RESUMO
Von Willebrand disease is a commonly inherited bleeding disorder caused by defects of von Willebrand factor (vWF). In the most common valve diseases, aortic valve stenosis (AVS) and mitral valve regurgitation (MVR), a bleeding tendency has been described in a number of patients. This has been associated to a high turbulence of blood flow through the compromised valve, promoting degradation of vWF with loss of high-molecular-weight multimers of vWF (HMWM), leading to an acquired von Willebrand syndrome (AvWS). We analysed three groups of patients, one affected by AVS, treated with transcatheter aortic valve implantation (TAVI), the second group of patients affected by MVR, treated with Mitraclip® mitral valve repair. The third group was represented by patients also affected by AVS, but not eligible for TAVI and treated with standard surgery. A fourth group of patients that underwent percutaneous coronary intervention (PCI) with stenting was used as a control. Our results demonstrated that the level of vWF measured as antigen concentration (vWF:Ag) increases in all cohorts of patients after treatment, while in control PCI patients, no modification of vWF:Ag has been registered. Western blot analysis showed only a quantitative loss of vWF in the pre-treatment time, but without significant HMWM modification. The monitoring of the vWF:Ag concentration, but not the quality of HMWM, can indicate the status of blood flow in the treated patients, thus introducing the possibility of using the vWF antigen detection in monitoring the status of replaced or repaired valves.
Assuntos
Estenose da Valva Aórtica/sangue , Insuficiência da Valva Mitral/sangue , Fator de von Willebrand/análise , Estenose da Valva Aórtica/diagnóstico , Humanos , Insuficiência da Valva Mitral/diagnóstico , Intervenção Coronária Percutânea , Plasma , Substituição da Valva Aórtica Transcateter , Doenças de von WillebrandRESUMO
BACKGROUND: To analyze the 5- and 7-year survival outcomes for women with platinum-sensitive recurrent epithelial ovarian cancer (REOC) who underwent secondary cytoreductive surgery (SCS) plus platinum-based hyperthermic intraperitoneal chemotherapy (HIPEC). METHODS: From the electronic databases of the Department of Obstetrics and Gynecology at the Catholic University of the Sacred Heart of Rome and of the S. Orsola Hospital, University of Bologna, a consecutive series of REOC patients were selected using the following inclusion criteria: primary platinum-free interval (PFI-1) of 6 months or longer, completeness of secondary cytoreduction score (CC) of 1 or lower, minimum follow-up period of 48 months, Eastern Cooperative Group (ECOG) performance status at recurrence of 1 or less, and platinum-based HIPEC. Progression-free survival (PFS) and post-relapse survival (PRS) were calculated as the time between SCS + HIPEC and secondary recurrence or death, respectively. RESULTS: The final study population included 70 women with platinum-sensitive REOC. The median follow-up time was 73 months (range 48-128 months), and the median PFI-1 was 19 months (range 6-100 months). At the time of recurrence, the median peritoneal cancer index was 7 (range 1-21), and a CC score of 0 was achieved for 62 patients (88.6 %). As the HIPEC drug, we used oxaliplatin in 17 cases (38.6 %) and cisplatin in 43 cases (61.4 %). No postoperative deaths were observed, and the complication rate for grades 3 and 4 disease was 8.6 %. The median PFS duration was 27 months (range 5-104 months), and the 5- and 7-year PRS rates were respectively 52.8 and 44.7 %, (median PRS 63 months). CONCLUSIONS: The current study demonstrated favorable 5- and 7-year PRS rates for platinum-sensitive REOC patients undergoing SCS + HIPEC, which encourages the inclusion of patients in randomized clinical trials for definitive conclusions to be drawn.
Assuntos
Adenocarcinoma de Células Claras/mortalidade , Cistadenocarcinoma Seroso/mortalidade , Procedimentos Cirúrgicos de Citorredução , Neoplasias do Endométrio/mortalidade , Hipertermia Induzida , Recidiva Local de Neoplasia/mortalidade , Neoplasias Ovarianas/mortalidade , Platina/uso terapêutico , Adenocarcinoma de Células Claras/secundário , Adenocarcinoma de Células Claras/terapia , Adulto , Idoso , Terapia Combinada , Cistadenocarcinoma Seroso/secundário , Cistadenocarcinoma Seroso/terapia , Neoplasias do Endométrio/secundário , Neoplasias do Endométrio/terapia , Feminino , Seguimentos , Humanos , Injeções Intraperitoneais , Pessoa de Meia-Idade , Gradação de Tumores , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/terapia , Estadiamento de Neoplasias , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/terapia , Prognóstico , Estudos Retrospectivos , Taxa de SobrevidaRESUMO
Heart failure (HF) is a condition with growing morbidity and mortality. Dyslipidemia in HF is not concentrated around hypercholesterolemia as in coronary artery disease. As a corollary, the robust benefits seen with statins across the spectrum of CAD have not been replicated in HF. Multiple potential pleiotropic effects of statins include anti-inflammatory, antioxidant, endothelial stabilization, antiapoptotic, anti-thrombotic, and modulation of the autonomic system apart from lipid lowering. These benevolent actions need to be counterbalanced with the potential derangement of ubiquinone, selenoprotein and endotoxin pathways. While small randomized and non-randomized studies demonstrated a multitude of benefits in clinical and surrogate endpoints, two large RCTs failed to demonstrate unequivocal benefits. However, multiple large meta-analyses do demonstrate definite improvement in clinical endpoints including death and heart failure hospitalization. The clinical likelihood of benefit was higher in younger patients with less advanced HF and use of lipophilic statins.
Assuntos
Doença da Artéria Coronariana , Dislipidemias , Insuficiência Cardíaca , Inibidores de Hidroximetilglutaril-CoA Redutases , Humanos , Dislipidemias/tratamento farmacológico , Insuficiência Cardíaca/tratamento farmacológico , Inibidores de Hidroximetilglutaril-CoA Redutases/uso terapêutico , Inibidores de Hidroximetilglutaril-CoA Redutases/farmacologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Metanálise como AssuntoRESUMO
High-density lipoprotein (HDL) cholesterol levels are inversely associated with risk of atherosclerotic cardiovascular disease. At least 50% of the variation in HDL cholesterol levels is genetically determined, but the genes responsible for variation in HDL levels have not been fully elucidated. Lipoprotein lipase (LPL) and hepatic lipase (HL), two members of the triacylglyerol (TG) lipase family, both influence HDL metabolism and the HL (LIPC) locus has been associated with variation in HDL cholesterol levels in humans. We describe here the cloning and in vivo functional analysis of a new member of the TG lipase family. In contrast to other family members, this new lipase is synthesized by endothelial cells in vitro and thus has been termed endothelial lipase (encoded by the LIPG gene). EL is expressed in vivo in organs including liver, lung, kidney and placenta, but not in skeletal muscle. In contrast to LPL and HL, EL has a lid of only 19 residues. EL has substantial phospholipase activity, but less triglyceride lipase activity. Overexpression of EL in mice reduced plasma concentrations of HDL cholesterol and its major protein apolipoprotein A-I. The endothelial expression, enzymatic profile and in vivo effects of EL suggest that it may have a role in lipoprotein metabolism and vascular biology.
Assuntos
Endotélio Vascular/enzimologia , Lipase/genética , Lipase/metabolismo , Lipoproteínas HDL/metabolismo , Sequência de Aminoácidos , Animais , Anticolesterolemiantes/farmacologia , Apolipoproteína A-I/genética , Northern Blotting , Células COS/enzimologia , Células Cultivadas , HDL-Colesterol/sangue , HDL-Colesterol/efeitos dos fármacos , Clonagem Molecular , Endotélio Vascular/citologia , Feminino , Humanos , Lipoproteínas HDL/sangue , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Transgênicos , Dados de Sequência Molecular , Placenta , Gravidez , Proteínas Recombinantes/genética , Proteínas Recombinantes/metabolismo , Proteínas Recombinantes/farmacologia , Homologia de Sequência de Aminoácidos , TransfecçãoRESUMO
Abstract: The recent COVID-19 pandemic caused by SARS-CoV-2 affected hundreds of millions of people and caused millions of deaths. There are few effective medications against SARS-CoV-2, and several studies attempted to make drugs based on natural components, such as olive leaves. Olive leaves are rich in polyphenolic compounds, which were proposed as a viable co-therapy supplement to treat and improve clinical symptoms in COVID-19 patients. Polyphenols have renown anti-inflammatory and multitarget antiviral effects on several virus families, which could be among the reasons of the beneficial effects of the Mediterranean diet against COVID-19. This scoping review is focused on the effect of olive tree polyphenols as a natural remedy to inhibit SARS-CoV-2, mainly discussing their influence on the process of viral entry into host cells by endocytosis.
Assuntos
COVID-19 , Olea , Humanos , COVID-19/prevenção & controle , SARS-CoV-2 , Antivirais/uso terapêutico , Polifenóis/farmacologia , Polifenóis/uso terapêutico , Pandemias/prevenção & controleRESUMO
OBJECTIVE: Osteoporosis is a chronic metabolic syndrome associated with debilitating consequences that represents one of the major non-communicable diseases and the most common bone illness that affects both men and women. This observational study evaluates the amount of physical activity and the nutritional intake in a group of postmenopausal women who have a sedentary job. PATIENTS AND METHODS: All subjects underwent a medical evaluation, a body impedance analysis to evaluate body composition (fat mass, fat-free mass, and body cell mass), and a dual-energy X-ray absorptiometry to analyze bone mineral density. Additionally, a 3-day food record questionnaire and the International Physical Activity Questionnaire were administered respectively to evaluate patients' foods and beverages assumptions and the participants' Physical Activity levels. RESULTS: The study showed that most of the patients had a moderate activity level and inadequate calcium and vitamin D assumption compared to guidelines. CONCLUSIONS: The onset of osteoporosis seemed to be reduced at higher levels of leisure time, domestic, and transport activities, even in subjects who have a sedentary job and insufficient assumption of micronutrients.
Assuntos
Osteoporose Pós-Menopausa , Osteoporose , Masculino , Humanos , Feminino , Pós-Menopausa , Densidade Óssea , Exercício Físico , Absorciometria de Fóton , Ingestão de AlimentosRESUMO
Abstract: The global COVID-19 outbreak, started in December 2019, resulted in severe financial losses and extraordinary health crises. Finding a potent and secure medication candidate to treat SARS-CoV-2 infection and its symptoms is still an urgent global need. After reviewing previous studies, olive leaves, being rich in polyphenolic compounds (a large class of bioactive substances naturally found in plants), were proposed as a viable co-therapy supplement to treat and improve clinical symptoms in COVID-19 patients. It has long been known that olive tree polyphenols-such as oleuropein, hydroxytyrosol, verbascoside, as well as triterpenoids like maslinic, ursolic, and oleanolic acids-have anti-inflammatory and multitarget antiviral effects on several virus families, and they could be one of the reasons of the beneficial effects of the Mediterranean diet against COVID-19. Thus, olive tree poly-phenols were tested in silico and in vitro for preventing SARS-CoV-2 infection, claiming that they have beneficial effects. Nevertheless, there is still a small number of research studies on this topic. The aim of this scoping review is to provide more information and offer an opinion on the feasibility of using olive tree polyphenols as a springboard for the creation of innovative natural remedies against this viral illness, ultimately planning future relevant studies.
Assuntos
COVID-19 , Olea , Humanos , COVID-19/prevenção & controle , SARS-CoV-2 , Polifenóis/farmacologia , Polifenóis/uso terapêutico , FenóisRESUMO
OBJECTIVE: As of today, healthcare systems worldwide face severe challenges that undermine their sustainability. The value-based healthcare (VBHC) approach has been proposed as a strategic and methodological framework to ensure the delivery of the best patient outcomes with economic efficiency. Through the illustrative example of B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) for heart failure (HF) patient management in the context of the Italian National Healthcare system, this article explores the role that in vitro diagnostics (IVDs) can play in enabling value-based care models. SUBJECTS AND METHODS: 14 healthcare professionals representing the relevant professional figures involved in HF patient management met to revise the current HF patient journey and design a new care pathway that, leveraging on BNP/NT-proBNP, reflects the VBHC principles. RESULTS: The literature recognizes the dosage of BNP/NT-proBNP as the gold stan-dard for diagnosing HF. However, as of today, these IVDs are not employed at their full potential regarding HF patient management. A new patient journey is proposed so that patients are diagnosed early and properly monitored in the aftermath of hospitalization, improving outcomes at contained costs. CONCLUSIONS: As testified by the example of HF patient management in Italy, laboratory medicine can represent a lever for adopting value-based care models. Still, large-scale adoption of VBHC will call for structural reforms that revise how healthcare delivery is organized, measured, and reimbursed.
Assuntos
Insuficiência Cardíaca , Cuidados de Saúde Baseados em Valores , Humanos , Prognóstico , Insuficiência Cardíaca/diagnóstico , Insuficiência Cardíaca/terapia , Peptídeo Natriurético Encefálico/metabolismo , Hospitalização , Pacientes , Fragmentos de Peptídeos/metabolismo , BiomarcadoresRESUMO
The new allele differs from HLA-DPB1*23:01 in exon 3.
Assuntos
Cadeias beta de HLA-DP/genética , Polimorfismo de Nucleotídeo Único , Alelos , Sequência de Bases , Cromossomos Humanos Par 6 , Éxons , Cadeias beta de HLA-DP/imunologia , Transplante de Células-Tronco Hematopoéticas , Teste de Histocompatibilidade , Humanos , Dados de Sequência Molecular , Alinhamento de Sequência , Análise de Sequência de DNA , Doadores de TecidosRESUMO
Patients with diabetes mellitus (DM) often present other chronic comorbidities including arterial hypertension (AH), chronic kidney disease (CKD), ischemic heart disease (IHD) and heart failure with preserved ejection fraction (HFpEF). The frequent association of the latter conditions is considered part of the spectrum of cardio-renal syndromes (CRS), a group of disorders of the heart and kidneys whereby acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other. Verapamil is a non-dihydropyridine calcium channel blocker (CCB) widely used in the treatment of hypertension, chronic stable angina, secondary prevention of reinfarction, paroxysmal supra-ventricular tachycardia and for rate control in atrial fibrillation/flutter. In addition to its antihypertensive and anti-ischemic actions verapamil exerts favorable effects also on glycemic control, proteinuric diabetic nephropathy, left ventricular diastolic dysfunction and sympathetic nervous system overactivity which may potentially benefit patients with DM and CRS. In this narrative review, we summarize the current evidence on the potential role of verapamil in the prevention and treatment of CRS in diabetic hypertensive patients.
Assuntos
Síndrome Cardiorrenal , Diabetes Mellitus , Nefropatias Diabéticas , Insuficiência Cardíaca , Hipertensão , Síndrome Cardiorrenal/complicações , Diabetes Mellitus/tratamento farmacológico , Feminino , Humanos , Hipertensão/complicações , Hipertensão/tratamento farmacológico , Masculino , Volume Sistólico , Verapamil/uso terapêuticoRESUMO
The 2-pentadecyl-2-oxazoline (PEA-OXA) is a natural compound with protective action in neuro-inflammation. We have previously shown that PEA-OXA behaves as an α2 adrenergic receptor (α2AR) antagonist and a putative protean agonist on histamine H3 receptors. Recently, neuroinflammation and monoaminergic neurotransmission dysfunction has drawn particular attention in Alzheimer Disease (AD) pathophysiology. In this context, the objective of this study was to investigate the effects of the dual-acting PEA-OXA in an AD-like model in mice. A combined computational and experimental approach was used to evaluate the ability of PEA-OXA to bind α2A-AR subtype, and to investigate the effects of PEA-OXA treatment on neuropathological (behavioural and functional) effects induced by soluble Amyloid ß 1-42 (sAß1-42) intracerebroventricular injection. Computational analysis revealed the PEA-OXA ability to bind the α2A-AR, a pharmacological target for AD, in two alternative poses, one overlapping the Na+ binding site. In vivo studies indicated that chronic treatment with PEA-OXA (10 mg/kg, os) restored the cognitive (discriminative and spatial memory) deficits and social impairments induced by sAß injection. Consistently, electrophysiological analysis showed a recovery of the long-term potentiation in the hippocampus (Lateral Entorhinal Cortex-Dentate Gyrus pathway), while neuroinflammation, i.e., increased pro-inflammatory cytokines levels and microglia cells density were reduced. These data provide the basis for further investigation of the pro-cognitive aptitude of PEA-OXA by proposing it as an adjuvant in the treatment in AD, for which the available pharmacological approaches remain unsatisfactory. Moreover, this study offers new future direction in research investigating the role of α2AR in neuropsychiatric illness and therapies.
Assuntos
Doença de Alzheimer , Peptídeos beta-Amiloides , Camundongos , Animais , Peptídeos beta-Amiloides/toxicidade , Peptídeos beta-Amiloides/metabolismo , Doença de Alzheimer/tratamento farmacológico , Doença de Alzheimer/prevenção & controle , Receptores Adrenérgicos alfa 2 , Modelos Animais de Doenças , Comportamento Social , CogniçãoRESUMO
Social interaction requires the ability to infer another person's mental state (Theory of Mind, ToM) and also executive functions. This fMRI study aimed to identify the cerebral correlates activated by ToM during a specific social interaction, the human-human competition. In this framework, we tested a conflict resolution task (Stroop) adapted to a virtual situation of competition. The participants were instructed to play in order to win either against a human-like competitor (human-human competition) or against a non-human competitor (human-machine competition). Only the human-human competition requires ToM as this type of competition is performed under social interaction. We identified first the classical network of executive regions activated by Stroop. Secondly, we identified the social (human-human) competition regions, represented by the bilateral superior and inferior frontal gyri, the anterior cingulate, the insula, the superior and anterior temporal, the hippocampus, the fusiform gyrus, the cuneus and the precuneus. Finally, we identified the executive regions that were modulated by the human-human competition, i.e., the executive control regions additionally activated when mentalizing in the context of social competition. They constituted a network predominant to the right and composed of the superior and middle frontal, anterior cingulate, insula and fusiform gyrus. We suggest that our experimental paradigm may be useful in exploration of the cerebral correlates of social adjustments in several situations such as psychiatric disorders presenting executive and social dysfunctions.
Assuntos
Encéfalo/fisiologia , Comportamento Competitivo/fisiologia , Relações Interpessoais , Comportamento Social , Adulto , Mapeamento Encefálico , Conflito Psicológico , Função Executiva/fisiologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Percepção Social , Teste de Stroop , Teoria da Mente/fisiologiaRESUMO
OBJECTIVE: It was hypothesized that activity exercise at professional levels could lead to an increase in metabolic levels and a decrease in performance parameters. These trends are explained by physical activity as a cellular stressor. SUBJECTS AND METHODS: We used an algorithm, Laboratory Index which evaluates salivary cortisol, CK and d-ROMs, collected previously from elite Italian soccer players, compared to InStat Index. The last one estimates analytically the athlete's performance in soccer pitch, applying the Heath Maps. RESULTS: A good agreement between the two Index was obtained, especially for two players, who showed an ideal combined trend. CONCLUSIONS: We would investigate the clinical and activity profile of soccer players with the aim of providing information for the development of training strategies. Also, the performances, during training and match time, are an objective evaluation of the athlete's physical preparation. As a consequence, the combination of two Index could be used for a new approach to the sports world.
Assuntos
Laboratórios Clínicos , Desempenho Físico Funcional , Futebol , Adulto , Humanos , Itália , MasculinoRESUMO
OBJECTIVE: Understanding changes of right ventricular (RV) geometry and function in repaired Tetralogy of Fallot (rToF) patients can improve decision-making for pulmonary valve replacement. Therefore, we aimed to assess the magnitude and clinical correlations of RV changes in rToF patients. PATIENTS AND METHODS: Clinical and MRI data of rToF patients who underwent repeated cardiac magnetic resonance imaging (MRI) at two centers between December 2003 and September 2020 were analyzed together with anatomical factors, including RV outflow tract obstruction, pulmonary artery branch stenosis, and tricuspid regurgitation. Adverse cardiac events and/or NYHA class worsening were documented and correlated with MRI changes. QRS length was reported at each MRI. RESULTS: Two-hundred-and-nineteen rToF patients (53% males, aged 20.2 ± 10.1 years) were enrolled. An increase of ventricular dimensions, except LVEDVi, and worsening of right and left ejection fractions were found over an average period of 5 years of follow-up. These changes were statistically significant but within 10% of the initial value. No significant changes were reported on a year-to-year basis, except in a small group of patients (6%) in whom no predictive factors were identified. Despite similar RV dimensions at the first examination, younger patients had a higher RV ejection fraction and a different annual rate of change of ventricular dimensions compared to older ones. Patients with arrhythmias (20%) were more frequently older and had larger RV dimensions but showed no significant correlations with MRI changes/years. CONCLUSIONS: Changes in RV dimensions and function occur rarely and very slowly in rToF patients. A small percentage of patients experience a significant worsening in a short time interval without any recognized risk factors. Arrhythmias appear to occur in a small percentage of cases in the late follow-up.
Assuntos
Arritmias Cardíacas/epidemiologia , Tetralogia de Fallot/cirurgia , Disfunção Ventricular Direita/epidemiologia , Função Ventricular Direita/fisiologia , Adolescente , Adulto , Fatores Etários , Criança , Progressão da Doença , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Fatores de Risco , Volume Sistólico/fisiologia , Disfunção Ventricular Direita/diagnóstico por imagem , Adulto JovemRESUMO
BACKGROUND: This multi-centre phase II clinical trial is the first prospective evaluation of radioembolisation of patients with colorectal liver metastases (mCRC) who failed previous oxaliplatin- and irinotecan-based systemic chemotherapy regimens. METHODS: Eligible patients had adequate hepatic, haemopoietic and renal function, and an absence of major hepatic vascular anomalies and hepato-pulmonary shunting. Gastroduodenal and right gastric arteries were embolised before hepatic arterial administration of yttrium-90 resin microspheres (median activity, 1.7 GBq; range, 0.9-2.2). RESULTS: Of 50 eligible patients, 38 (76%) had received > or =4 lines of chemotherapy. Most presented with synchronous disease (72%), >4 hepatic metastases (58%), 25-50% replacement of total liver volume (60%) and bilateral spread (70%). Early and intermediate (>48 h) WHO G1-2 adverse events (mostly fever and pain) were observed in 16 and 22% of patients respectively. Two died due to renal failure at 40 days or liver failure at 60 days respectively. By intention-to-treat analysis using Response Evaluation Criteria in Solid Tumours, 1 patient (2%) had a complete response, 11 (22%) partial response, 12 (24%) stable disease, 22 (44%) progressive disease; 4 (8%) were non-evaluable. Median overall survival was 12.6 months (95% CI, 7.0-18.3); 2-year survival was 19.6%. CONCLUSION: Radioembolisation produced meaningful response and disease stabilisation in patients with advanced, unresectable and chemorefractory mCRC.
Assuntos
Neoplasias Colorretais/patologia , Neoplasias Hepáticas/radioterapia , Neoplasias Hepáticas/secundário , Radioisótopos de Ítrio/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Embolização Terapêutica/métodos , Feminino , Artéria Hepática , Humanos , Contagem de Leucócitos , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/tratamento farmacológico , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Qualidade de Vida , Análise de Sobrevida , Tomografia Computadorizada por Raios X , Radioisótopos de Ítrio/administração & dosagem , Radioisótopos de Ítrio/efeitos adversosRESUMO
SUMMARY: Platelet transfusions, main therapy of Glanzmann Thromboasthenia (GT), can induce an allo-immunization against human leucocyte antigen and integrin alphaIIbbeta3. We have investigated in our GT patients the rate of allo-immunization and of refractoriness to platelet transfusions. From 1975 until December 2005, we have followed 17 GT patients: 14 type 1, 3 variant type; nine females, eight males; median age at diagnosis 9.8 years (range 1-44.5); median age at the time of the study 35.5 years (range 23.6-68.5). In our patients, 121 bleeding episodes occurred (24 severe, 37 moderate, and 60 mild). Ten major and 22 minor surgical procedures have been performed. Two spontaneous deliveries and three caesarian sections with five live births were performed; moreover, one late foetal loss occurred, and one voluntary abortion was performed. Sixteen of 17 patients have been transfused at least once in life with platelets and/or red blood cells (RBC). All transfused patients have been investigated for the presence of anti-HLA and anti-integrin alphaIIbbeta3 allo-antibodies. The positiveness of allo-antibodies has been demonstrated in 4/16 transfused patients (25%): isolated for anti-HLA in two; isolated for anti-integrin alphaIIbbeta3 in one; and combined in one. In spite of the presence of allo-antibodies, platelet transfusions have always been effective and the haemostasis was not compromised.
Assuntos
Antígenos HLA/imunologia , Isoanticorpos/análise , Complexo Glicoproteico GPIIb-IIIa de Plaquetas/imunologia , Transfusão de Plaquetas , Trombastenia/imunologia , Trombastenia/terapia , Adulto , Idoso , Parto Obstétrico , Ensaio de Imunoadsorção Enzimática , Feminino , Genótipo , Humanos , Integrina alfa2/genética , Integrina beta3/genética , Masculino , Pessoa de Meia-Idade , Mutação/genética , Fenótipo , Gravidez , Trombastenia/genética , Adulto JovemRESUMO
The Redundancy Discrimination Analysis (RDA) and Spearman correlation coefficients were used to investigate relationships between airborne bacteria at the phylum and genus level and chemical species in winter and spring PM10 samples over Southeastern Italy. The identification of main chemical species/pollution sources that were related to and likely affected the bacterial community structure was the main goal of this work. The 16S rRNA gene metabarcoding approach was used to characterize airborne bacteria. Seventeen phyla and seventy-nine genera contributing each by mean within-sample relative abundance percentage > 0.01% were identified in PM10 samples, which were chemically characterized for 33 species, including ions, metals, OC, and EC (organic and elemental carbon, respectively). Chemical species were associated with six different pollution sources. A shift from winter to spring in both bacterial community structure and chemical species mass concentrations/sources and the relationships between them was observed. RDA triplots pointed out significant correlations for all tested bacterial phyla (genera) with other phyla (genera) and/or with chemical species, in contrast to correlation coefficient results, which showed that few phyla (genera) were significantly correlated with chemical species. More specifically, in winter Bacillus and Chryseobacterium were the only genera significantly correlated with chemical species likely associated with particles from soil-dust and anthropogenic pollution source, respectively. In spring, Enterobacter and Sphingomonas were the only genera significantly correlated with chemical species likely associated with particles from the anthropogenic pollution and the marine and soil-dust sources, respectively. The results of this study also showed that the correlation coefficients were the best tool to obtain unequivocal identifications of the correlations of phyla (genera) with chemical species. The seasonal changes of the PM10 chemical composition, the microbial community structure, and their relationships suggested that the seasonal changes of atmospheric particles may have likely contributed to seasonal changes of bacterial community in the atmosphere.
Assuntos
Estações do Ano , Poluentes Atmosféricos , Bactérias , Monitoramento Ambiental , Itália , Tamanho da Partícula , Material Particulado , RNA Ribossômico 16SRESUMO
Obesity is linked to other systemic diseases, such as diabetes mellitus, dyslipidemia, and arterial hypertension. These comorbidities increase the risk of developing cardiovascular disease risk. Adipose tissue is a true endocrine organ and releases various pro-inflammatory cytokines. Periodontal disease (PD) is a chronic inflammatory disorder of the gingiva and bone support (periodontal tissues) that surrounds the teeth. The relationship between obesity and an increased risk of developing PD is already known in the literature. Many studies correlated the cardiometabolic risk with periodontal disease. Bariatric surgery is a way to reduce the adipose tissue in obese patients, that meet specific criteria. It has been observed that this type of surgery usually reduces both the systemic inflammation and the cardiometabolic risk. Some authors have hypothesized that, as a result, the progression of periodontal disease is also reduced. Five articles are analyzed in this systematic review. In these papers, the periodontal health before and after the bariatric surgery was compared. However, the conclusion of the previous studies demonstrated a scarce literature and did not confirm the reduction of periodontal disease after bariatric surgery, but a reduction of cardiometabolic risk. Therefore, periodontal disease in no way influences the reduction of cardiovascular risk after bariatric surgery.
Assuntos
Cirurgia Bariátrica , Obesidade/cirurgia , Doenças Periodontais/cirurgia , Tecido Adiposo/patologia , Humanos , Obesidade/patologia , Doenças Periodontais/patologia , Fatores de RiscoRESUMO
Microinjection of L-glutamate into the intermediate nucleus tractus solitarii in anesthetized rats elicits hypotension, bradycardia, and apnea, simulating baroreceptor reflexes. Ablation of the nodose ganglion results in selective reduction of high-affinity uptake of L-glutanate in the nucleus tractus solitarii. L-Glutamate may be the neurotransmitter of afferent nerve fibers from arterial baroreceptors.
Assuntos
Glutamatos/fisiologia , Bulbo/fisiologia , Neurotransmissores/fisiologia , Pressorreceptores/fisiologia , Vias Aferentes/fisiologia , Animais , Pressão Sanguínea/efeitos dos fármacos , Mapeamento Encefálico , Glutamatos/farmacologia , Frequência Cardíaca/efeitos dos fármacos , Ácido Caínico/farmacologia , Ratos , Reflexo/efeitos dos fármacos , Respiração/efeitos dos fármacosRESUMO
OBJECTIVE: The patients with repaired Tetralogy of Fallot (rToF) are a growing population due to the improvement of surgical management in neonatal age. However, the significant pulmonary regurgitation, consequent to the repair, is the most frequent sequelae and leads to a progressive right ventricle dilation over time. The latter, in turn, is responsible for the possible dysfunction of right and/or left ventricle and an increased risk of dangerous ventricular arrhythmias. Therefore, right ventricle monitoring is necessary for rToF patients and a 3D method is required due to its three anatomical and functional subunits. Magnetic resonance imaging (MRI) has become the 3D modality of choice in the evaluation of both cardiac anatomy and ventricular volumes in rToF patients since it is able to evaluate both the pathophysiology and anatomy, it is free of radiation and, when strictly necessary, it uses a non-iodinated contrast agent. Cardiac CT should be considered in the evaluation of the sequelae in rToF only in selected cases, given that it implies a radiation dose and iodinated contrast, in addition to not evaluating the pathophysiology as MRI.