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1.
Parasitol Res ; 123(4): 191, 2024 Apr 22.
Artigo em Inglês | MEDLINE | ID: mdl-38647713

RESUMO

Dirofilaria immitis is a mosquito-borne nematode-causing canine heartworm disease, with adult worms localized in the pulmonary arteries and right heart. In rare cases, ectopic migration might occur, and adults and blood circulating microfilariae can be found in unusual organs or fluids (e.g., eyes, abdominal cavity, bone marrow, and urine). A 17-year-old mixed-breed female dog was presented in a private veterinary clinic in Italy for hematuria and dysuria. Physical examination showed cardiac mitral murmur with marked respiratory distress and cyanotic mucous membranes after handling. Abdominal ultrasounds revealed a non-specific chronic cystopathy, while the echocardiography showed enlargement of the right heart associated with tricuspid insufficiency and mitral regurgitation, with the presence of an adult filariae in the right ventricular chamber. Circulating microfilariae were observed in the blood smear and molecularly identified as D. immitis. Unusual microfilaruria was detected in the urine sediment. Data presented raise awareness about the occurrence of microfilariae in unusual locations, such as the bladder, suggesting the need of a thorough clinical and laboratory assessment where D. immitis is endemic.


Assuntos
Dirofilaria immitis , Dirofilariose , Doenças do Cão , Microfilárias , Animais , Dirofilariose/parasitologia , Dirofilariose/diagnóstico , Cães , Dirofilaria immitis/isolamento & purificação , Doenças do Cão/parasitologia , Doenças do Cão/diagnóstico , Itália , Feminino , Microfilárias/isolamento & purificação , Urina/parasitologia
2.
Intern Emerg Med ; 19(1): 71-79, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37794281

RESUMO

Coronavirus disease 2019 (COVID-19) carries a high risk of vascular thrombosis. However, whether a specific anticoagulation intensity strategy may prevent clinical worsening in severe COVID-19 patients is still debated. We conducted a joint analysis of two randomized controlled trials, COVID-19 HD (NCT044082359) and EMOS-COVID (NCT04646655), to assess the efficacy and safety of two anticoagulant regimens in hospitalized severe COVID-19 patients. Subjects with COVID-19-associated respiratory compromise and/or coagulopathy were randomly assigned to low (4000 IU qd) or high (70 IU Kg-1 every 12 h) enoxaparin dose. The primary efficacy endpoint was clinical worsening within 30 days, defined as the occurrence of at least one of the following events, whichever came first: in-hospital death, evidence of arterial or venous thromboembolism, acute myocardial infarction, need for either continuous positive airway pressure (CPAP) or non-invasive ventilation (NIV) in patients receiving standard oxygen therapy or none at randomization, and need for mechanical ventilation in any patient. The safety endpoint was major bleeding. We estimated the relative risk (RR) and its 95% confidence interval (CI) for the outcomes. Among 283 patients included in the study (144 in the low-dose and 139 in the high-dose group), 118 (41.7%) were on NIV or CPAP at randomization. 23/139 (16.5%) patients in the high-dose group reached the primary endpoint compared to 33/144 (22.9%) in the low-dose group (RR 0.72, 95% CI 0.45-1.17). No major bleeding was observed. No significant differences were found in the clinical worsening of hospitalized COVID-19 patients treated with high versus low doses of enoxaparin.


Assuntos
COVID-19 , Heparina de Baixo Peso Molecular , Humanos , Anticoagulantes/efeitos adversos , COVID-19/complicações , Enoxaparina/efeitos adversos , Hemorragia/induzido quimicamente , Heparina de Baixo Peso Molecular/efeitos adversos , Mortalidade Hospitalar , Ensaios Clínicos Controlados Aleatórios como Assunto
3.
Cancers (Basel) ; 13(18)2021 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-34572782

RESUMO

New avenues for glioblastoma therapy are required due to the limited mortality benefit of the current treatments. The renin-angiotensin system (RAS) exhibits local actions and works as a paracrine system in different tissues and tumors, including glioma. The glioblastoma cell lines U-87 MG and T98G overexpresses Angiotensin II (Ang II)/Angiotensin II type I receptor (AGTR1) signaling, which enhances in vitro and in vivo local estrogen production through a direct up-regulation of the aromatase gene promoters p I.f and p I.4. In addition, Ang II/AGTR1 signaling transactivates estrogen receptor-α in a ligand-independent manner through mitogen-activated protein kinase (MAPK) activation. The higher aromatase mRNA expression in patients with glioblastoma was associated with the worst survival prognostic, according to The Cancer Genome Atlas (TCGA). An intrinsic immunosuppressive glioblastoma tumor milieu has been previously documented. We demonstrate how Ang II treatment in glioblastoma cells increases programmed death-ligand 1 (PD-L1) expression reversed by combined exposure to Losartan (LOS) in vitro and in vivo. Our findings highlight how LOS, in addition, antagonizes the previously documented neoangiogenetic, profibrotic, and immunosuppressive effects of Ang II and drastically inhibits its stimulatory effects on local estrogen production, sustaining glioblastoma cell growth. Thus, Losartan may represent an adjuvant pharmacological tool to be repurposed prospectively for glioblastoma treatment.

4.
Radiol Med ; 126(3): 494-497, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33047296

RESUMO

BACKGROUND: Percutaneous renal artery embolization is a valid non-invasive technique alternative to nephrectomy for patients with symptomatic non-functioning allograft (graft intolerance syndrome-GIS). The purpose of this article is to report the experience of our centre. METHODS: We analysed retrospectively 15 patients with symptomatic non-functioning renal allograft treated with percutaneous embolization from 2003 to 2017. Occlusion was obtained with the injection of calibrated microspheres of increasing size (from 100 to 900 µm) and completed with 5 to 8 mm metal coils placement in the renal artery. RESULTS: Technical success was achieved in all cases at the end of the procedure. Clinical success was obtained in 11 patients (73%). In four cases, nephrectomy was necessary: in one case because of septic fever and in three cases because of GIS persistence. In one case, it was possible to perform another procedure to embolize a perirenal collateral from a lumbar artery. Four patients (27%) reported minor complications which spontaneously resolved during the hospital stay. CONCLUSIONS: According to the scientific literature, we believe that, in selected patients, percutaneous renal artery embolization is a valid treatment option for GIS thanks to its efficacy, repeatability, minimal invasiveness and the absence of severe complications.


Assuntos
Embolização Terapêutica/métodos , Rejeição de Enxerto/terapia , Microesferas , Complicações Pós-Operatórias/terapia , Artéria Renal , Stents , Adolescente , Adulto , Embolização Terapêutica/efeitos adversos , Feminino , Rejeição de Enxerto/cirurgia , Humanos , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Nefrectomia , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Síndrome
5.
Radiol Med ; 126(1): 170-177, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-32377914

RESUMO

OBJECTIVES: To evaluate the incidence and clinical significance of pneumothorax (PTX) and pulmonary hemorrhage (PH) after CT-guided lung biopsy (CT-LB). To test correlations of PTX and chest tube insertion (CTI) with PH and other imaging and procedural parameters. METHODS: Pre-procedural CT and CT-LB scans of 904 patients were examined. Incidence of PTX and PH and PH location (type-1 along needle track; type-2 perilesional) and severity according to its thickness (low grade < 6 mm; high grade > 6 mm) were recorded. PTX was considered clinically significant if treated with CTI, PH if treated with endoscopic/endovascular procedure. Binary logistic regression analyses were used to determine the effects of different imaging and procedural parameters on the likelihood to develop PTX, CTI and PH and to define their correlation. RESULTS: PTX occurred in 306/904 cases (33.8%); CTI was required in 18/306 (5.9%). PH occurred in 296/904 cases (32.7%), and no case required treatment. Nodule-to-pleura distance (ORPTX = 1.052; ORCTI = 1.046; ORPH 1.077), emphysema (ORPTX = 1.287; ORPH = 0.573), procedure time (ORPTX = 1.019; ORCTI = 1.039; ORPH = 1.019), target size (ORPTX = 0.982; ORPH = 0.968) and needle gauge (ORPTX = 0.487; ORCTI = 4.311; ORPH = 2.070) showed statistically significant correlation to PTX, CTI and PH. Type-1 PH showed a protective effect against PTX and CTI (ORPTX = 0.503; ORCTI = 0.416). CONCLUSION: PTX and PH have similar incidence after CT-guided lung biopsy. PH along needle track may represent a protective factor against development of PTX and against PTX requiring CTI.


Assuntos
Hemorragia/etiologia , Biópsia Guiada por Imagem/efeitos adversos , Pneumopatias/patologia , Lesão Pulmonar/etiologia , Pneumotórax/etiologia , Tomografia Computadorizada por Raios X , Idoso , Feminino , Hemorragia/epidemiologia , Humanos , Doença Iatrogênica , Incidência , Lesão Pulmonar/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumotórax/epidemiologia , Fatores de Risco
6.
Biomolecules ; 10(6)2020 06 09.
Artigo em Inglês | MEDLINE | ID: mdl-32526957

RESUMO

Glioblastoma multiforme (GBM) is the most malignant form of glioma, which represents one of the commonly occurring tumors of the central nervous system. Despite the continuous development of new clinical therapies against this malignancy, it still remains a deadly disease with very poor prognosis. Here, we demonstrated the existence of a biologically active interaction between leptin and Notch signaling pathways that sustains GBM development and progression. We found that the expression of leptin and its receptors was significantly higher in human glioblastoma cells, U-87 MG and T98G, than in a normal human glial cell line, SVG p12, and that activation of leptin signaling induced growth and motility in GBM cells. Interestingly, flow cytometry and real-time RT-PCR assays revealed that GBM cells, grown as neurospheres, displayed stem cell-like properties (CD133+) along with an enhanced expression of leptin receptors. Leptin treatment significantly increased the neurosphere forming efficiency, self-renewal capacity, and mRNA expression levels of the stemness markers CD133, Nestin, SOX2, and GFAP. Mechanistically, we evidenced a leptin-mediated upregulation of Notch 1 receptor and the activation of its downstream effectors and target molecules. Leptin-induced effects on U-87 MG and T98G cells were abrogated by the selective leptin antagonist, the peptide LDFI (Leu-Asp-Phe-Ile), as well as by the specific Notch signaling inhibitor, GSI (Gamma Secretase Inhibitor) and in the presence of a dominant-negative of mastermind-like-1. Overall, these findings demonstrate, for the first time, a functional interaction between leptin and Notch signaling in GBM, highlighting leptin/Notch crosstalk as a potential novel therapeutic target for GBM treatment.


Assuntos
Glioblastoma/metabolismo , Leptina/metabolismo , Receptor Notch1/metabolismo , Movimento Celular , Proliferação de Células , Células Cultivadas , Glioblastoma/patologia , Humanos , Leptina/genética , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Receptor Notch1/genética , Transdução de Sinais
7.
Radiol Med ; 125(8): 790-797, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32206984

RESUMO

INTRODUCTION: To retrospectively evaluate the mid-term outcomes of percutaneous radiofrequency ablation (RFA) with multitined expandable electrodes externally cooled with saline solution in patients with T1a renal cell carcinoma (RCC). MATERIALS AND METHODS: In this retrospective study, we evaluated 39 RCC in 35 patients treated with CT-guided RFA in 41 procedures (2011-2017). All patients were staged T1a, N0, M0 prior to RFA. Mean tumor size was 24.48 mm. A 4-tined expandable RFA electrode cooled with pump-circulating saline was used. Efficacy was evaluated verifying complete tumor necrosis (no contrast enhancement on imaging) at the end of the procedure and on subsequent controls. Follow-up observation period was 5 years. Minor/major complications, hospitalization days, serum creatinine and GFR pre- and post-RFA (compared using paired t test) and post-operative pain (evaluated with NRS after treatment) were considered as safety indicators. Overall survival was also calculated (Kaplan-Meier method). RESULTS: Of 35 patients, 30/35 had 1 treatment (primary effectiveness rate 86%), 4/35 had 2 treatments and 1/35 had 3 treatments for residual disease. There were no relapses and no mid-long-term complications; 3 minor (8%) and 1 major (2.7%) complications during perioperative period were reported. Mean before and after RFA serum creatinine rates were, respectively, 1.08 mg/dl and 1.11 mg/dl (p value: 0.4117). NRS median value is 0.8. Hospitalization days median value is [2.8 ± 1.9] days. 91.4% of all patients survived, with a median overall survival time of 65 months. CONCLUSIONS: Mid-term results show that CT-guided RFA with multitined expandable electrodes externally cooled with saline solution is an effective and safe treatment in patients with RCC-staged T1aN0M0. Data reported in our study are in line with data reported in the literature from patients treated with other devices.


Assuntos
Carcinoma de Células Renais/cirurgia , Ablação por Cateter/instrumentação , Eletrodos , Neoplasias Renais/cirurgia , Radiografia Intervencionista , Tomografia Computadorizada por Raios X , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Renais/patologia , Desenho de Equipamento , Feminino , Humanos , Neoplasias Renais/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Complicações Pós-Operatórias , Estudos Retrospectivos
8.
Gland Surg ; 8(Suppl 3): S223-S232, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31559189

RESUMO

Detection of adrenal lesions, because of the widespread use of imaging and especially high-resolution imaging procedures, is increased. Because of the importance to characterize those findings, magnetic resonance imaging (MRI), in particular chemical shift imaging (CSI), is useful to distinguish whether a lesion is benignant or malignant and to avoid further diagnostic or surgical procedures. It represents the first choice of imaging in patient like children or pregnant women, and a valid complement to other imaging techniques like CT or PET/CT. In this review we analyze the role and characteristic of MRI and the imaging features of most common benignant (adenoma, hyperplasia, pheochromocytoma, hemorrhage, cyst, myelolipoma, teratoma, ganglioneuroma, cystic lymphangioma, hemangioma) and malignant [neuroblastoma, adrenocortical carcinoma (ACC), metastases, lymphoma] adrenal lesions.

9.
Acta Biomed ; 90(5-S): 62-67, 2019 04 24.
Artigo em Inglês | MEDLINE | ID: mdl-31085974

RESUMO

Percutaneous Needle Biopsy (PNB) is the insertion of a needle into a suspected lesion or an organ with the aim to obtain cells or tissue for diagnosis. It's a relatively non-invasive procedure and is performed by radiologist under guidance of imaging techniques such as ultrasound (US), computed tomography (CT), fluoroscopy, magnetic resonance imaging (MRI), and positron emission tomography CT (PET-CT). The choice of imaging technique depends on the evaluation of the target lesion and patient compliance. PNB includes two categories: fine-needle aspiration biopsy (FNAB) that is the use of a thin needle (18-25 gauge) to extract cells for cytological evaluation; and core needle biopsy (CNB) that is the use of a larger needle (9-20 gauge) to extract a piece of tissue for histological evaluation. The indications for biopsy are the characterization of nature (benign or malignant) of a lesion, diagnosis and staging of tumor, and biological or immunohistochemical/genetic analisys on tissue. Success of PNB is the procurement of sufficient material to characterize lesions and to guide the patient outcome.  Major complications are rare. PNB became a useful technique in diagnosis and study of retroperitoneal lesions, because of a more suitable access to specific intra-abdominal structures, lowering the risk of injury of interposed structures (such as bowel, great vessels).


Assuntos
Biópsia por Agulha Fina/métodos , Tomografia por Emissão de Pósitrons combinada à Tomografia Computadorizada/métodos , Neoplasias Retroperitoneais/diagnóstico , Ultrassonografia Doppler em Cores/métodos , Humanos , Espaço Retroperitoneal
10.
Acta Biomed ; 90(5-S): 95-100, 2019 04 24.
Artigo em Inglês | MEDLINE | ID: mdl-31085978

RESUMO

Rotator cuff calcific tendinopathy (RCCT) is a common and painful shoulder disease characterised  by deposition of calcium into the rotator cuff's tendond. Different therapeutic options have been proposed, but the ultrasound-guided percutaneous irrigation (US-PICT) is been proved as an effective and safe first-line treatment. It can be performed with a single- of a double-needle tecnique, using warm saline solution to improve the dissolution of the calcific deposit. The procedure is ended with an intrabursal injection of local anaesthetics and slow-release steroids to improve the pain relief and to prevent complications. US-PICT leads to significative improvement in the shoulder funtion and pain relief in the short and long term, with a low complications rate.


Assuntos
Anestesia Local/métodos , Calcinose/complicações , Manguito Rotador/diagnóstico por imagem , Dor de Ombro/terapia , Tendinopatia/terapia , Ultrassonografia de Intervenção/métodos , Anestésicos Locais/uso terapêutico , Artroscopia/métodos , Calcinose/diagnóstico , Calcinose/terapia , Humanos , Dor de Ombro/diagnóstico , Dor de Ombro/etiologia , Tendinopatia/complicações , Tendinopatia/diagnóstico , Irrigação Terapêutica
11.
Future Oncol ; 15(10): 1125-1134, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30880466

RESUMO

Computed tomography-guided lung biopsy is a valid and safe procedure for characterizing pulmonary nodules. In the past years, this technique has been mainly used to confirm the malignant nature of undetermined pulmonary lesions; however, today its role has been completely renewed. With the advent of target therapy and immunotherapy, it has arisen for lung cancer, in inoperable patients, the necessity to obtain adequate bioptical material to perform a correct molecular characterization of the lesion. Moreover, the possibility of acquired drug-resistance mechanisms makes it necessary in some cases to rebiopsy these lesions over time. For these reasons, it is likely that the request of computed tomography-guided lung biopsy will increase in the future, therefore every radiologist should be confident with its most important aspects.


Assuntos
Biópsia Guiada por Imagem/métodos , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/cirurgia , Medicina de Precisão , Tórax/diagnóstico por imagem , Tomografia Computadorizada por Raios X/métodos , Idoso , Feminino , Humanos , Neoplasias Pulmonares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Prognóstico
12.
Future Oncol ; 14(28): 2915-2922, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29441805

RESUMO

The number of percutaneous radiofrequency ablation procedures performed for renal tumors is progressively increasing worldwide. Periodic imaging follow-up has the double role to guarantee the treatment efficacy over time and to early detect any possible complication. Tumor size reductions, as well as the appearance of the characteristic 'halo sign', are normal findings that represent good ablative outcomes. However the most reliable factor of ablation efficacy remains the total absence of contrast enhancing zones within the ablated area. The aim of this article is to illustrate the typical aspect of an effective radiofrequency ablation treatment, which are the imaging findings that may suggest the presence of residual tumoral tissue and which are the main early and late procedural complications.


Assuntos
Diagnóstico por Imagem , Neoplasias Renais/diagnóstico por imagem , Idoso , Idoso de 80 Anos ou mais , Diagnóstico por Imagem/métodos , Feminino , Seguimentos , Humanos , Processamento de Imagem Assistida por Computador , Neoplasias Renais/patologia , Neoplasias Renais/terapia , Imageamento por Ressonância Magnética , Masculino , Ablação por Radiofrequência/efeitos adversos , Ablação por Radiofrequência/métodos , Tomografia Computadorizada por Raios X , Resultado do Tratamento
13.
Acta Biomed ; 89(1-S): 34-47, 2018 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-29350636

RESUMO

Infants and children undergo imaging studies to evaluate a wide variety of congenital and acquired disorders. Imaging protocols have to consider the patient's comfort, level of anxiety, and smaller size. The first imaging study is usually made with plain radiographs. The routine radiographic examination of the foot includes the anteroposterior (AP), lateral, and oblique projections. Magnetic Resonance Imaging (RMI) provides excellent anatomic detail of cartilage, vasculature and soft tissue thanks to superior soft tissue contrast and spatial resolution, so is valuable in many cases. According to the clinical and objective signs, guided by the radiographs images, we can be oriented to perform Computed Tomography (CT), CT imaging or MRI imaging. CT imaging is useful to observe the bones but it has the disadvantage of using radiation and doesn't  adequately define the bone's non-ossified portions. On the contrary, MRI imaging is very useful in identifying the cartilaginous parts and vascular and soft tissues, thanks to its superior contrast and spatial resolution. Finally, it is important to orientate the diagnostic process keeping in mind the clinical sign of the patient and to use the most appropriate diagnostic technique.


Assuntos
Deformidades Congênitas do Pé/diagnóstico por imagem , Artrite Infecciosa/diagnóstico por imagem , Doenças Ósseas/diagnóstico por imagem , Medula Óssea/diagnóstico por imagem , Criança , Ossos do Pé/anormalidades , Ossos do Pé/diagnóstico por imagem , Ossos do Pé/lesões , Fraturas Ósseas/diagnóstico por imagem , Humanos
14.
Acta Biomed ; 89(1-S): 166-174, 2018 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-29350645

RESUMO

Interventional radiology has known an exponential growth in the last years. Technological advances of the last decades, have made it possible to use new treatments on a larger scale, with safe and effective results. They could be considered as palliative treatments for painful lesions but also curative procedures, as single treatment or specially in combination with other techniques (surgery, radiation and oncology therapies, etc.).The main diffuse techniques are those of thermal ablation that destroy the target lesion through the heat; however there are also endovascular therapies that destroy the target tissue thanks to devascularization. Finally the is also the possibility to stabilize pathological fractures or impending fractures. In this paper all the most diffuse and effective techniques are reviewed and also a discussion of the main indications is done, with an analisys of the success and complications rates.


Assuntos
Técnicas de Ablação , Neoplasias Ósseas/cirurgia , Fixação Interna de Fraturas/métodos , Fraturas Espontâneas/cirurgia , Radiologia Intervencionista , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/secundário , Fraturas Espontâneas/diagnóstico por imagem , Humanos
15.
Acta Biomed ; 89(1-S): 175-185, 2018 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-29350646

RESUMO

Osteoid osteoma is a benign bone neoplasm with a reported incidence of 2-3% among all bone primary tumors. Although it is a small and benign lesion, it is often cause of patient complaint and discomfort. It is generally characterized by a long lasting, unremitting pain that typically exacerbates at night, often leading to sleep deprivation and functional limitation of the skeletal segment involved, with a significant reduction of patient daily life activities and consequent worsening of the overall quality of life. Over decades, complete surgical resection has represented the only curative treatment for symptomatic patients. In the last years, new percutaneous ablation techniques, especially radiofrequency ablation, have been reported to be a safe and effective alternative to classical surgery, with a low complication and recurrence rate, and a significant reduction in hospitalization cost and duration. The aim of this article is to provide an overview about the radiofrequency thermal ablation procedure in the treatment of osteoid osteoma.


Assuntos
Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/cirurgia , Osteoma Osteoide/diagnóstico por imagem , Osteoma Osteoide/cirurgia , Ablação por Radiofrequência/métodos , Humanos , Imageamento Tridimensional , Imagem por Ressonância Magnética Intervencionista , Radiografia Intervencionista
16.
Thromb Res ; 133 Suppl 2: S56-62, 2014 May.
Artigo em Inglês | MEDLINE | ID: mdl-24862147

RESUMO

Bleeding occurs in approximately 10% of patients with cancer: supportive transfusion therapy with Platelets Concentrates (PC), Fresh Frozen Plasma (FFP) and plasma-derived or recombinant concentrates is often required for the cessation and prevention of the bleeding episodes. The most frequent causes of bleeding in cancer is thrombocytopenia followed by liver insufficiency with or without vitamin K deficiency, disseminated intravascular coagulation (DIC) and the inappropriate or excessive use of anticoagulants. Other acquired hemostatic defects such as acquired hemophilia (AHA) and acquired von Willebrand syndrome (AVWS) are rare but they can be life-threatening. Thrombocytopenia in cancer patients may be the consequence of marrow invasion, chemotherapy or platelet auto-antibodies; patients with severe hypoproliferative thrombocytopenia, must be treated with PC and carefully followed to assess refractoriness to PC. The management of the other acquired defects of hemostasis usually requires the use of FFP and specific plasma-derived or recombinant concentrates. PC, FFP and plasma-derived concentrates can induce complications and/or adverse events in cancer patients: these include mainly allergic (ALR) or anaphylactic reactions (ANR), Transfusion-Associated Graft-Versus-Host Disease (TA-GVHD), Trasfusion-transmitted bacteriemia (TTB), Transfusion-Related Acute Lung Injury (TRALI), Acute Hemolytic Transfusion Reactions (AHTR), Febrile Non Hemolytic Transfusion Reactions (FNHTR). Therefore, modifications such as leukocyte-reduction and irradiation of the blood components to be transfused in cancer patients are recommended to reduce the risk of these complications.


Assuntos
Transfusão de Componentes Sanguíneos/métodos , Hemorragia/terapia , Neoplasias/complicações , Transfusão de Plaquetas/métodos , Trombocitopenia/terapia , Reação Transfusional/etiologia , Anticoagulantes/administração & dosagem , Anticoagulantes/efeitos adversos , Transfusão de Componentes Sanguíneos/efeitos adversos , Hemorragia/induzido quimicamente , Humanos , Neoplasias/sangue , Plasma , Transfusão de Plaquetas/efeitos adversos , Trombocitopenia/etiologia
17.
Arch Ital Urol Androl ; 86(1): 9-14, 2014 Mar 28.
Artigo em Inglês | MEDLINE | ID: mdl-24704924

RESUMO

OBJECTIVE: A precise characterization of erectile dysfunction (ED) of vascular origin has not yet been achieved, although cavernous peak systolic velocity (PSV) is generally considered a major parameter. Nevertheless the penile dynamic color Doppler is invasive and linked to several complications. The intima-media thicknesses (IMT) of cavernosal artery would add to the predictive value of vasculogenic ED risk and outcomes. We also hypothesized the existence of a correlation between IMT cavernosal artery and IMT carotid arteries. This study seeks to evaluate these hypotheses with our experience, investigating the predictive accuracy of carotid and cavernosal Doppler ultrasound findings for discriminating patients with vasculogenic ED. MATERIAL AND METHODS: A total of 59 subjects (32 vasculogenic ED patients - group A - and 27 no vasculogenic ED patients - group B) were evaluated in our andrological center from September 2012 to June 2013 and enrolled in the study. All subjects underwent medical history, erectile function domain of the International Index of Erectile Function, physical examination, routine and sex hormone blood tests, and high resolution dynamic color Doppler ultrasound evaluation of carotid and penile districts and valuation of IMT in both districts. RESULTS: The values of cavernosal artery IMT in group A were higher than in group B (0,28 ± 0,06 mm vs 0,17 ± 0,07 mm). Even the values of carotid artery IMT in vasculogenic ED group were higher than in no vasculogenic ED group (0,74 ± 0,14 mm vs 0,59 ± 0,11 mm). The cavernosal IMT showed a moderate (r = 0.61) positive linear correlation (p < 0.001) with the carotid artery IMT. CONCLUSIONS: An increased cavernous IMT might predict ED of vascular origin with more accuracy than PSV and could be a sensitive predictor also for systemic atherosclerosis at an earlier phase.


Assuntos
Disfunção Erétil/diagnóstico , Pacientes Ambulatoriais , Pênis/irrigação sanguínea , Pênis/diagnóstico por imagem , Túnica Íntima/patologia , Túnica Média/patologia , Ultrassonografia Doppler em Cores , Adulto , Estudos de Casos e Controles , Endotélio Vascular/diagnóstico por imagem , Disfunção Erétil/diagnóstico por imagem , Disfunção Erétil/patologia , Hemodinâmica , Humanos , Impotência Vasculogênica/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Túnica Íntima/diagnóstico por imagem , Túnica Média/diagnóstico por imagem
18.
J Crohns Colitis ; 6(3): 362-7, 2012 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-22405175

RESUMO

BACKGROUND AND METHODS: Portal vein thrombosis (PVT) has been reported as a complication of IBD in some case reports. We describe the presentation, diagnostic approaches, underlying risks factors and clinical outcome of 8 IBD patients with PVT. CASE-SERIES: The patients presented with partial PVT (4 patients) or portal cavernoma. Five patients had undergone surgery. In 2 patients portal biliopathy was diagnosed after detection of PVT. In 4 patients, the diagnosis of PVT was made while IBD was in remission. Five patients showed at least one risk factor for hypercoagulability: lupus anti-coagulant (one patient), increased von Willebrand factor (2 patients) or homocysteine levels (4 patients). Four patients received anticoagulant therapy for 6 months. None experienced other thrombotic events during a median of 5 years (range 2-8 years). CONCLUSION: PVT is a potential complication of IBD, usually associated with acquired or inherited risks factors for hypercoagulability and with a benign outcome.


Assuntos
Colite Ulcerativa/complicações , Doença de Crohn/complicações , Veia Porta , Trombose Venosa/complicações , Adulto , Anticoagulantes/uso terapêutico , Feminino , Homocisteína/sangue , Humanos , Inibidor de Coagulação do Lúpus/sangue , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Trombofilia/sangue , Trombofilia/complicações , Trombofilia/genética , Trombose Venosa/sangue , Trombose Venosa/tratamento farmacológico , Fator de von Willebrand/metabolismo
19.
Acta Biomater ; 8(6): 2068-76, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22342825

RESUMO

Superparamagnetic nanoparticles (20-40 nm) of maghemite, γ-Fe(2)O(3), with well-defined stoichiometric structure, are synthesized by the borohydride reduction of ferric chloride at an elevated temperature (100°C) followed by thermal treatment of the reaction product. Prepared maghemite nanoparticles reveal excellent colloidal stability for a long time without the necessity for any additional surface modification. These colloidal features are due to surface stabilizing OH(-) groups, which act as charge barriers preventing a particle aggregation and enabling a reversible binding of various oppositely charged organic substances. Such binding with rhodamine B isothiocyanate results in the fluorescent magnetic nanocarrier providing, at the same time, a spacer arm for covalent immobilization of other biosubstances including enzymes. In this work, we exploit this general applicability of the developed nanocarrier for covalent immobilization of glucose oxidase. This is the first reported example of magnetically drivable fluorescent nanocatalyst. The immobilized enzyme creates a 3-5 nm thick layer on the nanoparticle surface as proved by high-resolution transmission electron microscopy. This layer corresponds to 10 enzyme molecules, which are bound to the nanoparticle surface as found by the fluorimetric determination of flavin adenine dinucleotide. The developed magnetic fluorescent nanocatalyst, showing a rate constant of 32.7s(-1) toward glucose oxidation, can be used as a biosensor in various biochemical, biotechnological, and food chemistry applications. The presence of the nanocatalyst can be simply monitored by its fluorescence; moreover, it can be easily separated from the solution by an external magnetic field and repeatedly used without a loss of catalytic efficiency.


Assuntos
Técnicas Biossensoriais , Radical Hidroxila/química , Rodaminas/química , Fluorescência , Magnetismo , Microscopia Eletrônica de Varredura , Microscopia Eletrônica de Transmissão , Espectroscopia de Mossbauer
20.
J Inorg Biochem ; 103(5): 738-44, 2009 May.
Artigo em Inglês | MEDLINE | ID: mdl-19237201

RESUMO

The complexes [Me(2)(Meclo)SnOSn(Meclo)Me(2)](2) (2) and [Ph(3)Sn(Meclo)] (3) where HMeclo is meclofenamic acid, N-(2,6-dichloro-m-tolylanthranilic acid)], have been prepared and structurally characterized by means of vibrational, (1)H and (13)C NMR spectroscopies. The crystal structure of complexes (2) and (3) have been determined by X-ray crystallography. Three distannoxane rings are present to the dimeric tetraorganodistannoxane of planar ladder arrangement of (2). The structure is centro symmetric and features a central rhombus Sn(2)O(2) unit two additional tin atoms linked at the oxygen atoms. Five- and six-coordinated tin centers are present in the dimer distannoxane. X-ray analysis of (3) revealed a penta-coordinated structure containing Ph(3)Sn coordinated to the chelated carboxylato group. The polar imino hydrogen atom participates in intra-molecular hydrogen bonds. Complexes (2) and (3) are self-assembled via pi-->pi, C-H-pi, stacking interactions and intra-molecular hydrogen bonds. Meclofenamic acid and [Ph(3)Sn(Meclo)] have been evaluated for antiproliferative activity in vitro against three human cancer cell lines: MCF-7 (human breast cancer cell line), T24 (bladder cancer cell line), A-549 (non-small cell lung carcinoma) and a mouse L-929 (a fibroblast-like cell line cloned from strain L). The [Ph(3)Sn(Meclo)] complex exhibited high cytotoxic activity against all the cancer cell lines. Meclofenamic and [Ph(3)Sn(Meclo)] were tested for anti-mycobacterial activity against Mycobacterium tuberculosis H37Rv. The [Ph(3)Sn(Meclo)] complex was found to be a promising anti-mycobacterial lead compound, displaying high activity against M. tuberculosis H37Rv.


Assuntos
Antituberculosos/química , Antituberculosos/síntese química , Proliferação de Células/efeitos dos fármacos , Ácido Meclofenâmico/química , Compostos Orgânicos de Estanho/química , Compostos Orgânicos de Estanho/síntese química , Animais , Antituberculosos/farmacologia , Linhagem Celular , Linhagem Celular Tumoral , Cristalografia por Raios X , Humanos , Espectroscopia de Ressonância Magnética , Camundongos , Modelos Moleculares , Estrutura Molecular , Mycobacterium tuberculosis/efeitos dos fármacos , Compostos Orgânicos de Estanho/farmacologia , Espectrofotometria Infravermelho , Relação Estrutura-Atividade
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