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1.
J Neurol ; 270(11): 5475-5482, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37491680

RESUMO

BACKGROUND: Given that the pathogenetic process of ALS begins many years prior to its clinical onset, examining patients' residential histories may offer insights on the disease risk factors. Here, we analyzed the spatial distribution of a large ALS cohort in the 50 years preceding the disease onset. METHODS: Data from the PARALS register were used. A spatial cluster analysis was performed at the time of disease onset and at 1-year intervals up to 50 years prior to that. RESULTS: A total of 1124 patients were included. The analysis revealed a higher-incidence cluster in a large area (435,000 inhabitants) west of Turin. From 9 to 2 years before their onset, 105 cases were expected and 150 were observed, resulting in a relative risk of 1.49 (P = 0.04). We also found a surprising high number of patients pairs (51) and trios (3) who lived in the same dwelling while not being related. Noticeably, these occurrences were not observed in large dwellings as we would have expected. The probability of this occurring in smaller buildings only by chance was very low (P = 0.01 and P = 0.04 for pairs and trios, respectively). CONCLUSIONS: We identified a higher-incidence ALS cluster in the years preceding the disease onset. The cluster area being densely populated, many exposures could have contributed to the high incidence ALS cluster, while we could not find a shared exposure among the dwellings where multiple patients had lived. However, these findings support that exogenous factors are likely involved in the ALS pathogenesis.


Assuntos
Esclerose Lateral Amiotrófica , Humanos , Esclerose Lateral Amiotrófica/epidemiologia , Esclerose Lateral Amiotrófica/etiologia , Risco , Incidência , Análise por Conglomerados
2.
Animal ; 16(11): 100654, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36215797

RESUMO

Oral live vaccines stimulate host immunity, but they could also affect intestinal mucosa development and gut microbiota of piglets during the postweaning. The aim of this study was to determine the effect of an oral vaccine against Escherichia coli F4 and F18 (Coliprotec F4/F18®), on gut functionality and integrity, growth performance and health status of postweaning piglets. A total of 96 weaned piglets (23.30 ±â€¯1.85 days of age; 7334 ±â€¯1039 g BW) were divided into two groups (16 replicates/group; three piglets/replicate) as follows: (1) Control (CO), fed a standard diet (prestarter up to 14 days, then starter feed); (2) Treated (TRT): as CO but vaccinated with Coliprotec F4/F18® at weaning (day 0). Piglets were weighed at day 0 and weekly until day 35. Individual faecal score was recorded daily. Piglets were sacrificed at days 10 (1/3 of total) and 35 (2/3). Samples of jejunum mucosa and of cecum content were collected for morphometric, immunohistochemistry analysis and for microbiota profile analysis, respectively. Data were fitted using a linear model including treatment, class of starting BW as fixed factors and litter as random factor. From days 0 to 7, piglets from the TRT group tended to have a higher average daily gain (+22.6%, P = 0.08) and average daily feed intake compared to the CO group (+13.2%, P = 0.022). Gain to feed ratio was lower in the TRT group from days 14 to 35 (-6.6%, P = 0.011). From days 7 to 14, the TRT group had a higher diarrhoea index (-199%, P < 0.001). Crypt depth was higher in the CO group (+10.9%, P = 0.04) at day 10, but not at day 35. Jejunal expression of Claudin-4 (probability of having a score = 3) was higher in the TRT group at day 10 (CO = 1.50% vs TRT = 2.69%, P < 0.0001) and day 35 (CO = 1.29% vs TRT = 1.92%, P = 0.012). Oral vaccine affected beta diversity at day 10 (P = 0.040; R2 = 0.05) and increased the abundance of specific taxa and genera in the cecum at day 10, including Prevotella (lg2FC = 23.2, FDR < 0.001). The results showed how an Escherichia coli-based vaccine supplied to weaned pigs can promote gut health by controlling symptoms of the postweaning perturbation in the first 2 weeks postweaning. In addition, the vaccine strains showed a probiotic-like effect by modulating gut microbiota favouring the establishment of beneficial bacteria, and by promoting gut barrier integrity.


Assuntos
Escherichia coli Enterotoxigênica , Infecções por Escherichia coli , Suínos , Animais , Desmame , Vacinas Combinadas , Dieta/veterinária , Infecções por Escherichia coli/prevenção & controle , Infecções por Escherichia coli/veterinária , Nível de Saúde , Ração Animal/análise , Suplementos Nutricionais
3.
Sci Rep ; 12(1): 14905, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-36050357

RESUMO

In the Mediterranean Sea, the Strait of Messina (MS) is a very peculiar area, connecting highly different regions and representing a privileged observatory for an early comprehension and assessment of ecosystems shifts. It is hypothesized that the outbreaks observed near the coast of many sites in the Mediterranean Sea may be the result of transport of permanent populations of P. noctiluca in pelagic waters to the coast, caused by specific hydrodynamic conditions. By both visual observations and numerical experiments our objective is twofold: (A) to help clarify whether the basin of the Aeolian Islands Archipelago (AIA), in the Southern Tyrrhenian Sea (STS), may be the site from which large populations of P. noctiluca are transported to the MS, and (B) to evaluate whether the upwelling turbulent system of the MS can be an energetic opportunity for this species. It should offer a rich habitat without jeopardizing the overall survival of the population, that is subject to stranding due to strong currents. Although very different, the two involved ecosystems (AIA and MS ) are complementary for the success of Pelagia noctiluca life cycle. Outputs obtained by coupling the 3D hydrodynamic model (SHYFEM) with a Lagrangian particle tracking model support the hypothesis of a connectivity between these two ecosystems, particularly in the first half of the year, indicating the coastal areas around the AIA as potential optimal source location for Pelagia larval stages. We support the very attractive hypothesis that two connected systems exist, the former one favours Pelagia's reproduction and acts as a nursery and the latter favours its growth due to higher productivity. We speculate that the reproductive population of the AIA is not permanent, but is renewed every year by individuals who have fed and quickly grown in the MS and who are passively transported by downwelling along canyon "corridors".


Assuntos
Dinoflagellida , Cifozoários , Animais , Ecossistema , Humanos , Mar Mediterrâneo
4.
J Prev Med Hyg ; 50(2): 109-12, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-20099441

RESUMO

INTRODUCTION: In all Italian regions influenza vaccine is routinely administered to the elderly population. However, vaccination impact has been rarely evaluated because of the high costs of conventional cohort investigations. A promising low-cost alternative approach uses administrative discharge data to derive vaccine effectiveness indicators (hospitalizations and/or deaths) and involves General Practitioners (GPs) to document the exposure. We conducted a cohort analysis using such approach to assess influenza vaccine effectiveness and to investigate the feasibility and validity of that methodology for routine vaccine evaluation. METHODS: During October 2006, all GPs from two Local Health Units (LHUs) were requested to indicate immunization status of all their patients in a specific form containing patient's demographic records. Immunization status information were also collected from Prevention Departments. Main outcomes were hospitalizations for influenza and/or pneumonia. Analyses were based upon random-effect logistic regression. RESULTS: Of a total of 414 GPs assisting 103,162 elderly, 116 GPs (28%) provided data on 32,457 individuals (31.5%). The sample was representative and had an overall 66.2% vaccina-tion rate. During the first semester 2007, the hospitalization rate was low in the sample, with only 7 elderly patients admitted for influenza and 135 for pneumonia. At either bivariate or multivariate analysis, vaccination did not significantly reduce the risk of in-hospital death, influenza or pneumonia admission. DISCUSSION: The study had minimal costs, recruited a large and representative sample size, and had no evidence of a substantial selection bias. Administrative and GP's data may be successively pooled to provide routine assessment of vaccination effectiveness.


Assuntos
Medicina de Família e Comunidade/métodos , Vacinas contra Influenza/administração & dosagem , Influenza Humana/prevenção & controle , Idoso , Estudos de Coortes , Feminino , Humanos , Influenza Humana/epidemiologia , Itália/epidemiologia , Modelos Logísticos , Masculino
5.
Eur J Radiol Open ; 6: 152-155, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31024984

RESUMO

Gastrointestinal perforation (GI) is a common cause of acute abdomen in the emergency department that needs a prompt surgery intervention. Nowadays, CT examinations represent the method of choice to image patients with acute abdominal pain in emergency. GI perforations by foreign bodies ingested is rare and only <1% of ingested foreign bodies are believed to cause perforation of GI. MDCT is to be considered the best imaging method for identifying foreign bodies, the perforation site and the surgical treatment to be planned reliably. We presente a case of 70-year-old lady presented to our Emergency Department with acute abdominal pain.

6.
J Biomed Mater Res A ; 84(2): 413-24, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-17618478

RESUMO

In this work, novel hydrogel films based on hyaluronan (HA) chemically crosslinked with the alpha,beta-poly(N-2-hydroxyethyl) (2-aminoethylcarbamate)-D,L-aspartamide (PHEA-EDA) were produced by solution casting method. The goal was to exploit both the biological key role of HA in tissue repair and regeneration, and the versatility of a synthetic protein-like polymer as the PHEA-EDA, in order to obtain biomaterials with physicochemical and biological properties suitable for a clinical use. By varying the molar ratio between the PHEA-EDA amino groups and HA carboxyl groups, three different films were obtained and characterized. Particularly FTIR, swelling, hydrolysis, and enzymatic degradation studies were performed. In addition, the cytocompatibility of HA/PHEA-EDA hydrogel films was evaluated using human derm fibroblasts, by means of MTT and trypan blue exclusion assays. The high swelling capability, the long-term hydrolysis resistance, and the resistance to hyaluronidase greater than that of only HA, together with the cell compatibility, have suggested the potential application of these novel HA-based hydrogel films in the biomedical field of tissue engineering.


Assuntos
Materiais Revestidos Biocompatíveis/síntese química , Ácido Hialurônico/química , Proteínas/química , Aspartame/análogos & derivados , Calorimetria Indireta , Adesão Celular , Sobrevivência Celular , Reagentes de Ligações Cruzadas , Fibroblastos/fisiologia , Humanos , Hidrogéis , Hidrólise , Nefelometria e Turbidimetria , Poliaminas , Pele/citologia , Espectroscopia de Infravermelho com Transformada de Fourier , Sais de Tetrazólio , Tiazóis , Azul Tripano , Cicatrização
7.
Acta Chir Plast ; 50(2): 55-8, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-18807392

RESUMO

Glomus tumors are benign neoplasms that differentiate from the glomus apparatus. This neoplasm is clinically characterized by a typical symptomatological triad: paroxysmal pain, pinpoint pain and hypersensitivity to cold. The diagnosis is usually clinical, but can be confirmed by instrumental tests such as X-ray, MRI, selective arteriography and most commonly by ultrasound, with or without Doppler. Surgical resection of the glomus tumor is the definitive treatment with resolution of all symptoms. From 1997 to 2007, 21 surgically-treated cases were reviewed and here we report the clinical assessment that was used. The nine most recent cases of glomus tumor underwent surgery after clinical assessment alone. In our opinion clinical examination is the most effective method to diagnose this type of tumor and in selected cases it may be sufficient to undergo surgical therapy.


Assuntos
Angiografia/métodos , Dedos , Tumor Glômico/diagnóstico , Imageamento por Ressonância Magnética/métodos , Neoplasias de Tecidos Moles/diagnóstico , Adulto , Diagnóstico Diferencial , Feminino , Dedos/diagnóstico por imagem , Dedos/patologia , Seguimentos , Tumor Glômico/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Neoplasias de Tecidos Moles/cirurgia , Ultrassonografia
8.
G Chir ; 29(8-9): 369-72, 2008.
Artigo em Italiano | MEDLINE | ID: mdl-18834572

RESUMO

The most common complication in patients who underwent mammary implant surgery is capsular contracture. Actually, there is no standard effective treatment for this complication. The aim of this article is to show our experience about LTRAs (leukotriene receptor antagonists) for the treatment of the capsular contracture. The findings indicate that these drugs may reduce pain and breast capsule distortion for patients with long-standing contracture.


Assuntos
Doenças Mamárias/tratamento farmacológico , Implantes de Mama/efeitos adversos , Antagonistas de Leucotrienos/uso terapêutico , Complicações Pós-Operatórias/tratamento farmacológico , Falha de Prótese , Compostos de Tosil/uso terapêutico , Adulto , Doenças Mamárias/etiologia , Feminino , Humanos , Indóis , Pessoa de Meia-Idade , Fenilcarbamatos , Complicações Pós-Operatórias/etiologia , Sulfonamidas , Adulto Jovem
9.
Int J Pharm ; 335(1-2): 130-137, 2007 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-17141987

RESUMO

The preparation and physicochemical and biological characterization of a novel polyaminoacid hydrogel have been reported. The alpha,beta-poly(N-2-hydroxyethyl)-dl-aspartamide (PHEA) has been used as a starting polymer for a derivatization reaction with methacrylic anhydride (MA) to give rise to the methacrylate derivative named PHM. Photocrosslinking of PHM has been performed in aqueous solution at 313 nm and in the absence of toxic initiators. PHM-based hydrogel has been characterized by scanning electron microscopy, X-ray diffractometry, swelling measurements in aqueous media; the degradation of PHM-based hydrogel has been evaluated as a function of time in the absence or in the presence of esterase. Besides, the biocompatibility of this hydrogel and of its degradation products has been evaluated by performing in vitro assays on human chronic myelogenous leukaemia cells (K-562), chosen as a model cell line. Finally, ATR-FTIR measurements have showed that interaction between PHM-based hydrogel and each of four plasma proteins (albumin, gamma-globulin, transferrin and fibrinogen) does not cause change in protein conformation thus supporting its potential use as a material to prepare parenteral drug delivery systems.


Assuntos
Materiais Biocompatíveis/química , Portadores de Fármacos , Hidrogéis , Peptídeos/química , Ácidos Polimetacrílicos/química , Materiais Biocompatíveis/metabolismo , Materiais Biocompatíveis/toxicidade , Proteínas Sanguíneas/química , Proteínas Sanguíneas/metabolismo , Sobrevivência Celular/efeitos dos fármacos , Química Farmacêutica , Esterases/química , Humanos , Hidrólise , Células K562 , Microscopia de Força Atômica , Microscopia Eletrônica de Varredura , Peptídeos/toxicidade , Ácidos Polimetacrílicos/toxicidade , Porosidade , Ligação Proteica , Espectroscopia de Infravermelho com Transformada de Fourier , Propriedades de Superfície , Tecnologia Farmacêutica , Fatores de Tempo , Água/química , Difração de Raios X
10.
G Chir ; 28(10): 394-8, 2007 Oct.
Artigo em Italiano | MEDLINE | ID: mdl-17915056

RESUMO

Nowadays, the treatment of the difficult wounds represents an emergent socio-sanitary problem, due to the increase of the average duration of life, with consequent increasing costs by the National Sanitary System. The term 'difficult wounds' refers to all losses of cutaneous substances with multifactorial pathogenesis that do not spontaneously recover. Today it is possible to use advanced dressings, representing a valid tool to speed-up the healing process that--as a consequence--improves quality of life for the patient. These patients need to be followed by medical teams composed by different specialists sometimes working in different hospitals. As a consequence it is has been necessary to create an electronic document containing the clinical history of the patient and reporting the different treatments. The electronic sheet allows: a) to evaluate in detail the evolution of patient conditions, thanks to an always available iconographic documentation, even when the patient is not followed by the same physician; b) and to test the effectiveness of the new advanced dressings available on the market.


Assuntos
Bandagens , Sistemas Computadorizados de Registros Médicos , Equipe de Assistência ao Paciente , Úlcera Cutânea/terapia , Cicatrização , Adulto , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida
11.
Psychometrika ; 82(1): 158-185, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-27683298

RESUMO

A method is proposed that combines dimension reduction and cluster analysis for categorical data by simultaneously assigning individuals to clusters and optimal scaling values to categories in such a way that a single between variance maximization objective is achieved. In a unified framework, a brief review of alternative methods is provided and we show that the proposed method is equivalent to GROUPALS applied to categorical data. Performance of the methods is appraised by means of a simulation study. The results of the joint dimension reduction and clustering methods are compared with the so-called tandem approach, a sequential analysis of dimension reduction followed by cluster analysis. The tandem approach is conjectured to perform worse when variables are added that are unrelated to the cluster structure. Our simulation study confirms this conjecture. Moreover, the results of the simulation study indicate that the proposed method also consistently outperforms alternative joint dimension reduction and clustering methods.


Assuntos
Análise por Conglomerados , Testes de Personalidade , Estatística como Assunto , Humanos , Psicometria , Inquéritos e Questionários , Senso de Humor e Humor como Assunto
12.
Musculoskelet Surg ; 101(1): 11-17, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27822870

RESUMO

BACKGROUND: Fractures of the proximal humerus represent a common problem in clinical practice; in particular for three- or four-part fractures, there is no consensus regarding which is the best treatment. The aim of our study was to report clinical and radiological outcomes in patients treated with the Galaxy Fixation System™ for a proximal humerus fracture. MATERIALS AND METHODS: Thirty-two patients of which 18 (56.25%) women, and 14 (43.75%) men suffering from proximal humerus fractures were treated using the Galaxy Fixation System™. Fractures were classified according to Neer and only patients with a three- or four-part fracture with two-thirds of the methaphysis intact were included. Clinical examination included the Constant-Murley score, UCLA score and Quick DASH evaluated at 6, 12 and 24 months after surgery. In addition, at the final follow-up, patients were asked to complete the SF-12 questionnaire. The humeral head-shaft angle was evaluated by radiographs the day after surgery, as well as after 12 and 24 months. RESULTS: All 32 patients were available for the 6th, 12th and 24th month follow-up examination. The mean interval between trauma and surgery was 2.7 days (range 0-6 days). The period of hospital stay ranged from 2 to 8 days with an average of three days. The time of healing ranged from 4 to 10 weeks with an average of 7 weeks. The mean Constant score increased from 72.9 after 6 months to a mean of 82.8 at 12 months (p < 0.05) to 88.9 at 24 months (p < 0.05). UCLA score ranged from 27.5 at 6 months to 29.5 at 12 months (p < 0.05) and finally improved to 32.3 at final follow-up (p < 0.05). Quick DASH varied from 7.2 at 6 months after surgery to 5.2 at 12 months after surgery (p > 0.05) and reached the value of 3.1 after 24 months (p > 0.05). Mean Mental Component (MCS) resulted in a value of 48.1, while the Physical Component (PCS) was 52.7. The mean head-shaft angulation was 137.6° the day after surgery compared with 137.5° (p > 0.05) measured 12 months later, and 137.2° measured 24 months later (p > 0.05). CONCLUSIONS: Galaxy Fixation System™ is a safe and efficient procedure for the treatment of three- or four-part proximal humerus fractures, providing an excellent outcome. LEVEL OF EVIDENCE: Prospective case series, Level IV.


Assuntos
Fixação Interna de Fraturas , Fraturas do Ombro/cirurgia , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Seguimentos , Fixação Interna de Fraturas/métodos , Consolidação da Fratura , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fraturas do Ombro/diagnóstico por imagem , Inquéritos e Questionários , Resultado do Tratamento
13.
Transplant Proc ; 49(4): 716-721, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28457379

RESUMO

BACKGROUND: There is increasing interest in the development of vessel substitutes, and many studies are currently focusing on the development of biodegradable scaffolds capable of fostering vascular regeneration. We tested a new biocompatible and biodegradable material with mechanical properties similar to those of blood vessels. METHODS: The material used comprises a mixture of α,ß-poly(N-2-hydroxyethyl)-d,l-aspartamide (PHEA) and polylactic acid (PLA), combined with polycaprolactone (PCL) by means of electrospinning technique. Low-molecular-weight heparin was also linked to the copolymer. A tubular PHEA-PLA/PCL sample was used to create an arteriovenous fistula in a pig model with the use of the external iliac vessels. The flow was assessed by means of Doppler ultrasound examination weekly, and 1 month after the implantation we removed the scaffold for histopathologic evaluation. RESULTS: The implants showed a perfect leak-proof seal and adequate elastic tension to blood pressure. About ∼3 weeks after the implantation, Doppler examination revealed thrombosis of the graft, so we proceeded to its removal. Histologic examination showed chronic inflammation, with the presence of foreign body cells and marked neovascularization. The material had been largely absorbed, leaving some isolated spot residues. CONCLUSIONS: The biocompatibility of PHEA-PLA/PCL and its physical properties make it suitable for the replacement of vessels. In the future, the possibility of functionalizing the material with a variety of molecules, to modulate the inflammatory and coagulative responses, will allow obtaining devices suitable for the replacement of native vessels.


Assuntos
Prótese Vascular , Peptídeos , Poliésteres , Animais , Polímeros/química , Suínos
14.
Transplant Proc ; 49(4): 711-715, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28457378

RESUMO

Tissue engineering has emerged as a new approach with the potential to overcome the limitations of traditional therapies. The objective of this study was to test whether our polymeric scaffold is able to resist the corrosive action of bile and to support a cell's infiltration and neoangiogenesis with the aim of using it as a biodegradable tissue substitute for serious bile duct injuries. In particular, a resorbable electrospun polyhydroxyethyl-aspartamide-polylactic acid (90 mol% PHEA, 10 mol% PLA)/polycaprolactone (50:50 w/w) plate scaffold was implanted into rabbit gallbladder to assess the in vivo effects of the lytic action of the bile on the scaffold structure and then as a tubular scaffold to create a biliary-digestive anastomosis as well. For the above evaluation, 5 animals were used and killed after 15 days and 5 animals after 3 months. At 15-day and 3-month follow-ups, the fibrillar structure was not digested by lytic action bile. The fibers of the scaffold were organized despite being in contact with bile action. A new epithelial tissue appeared on the scaffold surface suggesting the suitability of this scaffold for future studies of the repair of biliary tract injuries with the use of resorbable copolymer on biliary injuries.


Assuntos
Procedimentos Cirúrgicos do Sistema Biliar/métodos , Engenharia Tecidual , Alicerces Teciduais , Animais , Ductos Biliares , Poliésteres , Coelhos
15.
J Chemother ; 18(6): 648-51, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17267344

RESUMO

We retrospectively evaluated the safety and effectiveness of colistin alone or in combination with other antimicrobials in eight diabetic patients with severe diabetic foot infections due to multidrug resistant (MDR) Pseudomonas aeruginosa, complicated in 4 cases by osteomyelitis. All patients received colistin after other ineffective antimicrobial treatment, when MDR P. aeruginosa strains were isolated by cultural examination and together with a multidisciplinary care approach including revascularization, surgical debridement and adequate offloading. The mean duration of therapy was 72 +/- 52.9 days. Six out of 8 patients (75%) successfully benefited from colistin therapy, while 2 patients failed and/or experienced side effects that led to discontinuation of therapy. Serious adverse events (i.e. acute renal failure and pulmonary edema) were observed in 1 patient. Our data allow us to conclude that colistin, alone or in combination with other antimicrobials, is safe and effective when administered as part of a multidisciplinary approach, to promote healing of diabetic foot infection due to MDR P. aeruginosa.


Assuntos
Colistina/uso terapêutico , Pé Diabético/terapia , Farmacorresistência Bacteriana Múltipla , Osteomielite/terapia , Infecções por Pseudomonas/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Colistina/administração & dosagem , Terapia Combinada , Desbridamento/métodos , Pé Diabético/complicações , Pé Diabético/microbiologia , Sinergismo Farmacológico , Quimioterapia Combinada , Feminino , Humanos , Imipenem/uso terapêutico , Masculino , Pessoa de Meia-Idade , Osteomielite/complicações , Osteomielite/microbiologia , Infecções por Pseudomonas/complicações , Infecções por Pseudomonas/microbiologia , Estudos Retrospectivos , Rifampina/uso terapêutico , Resultado do Tratamento
16.
Int J Low Extrem Wounds ; 5(3): 213-6, 2006 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-16928678

RESUMO

The evaluation of the safety and effectiveness of colistin in association with rifampin and imipenem in 1 diabetic patient with severe diabetic foot infection (DFI) due to multidrug-resistant (MDR) Pseudomonas aeruginosa, complicated by osteomyelitis, is presented in this "Case Report". The patient received colistin after other ineffective antimicrobial treatment when an MDR P aeruginosa strain was isolated by cultural examination, together with a multidisciplinary care approach including surgical debridement and adequate offloading. The efficacy of combination colistin plus rifampin plus imipenem was observed with a checkerboard method and bactericidal activity of the serum. The patient received colistin combination therapy for 6 weeks with cure of the infection and without renal toxicity. These data suggest that colistin, in combination with rifampin and imipenem, is safe and effective, in promoting healing in DFI due to MDR P aeruginosa and suggest the need for controlled clinical studies.


Assuntos
Colistina/uso terapêutico , Pé Diabético/complicações , Imipenem/uso terapêutico , Osteomielite/complicações , Infecções por Pseudomonas/complicações , Pseudomonas aeruginosa/efeitos dos fármacos , Rifampina/uso terapêutico , Idoso , Antibacterianos/uso terapêutico , Farmacorresistência Bacteriana Múltipla , Quimioterapia Combinada , Seguimentos , Humanos , Masculino , Ossos do Metatarso , Osteomielite/tratamento farmacológico , Osteomielite/microbiologia , Infecções por Pseudomonas/tratamento farmacológico , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/isolamento & purificação
17.
Musculoskelet Surg ; 100(Suppl 1): 25-32, 2016 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-27900700

RESUMO

BACKGROUND: Results on the effectiveness of PRP supplementation in arthroscopic rotator cuff repair are conflicting, making it difficult to draw definitive conclusions. METHODS: This was a prospective, randomized, and double-blind study with two groups of 20 patients each (PRP group and control group). Degenerative supraspinatus full-thickness tears grade C2-C3 were subjected to arthroscopic repair; PRP supplementation was given to patients in the PRP group. The outcomes were assessed by DASH, Constant scales, and ultrasound before and 6 months after surgery. Pain measured by VAS was evaluated preoperatively and 7 and 30 days after surgery. RESULTS: The two groups did not differ significantly by age, sex, and dominance of the affected side. In all surgical procedures, a long head of the biceps tenotomy and single-row repair were performed. The preoperative VAS was 5.6 ± 2.4 in PRP group and 6.4 ± 1.5 in the control group (p > 0.05). The group supplemented with PRP reported a VAS significantly better in the first week (2.5 ± 1.9 vs 5.3 ± 2.1, p < 0.05) and during the first month after surgery (1.5 ± 1.0 vs 3.2 ± 1.7, p < 0.05) compared to the control group. The preoperative Constant and DASH scores were 39.95 ± 12 and 51 ± 15.2, respectively, in the PRP group and 41 ± 11 (p > 0.05) and 45 ± 12.6 (p > 0.05) in the control group. The average Constant score improved significantly after 6 months to 81 ± 11.2 (p < 0.05) in the PRP group and 78.5 ± 9 (p < 0.05) in the control group. No differences were noted between the two groups (p > 0.05). The DASH score after 6 months was 17.4 ± 8 (p < 0.05) for the treatment group (the PRP group) and 21 ± 8.4 (p < 0.05) for the control group. No statistically significant differences were found as regards the DASH score in the two groups after 6 months (p > 0.05). The two groups showed no differences in the ultrasound evaluation after 6 months either. No re-ruptures occurred in either group. CONCLUSIONS: PRP leads to a reduction in pain during a short-term follow-up. Pain reduction allows for a more rapid recovery of mobilization and improvement in functionality. LEVEL OF EVIDENCE: Randomized controlled trial, Level of evidence, 1.


Assuntos
Artroscopia , Plasma Rico em Plaquetas , Lesões do Manguito Rotador/terapia , Idoso , Artroscopia/métodos , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Amplitude de Movimento Articular , Lesões do Manguito Rotador/diagnóstico por imagem , Resultado do Tratamento , Cicatrização
18.
Int J Impot Res ; 17(1): 23-6, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15526009

RESUMO

The effects of castration on vasoactive intestinal polypeptide (VIP) immunostaining in human corpus cavernosum (CC) and the relationship between VIP immunostaining and erectile function were studied in patients with localised prostate cancer who had (Group 1 = castrated) or had not (Group 2 = control) undergone 3-month neoadjuvant chemical castration before radical prostatectomy. Evaluation of erectile function included medical and sexual history, physical examination, and measurement of total serum testosterone. CC biopsies were taken at the end of radical prostatectomy and samples immunostained with anti-human VIP antibody. Specific staining was quantified by image analysis and expressed in arbitrary units (AU). Chemical castration induced erectile function deterioration in 70% of patients due to loss of sexual interest and confidence in the ability of having an erection rather than reduced ability of obtaining sexually induced erections. Average VIP content was 34.5 AU in Group 1 and 39 AU in Group 2 and this difference was not statistically significant. Chemical castration does not influence VIP immunostaining of human CC, suggesting that VIP is not an androgen-dependent neuromediator of penile erection and that it can be responsible for sexually induced erections in castrated patients.


Assuntos
Androgênios/fisiologia , Neurotransmissores/fisiologia , Ereção Peniana/fisiologia , Peptídeo Intestinal Vasoativo/metabolismo , Idoso , Antagonistas de Androgênios/farmacologia , Disfunção Erétil/fisiopatologia , Humanos , Imuno-Histoquímica , Hormônio Luteinizante/farmacologia , Masculino , Pessoa de Meia-Idade , Fibras Nervosas/metabolismo , Orquiectomia , Pênis/inervação , Pênis/metabolismo , Prostatectomia
19.
Arch Intern Med ; 157(14): 1537-44, 1997 Jul 28.
Artigo em Inglês | MEDLINE | ID: mdl-9236555

RESUMO

OBJECTIVE: To estimate the risk of sexual transmission of hepatitis C and to assess the value of prophylaxis with periodic intramuscular immune serum globulin administration. METHODS: Of 1102 steady heterosexual partners of patients with antibodies to the hepatitis C virus (HCV), 899 were enrolled in a single-blind, randomized, controlled trial. All the partners tested negative for antibodies to HCV and had normal baseline serum aminotransferase concentrations. The partners were assigned to receive 4 mL of 16% polyvalent immune serum globulin prepared from unscreened donors every 2 months (n = 450) or a placebo (n = 449). Tests for HCV infection were performed every 4 months. RESULTS: Eight hundred eighty-four partners completed the study. Seven partners became infected with HCV: 6 in the control group (incidence density, 12.00 per 1000 person-years; 95% confidence interval, 3.0 21.61) and 1 in the immune serum globulin group (incidence density, 1.98 per 1000 person-years; 95% confidence interval, 0-5.86). The risk of infection was significantly higher for partners in the control group (P = .03): for each year approximately 1% of the partners became infected. Sequence homology studies strongly suggest the sexual transmission of HCV. All immune serum globulin lots used had high enzyme-linked immunosorbent assay titers of neutralizing antibodies to HCV envelope glycoproteins and high neutralization titers in the neutralization of binding assay. CONCLUSIONS: Hepatitis C can be sexually transmitted. Immune serum globulin prepared from unscreened donors significantly reduced the risk. The treatment was safe and well tolerated. Because only immune serum globulin from unscreened donors (and not from those screened for HCV) contain anti-HCV neutralizing antibodies, hyperimmune anti-HCV immune serum globulin should be prepared from blood testing positive for antibodies to HCV, which is currently discarded.


Assuntos
Hepatite C/prevenção & controle , Hepatite C/transmissão , Imunização Passiva , Doenças Virais Sexualmente Transmissíveis/prevenção & controle , Adulto , Ensaio de Imunoadsorção Enzimática , Feminino , Glicoproteínas/imunologia , Hepacivirus/genética , Hepatite C/genética , Hepatite C/imunologia , Anticorpos Anti-Hepatite C/sangue , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Risco , Doenças Virais Sexualmente Transmissíveis/imunologia , Método Simples-Cego , Resultado do Tratamento , Proteínas do Envelope Viral/imunologia
20.
Drug Deliv ; 12(6): 377-84, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16253953

RESUMO

Alpha,beta-poly(asparthylhydrazide) (PAHy), a water soluble synthetic polymer, was functionalized by using EDCI chemistry with 3-(carboxypropyl)trimethyl-ammonium chloride (CPTACl) obtaining carboxypropyltrimethyl ammonium copolymers (PAHy-CPTA). Three PAHy-CPTA copolymers at increasing derivatization degrees (38%, 48%, 58%) were chosen for subsequent investigations. The capability of these copolymers to bind, neutralize, and protect DNA against degradation by DNase II was evalued by gel retardation assay and DNA degradation test at pH 5.5. Zeta potential measurements show that all studied polymers are able to neutralize the anionic charge of DNA at polymer/DNA weight ratio in the range of 0.8/1-5/1. Polyplex dimensional distribution analyses in bistilled water, saline solution NaCl 0.9%, and HEPES pH 7 show that polyplex size is strongly affected by both presence and type of electrolyte and with time incubation.


Assuntos
Peptídeos/química , Polímeros/química , Carbodi-Imidas , Cátions , DNA/química , DNA/metabolismo , Eletrólitos/química , Ensaio de Desvio de Mobilidade Eletroforética , Endodesoxirribonucleases/metabolismo , Peptídeos/síntese química , Polímeros/síntese química , Compostos de Amônio Quaternário/química
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