RESUMEN
BACKGROUND: According to the World Alzheimer Report (Prince, The Global Impact of Dementia: an Analysis of Prevalence, Incidence, Cost and Trends, 2015), 46.8 million people worldwide are nowadays living with dementia. And this number is estimated to approximate 131.5 million by 2050, with an increasing burden on society and families. The lack of medical treatments able to stop or slow down the course of the disease has moved the focus of interest toward the nonpharmacological approach and psychosocial therapies for people with/at risk of dementia, as in the Mild Cognitive Impairment (MCI) condition. The purpose of the present study is to test an individualized home-based multidimensional program aimed at enhancing the continuum of care for MCI and outpatients with dementia in early stage using technology. METHODS: The proposed study is a single blind randomized controlled trial (RCT) involving 30 subjects with MCI and Alzheimer's disease (AD) randomly assigned to the intervention group (Ability group), who will receive the "Ability Program", or to the active control group (ACG), who will receive "Treatment As Usual" (TAU). The protocol provides for three steps of assessment: at the baseline (T_0), after treatment, (T_1) and at follow-up (T_2) with a multidimensional evaluation battery including cognitive functioning, behavioral, functional, and quality of life measures. The Ability Program lasts 6 weeks, comprises tablet-delivered cognitive (5 days/week) and physical activities (7 days/week) combined with a set of devices for the measurement and monitoring from remote of vital and physical health parameters. The TAU equally lasts 6 weeks and includes paper and pencil cognitive activities (5 days/week), with clinician's prescription to perform physical exercise every day and to monitor selected vital parameters. DISCUSSION: Results of this study will inform on the efficacy of a technology-enhanced home care service to preserve cognitive and motor levels of functioning in MCI and AD, in order to slow down their loss of autonomy in daily life. The expected outcome is to ensure the continuity of care from clinical practice to the patient's home, enabling also cost effectiveness and the empowerment of patient and caregiver in the care process, positively impacting on their quality of life. TRIAL REGISTRATION: ClinicalTrials.gov ID: NCT02746484 (registration date: 12/apr/2016 - retrospectively registered).
Asunto(s)
Enfermedad de Alzheimer/rehabilitación , Disfunción Cognitiva/rehabilitación , Servicios de Atención de Salud a Domicilio , Telerrehabilitación , Anciano , Protocolos Clínicos , Femenino , Humanos , Masculino , Calidad de Vida , Método Simple CiegoRESUMEN
We numerically study the aging properties of the dynamical heterogeneities in the Ising spin glass. We find that a phase transition takes place during the aging process. Statics-dynamics correspondence implies that systems of finite size in equilibrium have static heterogeneities that obey finite-size scaling, thus signaling an analogous phase transition in the thermodynamical limit. We compute the critical exponents and the transition point in the equilibrium setting, and use them to show that aging in dynamic heterogeneities can be described by a finite-time scaling ansatz, with potential implications for experimental work.
RESUMEN
BACKGROUND: Definitive diagnosis of feline pancreatic disease is dependent on histologic examination of biopsies. HYPOTHESIS: Laparoscopic punch biopsy of the pancreas does not significantly affect pancreatic health or clinical status of healthy cats, and provides an adequate biopsy sample for histopathology. ANIMALS: Eleven healthy female domestic shorthair cats. METHODS: Effects of laparoscopic pancreatic visualization alone in 5 cats compared with laparoscopic pancreatic visualization and punch biopsy in 6 cats were studied. Temperature, pulse, and respiratory rate, physical examination, and daily caloric intake were evaluated for 1 week before and 1 week after the procedure. Pain scores (simple descriptive score and dynamic interactive visual assessment score) were evaluated hourly during the 1st 6 hours postprocedure. Complete blood cell counts, serum biochemical profiles, serum feline pancreatic lipase immunoreactivity, and urine specific gravity were evaluated before the procedure and at 6, 24, and 72 hours postprocedure. One month postprocedure, during sterilization, the pancreas was reassessed visually in all cats, and microscopically in the biopsy group. RESULTS: For all variables evaluated, there were no significant differences between biopsy and control cats. Re-evaluation of the pancreatic biopsy site 1 month later documented a normal tissue response to biopsy. The laparoscopic punch biopsy forceps provided high-quality pancreatic biopsy samples with an average size of 5 mm x 4 mm on 2-dimensional cut section. CONCLUSIONS AND CLINICAL IMPORTANCE: Laparoscopic pancreatic biopsy is a useful and safe technique in healthy cats.
Asunto(s)
Biopsia/veterinaria , Laparoscopía/veterinaria , Páncreas/anatomía & histología , Animales , Biopsia/métodos , Gatos , FemeninoRESUMEN
AIM: Benign prostatic hypertrophy (BPH), which is characterized by a progressive swelling of the prostate causing symptoms of the lower urinary tract, is the second pathology as frequency among the diagnoses placed in men every year in Italy. The extract of Serenoa repens is an alternate therapeutic option to traditional drug therapies with a good profile of efficacy and safety for the management of the symptoms of BPH. The aim of this paper was to analyze systematically the results of two Italian studies carried out on patients with BPH treated with extract of serenoa repens (SABA. a product of Lampugnani Farmaceutici S.p.A.). METHODS: The studies were carried out on a total of 70 adult patients with diagnosis of benign prostatic hypertrophy. In one study the patients were treated with Serenoa repens 320 mg/day for 30 days; in the other study the patients received Serenoa repens 320 mg/day or Pygeum africanum (Tadenan) 4 capsules of 25 mg/day for 30 days. RESULTS: Both studies showed an improvement versus the baseline of about 50% of dysuria and pollakisuria, an about 50% increase in micturition rate with positive effects also in terms of reduction of the micturition rate and of prostate size. Also the tolerability profile was favorable. CONCLUSION: The extract of Serenoa repens (SABA Lampugnani Farmaceutici S.p.A.) administered at the dose of 320 mg/day to patients with benign prostatic hypertrophy, is effective in terms of improvement of the functional symptomatologic picture improvement and of the instrumental parameters with a good tolerability profile.
Asunto(s)
Antagonistas de Andrógenos/administración & dosificación , Fitoterapia , Preparaciones de Plantas/administración & dosificación , Hiperplasia Prostática/tratamiento farmacológico , Prunus africana , Serenoa , Adulto , Anciano , Anciano de 80 o más Años , Disuria/tratamiento farmacológico , Disuria/etiología , Humanos , Italia , Masculino , Persona de Mediana Edad , Hiperplasia Prostática/complicaciones , Hiperplasia Prostática/diagnóstico , Prunus africana/efectos adversos , Serenoa/efectos adversos , Resultado del Tratamiento , Micción/efectos de los fármacosRESUMEN
This study evaluated the adverse effects of carprofen in seven healthy cats. Values for CBC, biochemical profiles and platelet aggregation were measured before and at seven days after SID treatment with subcutaneous carprofen: 4 mg/kg (day 1), 2mg/kg (day 2 and 3) and 1mg/kg (day 4 and 6) (CG) or 0.35 ml of saline (SG) for six days in a randomized, blinded, cross-over study with a four-week washout period. No treatment was given on day 5. Endoscopy of the GI tract was performed pre-treatment and on day 7 post-treatment. There were no significant changes in hematological profiles, biochemical profiles and endoscopy grading scores within nor between groups, except for lower albumin values at baseline than on day 7 (CG), and globulin and ALP values were higher at baseline than on day 7 in CG and SG. SC administration of carprofen over six days did not cause any adverse effects on gastrointestinal, hematological, or serum biochemical variables.
Asunto(s)
Antiinflamatorios no Esteroideos/toxicidad , Carbazoles/toxicidad , Gatos/sangre , Fosfatasa Alcalina/sangre , Animales , Antiinflamatorios no Esteroideos/administración & dosificación , Recuento de Células Sanguíneas/veterinaria , Carbazoles/administración & dosificación , Creatinina/sangre , Estudios Cruzados , Endoscopía/veterinaria , Femenino , Tracto Gastrointestinal/efectos de los fármacos , Hematócrito/veterinaria , Hemoglobinas/análisis , Inyecciones Subcutáneas/veterinaria , Masculino , Agregación Plaquetaria/fisiología , Recuento de Plaquetas/veterinaria , Distribución Aleatoria , Urea/sangre , gamma-Glutamiltransferasa/sangreRESUMEN
The aim of this study was to compare the antinociceptive effects of epidural buprenorphine (EB), epidural medetomidine (EM) or epidural buprenorphine-medetomidine (EBM). Eight cats were studied. Thermal thresholds (TT) were measured by increasing the temperature of a probe placed on the thorax. Mechanical thresholds (MT) were measured through inflation of a modified blood pressure bladder to the cat's forelimb. After baseline measurements, EB (0.02 mg/kg), EM (0.01 mg/kg) or half of the doses of each drug (EBM) were administered. Data were analysed using anova (P < 0.05) and 95% confidence interval (CI). TT increased from 30 min to 1 h after EB and at 45 min after EM. MT increased from 45 min to 2 h after EB, from 15 min to 1 h after EM and at 30, 45 min and at 2 h after EBM. MT were significantly lower after EB than EM at 30 min. TT were above the upper 95%CI from 15 min to 24 h after EB, from 15 min to 4 h after EM and from 15 min to 8 h after EBM. MT were above the upper 95%CI from 15 min to 5 h, and at 8, 12 and 24 h after EB, from 15 min to 6 h after EM and from 15 min to 6 h and at 12 and 24 h after EBM. All treatments had similar onset. Overall, EB presented longer period of action than EBM and EM. The same magnitude of analgesia was achieved, but with fewer side effects when EBM was compared with EM.
Asunto(s)
Analgésicos no Narcóticos/farmacología , Analgésicos Opioides/farmacología , Buprenorfina/farmacología , Medetomidina/farmacología , Analgésicos no Narcóticos/administración & dosificación , Analgésicos Opioides/administración & dosificación , Animales , Temperatura Corporal/efectos de los fármacos , Buprenorfina/administración & dosificación , Gatos , Sedación Consciente/veterinaria , Relación Dosis-Respuesta a Droga , Quimioterapia Combinada , Femenino , Inyecciones Epidurales , Masculino , Medetomidina/administración & dosificación , Temperatura Cutánea/efectos de los fármacosRESUMEN
BACKGROUND: The latest developments in Lewy Body Dementia (DLB) raise some controversies on clinical features, neuroimaging and therapy. The aim of our study is to determine clinical, neuropsychological, neuroimaging and EEG profile of DLB through retrospective and prospective data of 102 patients. METHODS: data were collected with an analytical form that was developed by an expertise of neurologists. RESULTS: DLB represented 4.8% of the dementia population, with no sex difference. Family history of dementia was common (24.5%), while familiarity for parkinsonism was rare (4.9%). Cognitive disturbances were the predominant clinical presentation at onset (49%), followed by behavioral symptoms (29.4%) and parkinsonism (21.6%). Clinical features at consultation were: memory disturbances (almost all cases), symmetrical (68.6%) or asymmetrical (18.6%) parkinsonism, cognitive fluctuations (49%), visuospatial deficits (53.9%), and visual hallucinations (44.1%). Autonomic signs were present in a third of the cases, while sleep disorders were present in 44.1%. Some clinical response to antiparkinsonian drugs was evident in half of the cases. MRI, SPET, EEG and Neuropsychiatric Inventory data were available in a subgroup of patients. CONCLUSIONS: Most of our data were in accordance with the previous literature. However, some data underline the relationship between DLB, Alzheimer's and Parkinson's disease.
Asunto(s)
Enfermedades del Sistema Nervioso Autónomo/epidemiología , Síntomas Conductuales/epidemiología , Enfermedad por Cuerpos de Lewy/complicaciones , Enfermedad por Cuerpos de Lewy/psicología , Trastornos de la Percepción/epidemiología , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Diagnóstico por Imagen , Electroencefalografía , Femenino , Hospitales Psiquiátricos , Humanos , Italia , Enfermedad por Cuerpos de Lewy/diagnóstico , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Prevalencia , Psicotrópicos/uso terapéutico , Estudios RetrospectivosRESUMEN
The aim of the present study was to apply diffusion tensor MRI (DT-MRI), a quantitative MRI measure which reflects tissue organization, to dementia with Lewy bodies (DLB). DT-MRI scans were obtained from 15 patients with probable DLB and 10 sex- and age-matched healthy controls. Abnormalities were found in the corpus callosum, pericallosal areas and the frontal, parietal, occipital and, less prominently, temporal white matter of patients compared with controls. Abnormalities were also found in the caudate nucleus and the putamen. The average grey matter volume was lower in patients than in controls. These findings of concomitant grey matter atrophy and white matter abnormalities (as detected by DT-MRI) in regions with a high prevalence of long connecting fibre tracts might suggest the presence of neurodegeneration involving associative cortices. The modest involvement of the temporal lobe fits with the relative preservation of global neuropsychological measures and memory tasks in the early stage of DLB. The selective involvement of parietal, frontal and occipital lobes might explain some of the clinical and neuropsychological features of DLB, providing a possible distinctive marker for this disease. The abnormalities found in the subcortical grey matter may indicate that DLB and Parkinson's disease share a similar nigrostriatal involvement caused by common pathophysiological mechanisms.
Asunto(s)
Encéfalo/patología , Imagen de Difusión por Resonancia Magnética/métodos , Enfermedad por Cuerpos de Lewy/patología , Anciano , Anciano de 80 o más Años , Estudios de Casos y Controles , Núcleo Caudado/patología , Femenino , Humanos , Enfermedad por Cuerpos de Lewy/psicología , Modelos Lineales , Masculino , Pruebas Neuropsicológicas , Putamen/patología , Lóbulo Temporal/patologíaRESUMEN
The expression of nuclear proteins high mobility group (HMG) I and HMGY was investigated in intraepithelial and invasive lesions of the uterine cervix. Human carcinoma cell lines C-41, ME-180, and CaSki were used for testing protein expression in neoplastic cells from the cervix. Morphological grading of the dysplasias (CIN 1, CIN 2, and CIN 3) and invasive carcinomas from formalin-fixed paraffin-embedded samples parallels the degree of nuclear immunostaining obtained using a polyclonal antibody raised against the amino-terminal region of HMGI(Y) proteins. The immunostaining obtained with HMGI(Y) antibody was compared with that observed using the antibody Ki-67, and the results were similar. We suggest the use of HMGI(Y) antibody in clinical oncology as a useful marker of intraepithelial lesions and invasive carcinomas.
Asunto(s)
Antígenos de Neoplasias/análisis , Biomarcadores de Tumor/análisis , Carcinoma de Células Escamosas/química , Proteínas del Grupo de Alta Movilidad/análisis , Displasia del Cuello del Útero/química , Neoplasias del Cuello Uterino/química , Anticuerpos Monoclonales/inmunología , Northern Blotting , Western Blotting , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/patología , Femenino , Expresión Génica , Proteína HMGA1a , Proteínas del Grupo de Alta Movilidad/inmunología , Humanos , Técnicas para Inmunoenzimas , Antígeno Ki-67/análisis , Invasividad Neoplásica , Adhesión en Parafina , Células Tumorales Cultivadas , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/patología , Displasia del Cuello del Útero/diagnóstico , Displasia del Cuello del Útero/patologíaRESUMEN
The E6 proteins derived from tumour associated papillomavirus types target the cellular tumour suppressor protein p53 for ubiquitin mediated degradation. In cell lines derived from cervical tumours the p53 protein is present in very low amounts, but it can be activated by appropriate DNA damaging agents, indicating that functional p53 is present within these lines. Recent studies have also shown that different polymorphic forms of the p53 protein are differentially susceptible to E6 mediated degradation. Therefore we have been interested in analysing the effects of different HPV E6 proteins upon p53 levels in a variety of cervical tumour derived cell lines. We show that inhibition of E6 mediated degradation of p53 frequently results in increased levels of p53 expression. However, there are notable exceptions to this where increased p53 levels are only obtained following DNA damage and proteasome inhibition. We also show in E6 expressing cells, that as well as p53 being targeted for degradation, the localization of p53 to the nucleus is also inhibited, consistent with previous observations which indicate that degradation of p53 is not essential for E6 mediated inhibition of p53 function. These results have important implications for any potential therapies which might aim to block E6 mediated degradation of p53.
Asunto(s)
Carcinoma/virología , Proteínas de Unión al ADN , Proteínas Oncogénicas Virales/metabolismo , Papillomaviridae/metabolismo , Proteínas Represoras , Proteína p53 Supresora de Tumor/metabolismo , Neoplasias del Cuello Uterino/virología , Acetilcisteína/análogos & derivados , Acetilcisteína/farmacología , Adenocarcinoma/tratamiento farmacológico , Adenocarcinoma/genética , Animales , Antibióticos Antineoplásicos/farmacología , Neoplasias de la Mama/tratamiento farmacológico , Neoplasias de la Mama/genética , Carcinoma/tratamiento farmacológico , Carcinoma/genética , Núcleo Celular/metabolismo , Inhibidores de Cisteína Proteinasa/farmacología , Daño del ADN/efectos de los fármacos , Femenino , Fibrosarcoma/tratamiento farmacológico , Fibrosarcoma/genética , Humanos , Leupeptinas/farmacología , Mitomicina/farmacología , Polimorfismo Genético , Células Tumorales Cultivadas/efectos de los fármacos , Células Tumorales Cultivadas/metabolismo , Células Tumorales Cultivadas/virología , Proteína p53 Supresora de Tumor/efectos de los fármacos , Proteína p53 Supresora de Tumor/genética , Neoplasias del Cuello Uterino/tratamiento farmacológico , Neoplasias del Cuello Uterino/genéticaRESUMEN
The human papillomavirus (HPV) E6 protein is one of three oncoproteins encoded by the virus. It has long been recognized as a potent oncogene and is intimately associated with the events that result in the malignant conversion of virally infected cells. In order to understand the mechanisms by which E6 contributes to the development of human malignancy many laboratories have focused their attention on identifying the cellular proteins with which E6 interacts. In this review we discuss these interactions in the light of their respective contributions to the malignant progression of HPV transformed cells.
Asunto(s)
Transformación Celular Neoplásica , Transformación Celular Viral/fisiología , Proteínas Oncogénicas Virales/fisiología , Papillomaviridae/fisiología , Progresión de la Enfermedad , Humanos , Proteína p53 Supresora de Tumor/fisiologíaRESUMEN
The Naturally Occurring Radioactive Materials (NORMs) that are potentially generated from oil and gas extractions in Albania have been disposed of without regulations for many decades, and therefore, an extensive survey in one of the most productive regions (Vlora-Elbasan) was performed. A total of 52 gamma ray spectrometry measurements of soil, oil-sand, sludge, produced water and crude oil samples were performed. We discovered that relatively low activity concentrations of (226)Ra, (228)Ra, (228)Th and (40)K, with concentrations of 23±2Bq/kg, 23±2Bq/kg, 24±3Bq/kg and 549±12Bq/kg, respectively, came from the oil-sands produced by the hydrocarbon extraction of the molasses formations. The mineralogical characterizations and the (228)Ra/(40)K and (226)Ra/(40)K ratios of these Neogene deposits confirmed the predictions of the geological and geodynamic models of a dismantling of the Mesozoic source rocks. The average activity concentrations (±standard deviations) of the radium isotopes ((226)Ra and (228)Ra) and of the (228)Th and (40)K radionuclides in soil samples were 20±5Bq/kg, 25±10Bq/kg, 25±9Bq/kg and 326±83Bq/kg, respectively. Based on the measurements in this study, the future radiological assessments of other fields in the region should be strategically planned to focus on the oil-sands from the molasses sediments. Disequilibrium in the (228)Ra decay segment was not observed in the soil, sludge or oil-sand samples within the standard uncertainties. After a detailed radiological characterization of the four primary oil fields, we concluded that the outdoor absorbed dose rate never exceeded the worldwide population weighted average absorbed dose rate in outdoor air from terrestrial gamma radiation.
Asunto(s)
Yacimiento de Petróleo y Gas , Contaminantes Radiactivos/análisis , Radioisótopos/análisis , Albania , Residuos Industriales/análisis , Petróleo/análisis , Monitoreo de Radiación , Suelo/química , Espectrometría gammaRESUMEN
The HMGI-C protein is a nuclear factor expressed in human and rodent neoplastic cells which has been shown to be involved in the process of cell transformation. We have previously isolated the cDNA encoding murine HMGI-C and now we report the cloning and analysis of the mouse Hmgi-c gene. The gene is at least 50 kb long, contains five exons, and each of the three DNA-binding domains is encoded by a different exon. The location of exon-intron junctions was determined and shown to follow the GT-AG rule. The sequence revealed that the overall organization is similar to the gene encoding human HMGI(Y), the other member of the HMGI family, suggesting that HMGI genes probably evolved through gene duplication and exon shuffling events from an ancestral gene. A highly homologous pseudogene is also present in the mouse genome. Our results on Hmgi-c structure provide basic information to carry out further studies on the regulation of its expression.
Asunto(s)
Proteínas del Grupo de Alta Movilidad/genética , Secuencia de Aminoácidos , Animales , Secuencia de Bases , Cartilla de ADN/química , Proteínas de Unión al ADN/genética , Exones , Genes , Proteína HMGA2 , Ratones , Datos de Secuencia Molecular , Seudogenes , Mapeo Restrictivo , Homología de Secuencia de Ácido NucleicoRESUMEN
Numerical and structural chromosome aberrations were found in cell plaque metaphases from 9 of 14 patients with Peyronie's disease. In two cases there was evidence of clonal evolution for some of the chromosomal aberrations observed. The Y chromosome was the most frequently involved in numerical changes. Four of 9 cases with abnormal karyotype showed more than one abnormal, cytogenetically unrelated clone. Our findings suggest the possibility of a multiclonal origin for this benign tumor, and confirm the presence of chromosome instability in this cell growth disorder.
Asunto(s)
Aberraciones Cromosómicas , Trastornos de los Cromosomas , Induración Peniana/genética , Cromosoma Y , Adulto , Células Cultivadas , Humanos , Cariotipificación , Masculino , Persona de Mediana EdadRESUMEN
Congenital anomalies of the penis expressed in various forms of flexures can be associated with a rotation of the shaft. An asymmetrical insertion of the suspensory ligament on the dorsal surface of the tunica albuginea often accounts for corporal rotation. This distorts the spatial relationship between the corpora cavernosa and the pubic bone. The two corpora may overlap and the shaft is partially rotated. For the surgical treatment of these defects we proposed (1989) a technique of contrarotation of the tunica albuginea which was later abandoned because it was too invasive. We developed a technique based on the ipsilateral re-suspension of the suspensory ligament of the penis between the tunica of the lower corpus and the pubic symphysis to restore the true axis. The neurovascular adnexa, the corpora cavernosa, and the corpus spongiosum remain untouched.
Asunto(s)
Enfermedades del Pene/cirugía , Pene/anomalías , Pene/cirugía , Adolescente , Adulto , Humanos , Ligamentos/cirugía , Masculino , Dolor Postoperatorio , Enfermedades del Pene/congénito , Erección Peniana/fisiologíaRESUMEN
Three genotoxic mouse carcinogens, 4-chloro-o-phenylenediamine (4-C-o-PDA), 2-nitro-p-phenylenediamine (2-N-p-PDA), and 2,4-diaminotoluene (2,4-DAT), were tested in the Big Blue transgenic mouse mutation assay. Each experiment consisted of a vehicle control group with ten Big Blue C57BL/6 mice, five of either sex, and an equally sized group treated with a high dose of the test chemical. In addition, four animals were treated with the vehicle and six animals with the test compound for the measurement of bromodeoxyuridine (BrdU) incorporation to determine cellular proliferation. Prior to the mutagenicity experiments, the maximally tolerated dose of each compound was determined using nontransgenic C57BL/6 mice. Based on these results the doses used in the main study were 200 mg/kg/day for 4-C-o-PDA, 150 mg/kg/ day for 2-N-p-PDA, and 80 mg/kg/day for 2,4-DAT. Animals were treated for 10 days over a 2 week period and were killed 10 days after the ast treatment. In an additional experiment with 2,4-DAT, animals were killed 28 days after treatment. Since all three chemicals are liver carcinogens in the mouse, the DNA of the liver was analyzed using the standard procedures for the Big Blue assay. Hepatocyte proliferation was assessed by immunohistochemical detection of proliferating cell nuclear antigen (PCNA) and, in some studies, by measuring BrdU incorporation. 4-C-o-PDA and 2-N-p-PDA did not induce an increase in PCNA expression when measured 10 days after the last treatment. There was no increase in BrdU incorporation immediately after treatment with 4-C-o-PDA or with 2,4-DAT. However, 10 days after the last treatment with 2,4-DAT, a strong mitogenic effect was found with both techniques, i.e., in the PCNA and BrdU assays. 4-C-o-PDA, a liver carcinogen in both genders of mice, induced a small, statistically significant increase of the mutant frequencies in females. No increase was found in males. 2-N-p-PDA, which has been reported to induce liver tumors only in females, was found positive in males and was clearly negative in females. 2,4-DAT, a liver carcinogen in female mice, was positive in females and negative in males when the animals were killed 10 days after the last treatment. After an expression time of 28 days, 2,4-DAT induced a statistically significant increase in both sexes. The effect in females was marginally stronger than after 10 days' expression time and almost identical to the effect observed in males under these test conditions. In conclusion, the experiments showed that the Big Blue assay detects the genotoxicity of the three carcinogenic monocyclic aromatic amines tested. However, it seems that the sex specificity of the carcinogenic effects of these compounds is not reflected by the mutagenicity data in Big Blue mice.
Asunto(s)
Proteínas de Escherichia coli , Hígado/efectos de los fármacos , Ratones Transgénicos/genética , Mutación , Fenilendiaminas/toxicidad , Animales , Proteínas Bacterianas/efectos de los fármacos , Proteínas Bacterianas/genética , Bromodesoxiuridina/metabolismo , Carcinógenos/toxicidad , División Celular/efectos de los fármacos , División Celular/genética , Relación Dosis-Respuesta a Droga , Femenino , Represoras Lac , Hígado/metabolismo , Masculino , Ratones , Ratones Endogámicos C57BL , Pruebas de Mutagenicidad/métodos , Mutágenos/toxicidad , Antígeno Nuclear de Célula en Proliferación/inmunología , Antígeno Nuclear de Célula en Proliferación/metabolismo , Proteínas Represoras/efectos de los fármacos , Proteínas Represoras/genéticaRESUMEN
The radical surgical option we propose for Peyronie's disease consists in removing the sclerohyalinotic focus of disease and replacing it by an autologous dermal graft taken from the upper outer thigh area. Between 1981 and 1991, we operated on 335 patients with Peyronie's disease, 152 of whom underwent plaque excision and dermal graft. All could be assessed with a 2-year follow-up. Two main complications were observed: mild penile flexure due to scar retraction of the graft (35% of cases), and partial erectile deficit with decreased corporal rigidity (17% of cases). The degree of graft retraction is linked to the individual's histologic response. A mild deviation of the penis can occur some months after surgery and is not a relapse flexure due to disease progression, but is mere scar retraction and will spontaneously regress. Because the patient will date the onset of a postoperative erectile deficit from the time of the operation, it is advisable to assess preoperatively the erectile ability of all patients. Furthermore, an impaired erectile response could result from hypoaesthesia of the glans, postsurgical stress, and fibrosis of the erectile tissue. A retrospective assessment of radical surgery cases involving plaque excision and dermal graft led us to propose this option where precise indications apply, providing that other alterations of the erectile function are preoperatively assessed.
Asunto(s)
Disfunción Eréctil/etiología , Induración Peniana/cirugía , Pene/cirugía , Complicaciones Posoperatorias , Adulto , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Pene/anatomía & histología , Estudios RetrospectivosRESUMEN
The process of thrombus formation, as a consequence of the interaction of artificial surfaces with blood, is related to the activation of blood platelets. A simple ex vivo method, which is suitable for the evaluation of the platelet-surface interaction is described. This method has been used to compare the haemocompatibility of several artificial materials, including nylon-6, Silastic and pyrolytic carbon.
Asunto(s)
Materiales Biocompatibles/metabolismo , Plaquetas/metabolismo , Animales , Plaquetas/ultraestructura , Carbono , Masculino , Métodos , Microscopía Electrónica de Rastreo , Nylons , Adhesividad Plaquetaria , Conejos , Elastómeros de Silicona , Trombosis/etiologíaRESUMEN
BACKGROUND: The patients who undergo radical pelvic surgery often found that sexual function is impaired. In this research hypothesis, we evaluated the efficacy of alternative therapy to conventional PGE 1 injections, such as the association of Sildenafil and L-Arginine. This association in based on the principle that L-Arginine, the precursor of nitric oxide, improves the effect of Sildenafil, which is effective in the presence of nitric oxide. METHODS: The experimental plan was to make a comparative study of 2 random groups of patients selected from those undergoing radical cystectomies and prostatectomies over the past three years. 116 patients were illegible (64 prostatectomies and 52 cystectomies). The fìrst random group was treated with Sildenafil alone and the second with Sildenafil and L-Arginine. The efficacy of treatment was evaluated by the Buckling test (pressure threshold of cavernous flexation at penile axial rigidity) once-after ambulatorial administration and then by telephonic interview (subjective evaluation) after home administration. RESULTS: The starter dose was 50 mg and was inefficient in both groups (Buckling test between 0 and 250). 100-mg doses gave significant results (Buckling test > 500) in both groups, especially the second. Cardiopathic patients, diabetics and patients with retinal disorders were excluded from the study. The mean age of patients was 65 years. CONCLUSIONS: The resumption of relatively satisfactory sexual activity was demonstrated using non-invasive pharmacological treatment.
Asunto(s)
Arginina/uso terapéutico , Disfunción Eréctil/tratamiento farmacológico , Disfunción Eréctil/etiología , Exenteración Pélvica/efectos adversos , Inhibidores de Fosfodiesterasa/uso terapéutico , Piperazinas/uso terapéutico , Anciano , Humanos , Masculino , Exenteración Pélvica/métodos , Purinas , Citrato de Sildenafil , SulfonasRESUMEN
BACKGROUND: In mini-invasive surgery for the treatment of urinary incontinence injectable substances such as politef, autologous fat or bovine collagen, which can increase urethral resistance or support the sphincteric one are particularly used. It's a simple procedure in which patients may undergo local anesthesia, in short time and in "day hospital" regimen. Collagen, used as an injectable bulking agent, is the gold standard for this surgical technique because of complete biocompatibility, no evidences of adverse immunogenic effects, foreign-body reaction, migration of injected material, and because of higher fluidity which allows the use of thin needles compared to Politef (polytetrafluoroethylene) where an injection device is requested. Bovine collagen is partially reabsorbed within 24-36 months and a reinjection is often necessary. Although autologous fat is cheaper than bovine collagen, its injection shows more difficulties due to the need of higher needle diameter and time to store and prepare the material to inject. METHODS: The results obtained by two different approaches: transurethral injection of collagen and periurethral injection of collagen have been studied. A total of 48 patients underwent collagen injection for treatment of urinary incontinence: 24 treated by transurethral approach and 24 by periurethral approach. Follow-up at 6, 12, 24 months after treatment includes: objective exam, PAD test, functional evaluation, complete urodynamic evaluation (uroflow, cystomanometry, LPP, pressure/flow study, UPP). RESULTS: No clinical differences between peri/trans-urethral approach were found although collagen injection via transurethral technique need fewer material, reducing cost of treatment: an efficacy of treatment in 80% of patients and restoration of a complete urinary continence in 50% of patients was obtained. Although no clinical differences were demonstrated between the two different sites of injection, transurethral approach can be used similarly in both sexes even if without a modified resector as "injection device" it's more difficult to inject collagen in the right position, at the level of bladder neck submucosa. Perineal approach, exclusive of female sex, realizes the procedure without bleeding of urethral mucosa and no waste of collagen, though a longer period of training by surgeon is requested. After four years of experience the authors agreed that with an adequate injection device (modified resector), transurethral approach should be preferred, thus depending on the possibility to inject collagen in a correct position, just under bladder neck mucosa, which is possible to manage with this technique, in order to reduce reabsorption process of collagen and to obtain a longer efficacy of treatment reducing the number of reinjection and of course the cost of treatment. Collagen injection should be considered within an integrated therapeutical picture together with topic and systemic pharmacotherapy, physiotherapy, not excluding surgery techniques such as implantation of an artificial sphincter device in man or a sling procedure in woman. CONCLUSIONS: The urethral collagen injection for the treatment of urinary incontinence is a safe, durable and valid technique to improve urinary continence through a non obstructive effect increasing urethral resistance. Performed under local anesthesia this procedure allows the treatment of patients who may not be candidates suitable for general anesthesia and conventional surgery.