióticos Antineoplásicos/efectos adversos , Causas de Muerte , Progresión de la Enfermedad , Relación Dosis-Respuesta a Droga , Esquema de Medicación , Femenino , Humanos , Inmunosupresores/administración & dosificación , Inmunosupresores/efectos adversos , Leucemia de Células Pilosas/tratamiento farmacológico , Leucemia Linfocítica Crónica de Células B/tratamiento farmacológico , Leucemia Prolinfocítica/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Micosis Fungoide/tratamiento farmacológico , Pentostatina/administración & dosificación , Pentostatina/efectos adversos , Inducción de Remisión , Síndrome de Sézary/tratamiento farmacológico , Neoplasias Cutáneas/tratamiento farmacológico , Resultado del TratamientoRESUMEN
A 48-year-old woman underwent allogeneic BMT for CML in chronic phase. One day +180 she experienced fever (37.8 degrees C) and skin rash. Blood cultures from the Hickman catheter and peripheral veins were positive for Saccharomyces cerevisiae. The clinical course of this patient indicates that Saccharomyces should be considered as a possible cause of fever of otherwise unknown origin.
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Enfermedades de la Médula Ósea/microbiología , Trasplante de Médula Ósea , Fungemia/complicaciones , Granuloma/microbiología , Leucemia Mielógena Crónica BCR-ABL Positiva/cirugía , Saccharomyces cerevisiae/aislamiento & purificación , Enfermedades de la Médula Ósea/complicaciones , Femenino , Granuloma/complicaciones , Humanos , Leucemia Mielógena Crónica BCR-ABL Positiva/complicaciones , Persona de Mediana Edad , Trasplante HomólogoRESUMEN
Knowledge of the vital role of adenosine deaminase in lymphatic tissues has led to the development of enzyme inhibitors for treatment of lymphoid neoplasms. Deoxycoformycin is a potent ADA inhibitor and has been shown to be active in acute lymphoblastic leukemia at high doses but associated with unpredictable toxicity. In indolent lymphocytic leukemia or lymphoma with low ADA concentrations, this drug is effective at low doses with mild toxicity. The on-going EORTC trial shows that pentostatin is highly effective in hairy cell leukemia and can achieve durable complete remissions even if interferon alpha has failed. It will probably play an important role in the treatment of prolymphocytic leukemia, T- and B-cell chronic lymphocytic leukemia and Sézary syndrome.
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Antineoplásicos/uso terapéutico , Coformicina/uso terapéutico , Leucemia de Células Pilosas/tratamiento farmacológico , Leucemia Linfocítica Crónica de Células B/tratamiento farmacológico , Leucemia Prolinfocítica/tratamiento farmacológico , Ribonucleósidos/uso terapéutico , Síndrome de Sézary/tratamiento farmacológico , Adenosina/metabolismo , Inhibidores de la Adenosina Desaminasa , Coformicina/análogos & derivados , Coformicina/farmacología , ADN de Neoplasias/metabolismo , Evaluación de Medicamentos , Humanos , Estudios Multicéntricos como Asunto , Proteínas de Neoplasias/antagonistas & inhibidores , PentostatinaRESUMEN
BACKGROUND: ATIII is decreased in sepsis and/or shock and its baseline value correlates with mortality. The efficacy of ATIII therapy on mortality was assessed in a selected group of patients admitted to the intensive care unit (ICU) in a double-blind, randomized, multicenter study. METHODS: 120 patients admitted to the ICU with an ATIII concentration < 70% were randomized to receive ATIII (total dose 24000 units) or placebo treatment for 5 days; 56 patients had septic shock. RESULTS: ATIII concentrations in the treated group remained constant throughout the treatment period (range 97-102%). The Kaplan-Meier analysis showed no difference in overall survival between the two groups: 50 and 46% for ATIII and placebo, respectively. Septic shock and hemodynamic support were unbalanced in the two groups at admission. Therefore the Cox analysis was carried out after adjusting for these two variables. Treatment with ATIII decreases the risk of death with an odds ratio (OR) of 0.56. Of the covariates analyzed, septic shock and the baseline multiple organ failure score were negatively associated with survival and plasma activity level was positively associated with survival with an OR of 0.97 for each 1% increase in the ATIII plasma concentration at baseline. CONCLUSIONS: The results of ATIII treatment in this population of patients suggests that replacement therapy reduces mortality in the subgroup of septic shock patients only.
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Antitrombina III/uso terapéutico , Complicaciones Posoperatorias/tratamiento farmacológico , Sepsis/tratamiento farmacológico , Inhibidores de Serina Proteinasa/deficiencia , Inhibidores de Serina Proteinasa/uso terapéutico , APACHE , Anciano , Método Doble Ciego , Femenino , Humanos , Masculino , Persona de Mediana Edad , Insuficiencia Multiorgánica/etiología , Oportunidad Relativa , Complicaciones Posoperatorias/mortalidad , Modelos de Riesgos Proporcionales , Sepsis/complicaciones , Sepsis/mortalidad , Análisis de SupervivenciaRESUMEN
The multimeric analysis was carried out on the plasma of 18 patients with severe von Willebrand's disease (vWD) using two different types of agarose: Seakem HGT(P) and Seaplaque LGT. No pattern was found in any of the patients using Seakem HGT(P). On the contrary, by Seaplaque LGT, a multimeric pattern was found in four patients belonging to three different families, indicating that it is possible to identify and characterize variable multimeric patterns also in type III vWD.
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Enfermedades de von Willebrand/sangre , Factor de von Willebrand/química , Biopolímeros , HumanosRESUMEN
The standard modality of administration of rFVIIa to patients with FVIII and FIX inhibitors is the intermittent infusion every 2 to 6 hours. No untoward local or systemic effects have been reported; laboratory data of activation of coagulation were reported in the presence of coexistent problems (sepsis, septic shock) or with high doses. We treated four patients with FVIII inhibitor with rFVIIa administered by continuous infusion by a central vein catheter, monitoring the signs of systemic activation of the hemostatic system. The F(1+2) prothrombin fragments and the D-dimer increased after the bolus, and remained above the baseline values throughout the treatment period. These variations observed during the infusion period were not accompanied by clinical events.
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Coagulación Sanguínea/efectos de los fármacos , Factor VIII/inmunología , Factor VII/administración & dosificación , Fibrinólisis/efectos de los fármacos , Adulto , Anciano , Coagulación Sanguínea/fisiología , Cateterismo Venoso Central , Factor VII/efectos adversos , Factor VII/metabolismo , Factor VII/farmacología , Factor VIII/antagonistas & inhibidores , Factor VIIa , Femenino , Productos de Degradación de Fibrina-Fibrinógeno/metabolismo , Fibrinógeno/metabolismo , Fibrinólisis/fisiología , Hematoma/inducido químicamente , Hematoma/tratamiento farmacológico , Hemofilia A/complicaciones , Hemofilia A/tratamiento farmacológico , Humanos , Infusiones Intravenosas/métodos , Isoanticuerpos/sangre , Masculino , Persona de Mediana Edad , Fragmentos de Péptidos/sangre , Fragmentos de Péptidos/metabolismo , Recuento de Plaquetas , Protrombina/metabolismo , Proteínas Recombinantes/administración & dosificación , Proteínas Recombinantes/efectos adversos , Proteínas Recombinantes/farmacologíaRESUMEN
In the last years our knowledge on epidemiology of celiac disease has increased: there is a wide spectrum of its clinical presentation (classical, atypical, silent and latent forms of celiac disease), and of its pathological mucosal intestinal features, which range from early and mild pictures to severe villous atrophy (Marsh stages). In addition, a strong genetic component, associated with the susceptibility to the disease (HLA and non HLA genes), has been found. This knowledge, together with the availability of new high sensitive and specific serological tests (antigliadin, antiendomysium and antitransglutaminase antibodies), has led us to the realization that celiac disease is the most common food intolerance in the world, involving genetically predisposed individuals consuming gluten-containing cereals in their diet. So, today it is well known that celiac disease is a common disorder not only in Europe but also in populations of European ancestry (North and South Americas, Australia), in North Africa, in the Middle East and in South Asia, where until a few years ago it was historically considered extremely rare. Therefore, celiac disease is spread worldwide as in a common "Global Village", and greater levels of awareness and attention on gluten intolerance are needed, both in the Old and in the New World.
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Enfermedad Celíaca/epidemiología , HumanosRESUMEN
BACKGROUND: There are no available data concerning the incidence and the clinical pattern of coeliac disease in immigrant children coming to Italy from developing countries. AIMS: To evaluate the epidemiological and clinical features of coeliac immigrant children coming to Italy. PATIENTS AND METHODS: Hospital records of 1917 children diagnosed in 22 Italian Centres from 1999 to 2001 as having coeliac disease were retrospectively reviewed, comparing immigrant patients versus Italian ones. RESULTS: 36/1917 (1.9%) coeliac children were immigrant. This prevalence was similar to that of the immigrant children among the whole paediatric population living in Italy. Prevalence was influenced by geographical factors, being higher in Northern Italy (1.7%) and in Central Italy (2.5%) than in Southern-Insular Italy (1.5%), as consequence of a higher proportion of immigrants in these regions. The native areas of the immigrant children were East Europe (15/36), Northern Africa (14/36), Southern Asia (4/36), West Africa (1/36), East Africa (1/36) and the Middle East (1/36). The clinical spectrum and dietary habits in immigrant patients were similar to those of the Italian children. CONCLUSIONS: Coeliac disease among the immigrant children coming from developing countries is an emerging problem, and physicians need to be fully aware of it. An important risk factor for coeliac disease in immigrant children appears to be sharing of the same dietary habits with the Italian population. The finding of coeliac disease in children coming from many countries worldwide suggests that coeliac disease is a global public health problem.
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Enfermedad Celíaca/diagnóstico , Enfermedad Celíaca/epidemiología , Emigración e Inmigración , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Italia/epidemiología , Masculino , Estudios RetrospectivosRESUMEN
BACKGROUND: In Burkina Faso, in contrast with high rates of Helicobacter pylori infection from an early age, the prevalence of H. pylori-associated diseases (ulcer and gastric cancer) is low. AIMS: To look for the prevalence of H. pylori in healthy natives of Burkina Faso, both children and adults. METHODS: We studied the prevalence of H. pylori infection in 258 healthy natives of Burkina Faso (70 children aged 6 months-15 years and 188 adults aged 16-65 years), using a serological screening (IgA and IgG H. pylori antibodies). All the studied subjects underwent a questionnaire regarding their life-style, socio-economic status, dietary habits and hygienic sanitary conditions. Data concerning the questionnaire were compared between H. pylori positive and negative subjects. RESULTS: The rates of H. pylori positivity in children were significantly higher than in adults, and in adults the positivity for H. pylori infection decreased with increasing age. The comparison of the questionnaire's data between H. pylori seropositive and seronegative subjects showed that poor socio-economic status and hygienic sanitary conditions were similar in the two groups. Instead, a higher prevalence of H. pylori positivity was observed in subjects belonging to families living in close contact with sheep, because of their labour and agro-pastoral tradition (shepherds and sedentary farmers). CONCLUSION: H. pylori infection in Burkina Faso is acquired early in life and is related not only to some yet well-known risk factors (poor socio-economic and hygienic status), but also to a close contact with sheep. The gradually decreasing H. pylori seropositivity in adult population of Burkina Faso represents an unexplained enigma, which needs further studies.
Asunto(s)
Infecciones por Helicobacter/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Burkina Faso/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Infecciones por Helicobacter/sangre , Infecciones por Helicobacter/diagnóstico , Humanos , Inmunoglobulina A/sangre , Inmunoglobulina G/sangre , Lactante , Masculino , Persona de Mediana Edad , Prevalencia , Estudios SeroepidemiológicosRESUMEN
BACKGROUND: The aim of this study was to evaluate health state of newborns of immigrated parents from developing countries. METHODS: Hospital records of 69,605 infants born during 1996/1997 in Italy were reviewed comparing, in a case-control study, each infant of immigrated parents to two infants born immediately before and after to Italian parents. RESULTS: Of the 69,605 newborns 3906 (5.6%) were born to immigrated parents. This prevalence prolongs the increasing trend observed during the last 10 years of infants born to immigrated parents and reduces the fall of the birth rate linked to the few infants born to Italian parents. It was influenced by geographical factors, being higher in Northern-Central Italy (7%) than in Southern and Insular Italy (2.8%), as consequence of more elevated incomes in these Italian regions. The origin countries of immigrated parents were mainly Northern Africa (31.7%), Eastern Europe (18%) and Sub Saharan Africa (11.6%). Infants of immigrated parents showed higher incidences of prematurity, low birth weight, asphyxia and neonatal mortality rate than newborns with Italian parents. These higher incidences appeared related to some risk factors such as higher parity, short gestational age, some maternal infections, maternal drug dependence, maternal age less than 18 years, low familiar income, inadequate obstetric cares, difficulty to accessing the public health services. CONCLUSIONS: The health problems of infants with immigrated parents are mainly related to social disadvantage and can be overcome improving the social state, the lifestyles and the obstetric cares of the immigrated women, so as monitoring their risk pregnancies.
Asunto(s)
Emigración e Inmigración , Estado de Salud , Recién Nacido , Adolescente , Adulto , Anciano , Peso al Nacer , Estudios de Casos y Controles , Femenino , Muerte Fetal/epidemiología , Humanos , Italia , Masculino , Edad Materna , Persona de Mediana Edad , Trabajo de Parto Prematuro/epidemiología , Embarazo , Estudios RetrospectivosRESUMEN
The action of intense ultrasound on solutions of decahydronaphthalene (decalin) or tetrahydronaphthalene (tetralin) causes, in both cases, a dehydrogenation reaction at room temperature. According to thermodynamic calculations, temperatures as high as 500 degrees C are necessary to achieve the same results. The use of Pd and Se as dehydrogenation catalysts has confirmed the dehydrogenation reactions. Benzene and toluene sonication at room temperature causes aromatic ring breakdown with formation of acetylene and other products. The analogy with radiolysis was noticed. A thermodynamic analysis was conducted on the possible reaction products formed from benzene ring cleavage including polymerization products. It was concluded that acetylene formation from benzene is possible for instance at 650 degrees C only if it is accompanied by coke formation. Otherwise temperatures as high as 1700 degrees C are needed. The nature of the 'coke' formed during sonication is discussed, it was revealed by FT-IR spectroscopy to be a crosslinked polystyrene and hence it is a sonopolymer derived from benzene or toluene ring breakdown products reacted with phenyl and polyphenyl radicals. Again the striking analogy between the IR spectrum of irradiated polystyrene and benzene sonopolymer was noticed. The formation of poly-p-phenylene was excluded by the FT-IR pattern which did not match that of an authentic sample.