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1.
Artigo em Inglês | MEDLINE | ID: mdl-38597362

RESUMO

The prevalence of anatomical-based subtypes of feline congenital extrahepatic portosystemic shunts (EHPSS) has not been completely elucidated. The goal of this study was to use CT angiography to create an anatomical-based nomenclature system for feline congenital EHPSS. Additionally, subjective portal perfusion scores were generated to determine if intrinsic portal vein development was associated with different shunt conformations or patient age at the time of CT. The SVSTS and VIRIES list services were used to recruit cases. Data collected included patient DOB, gender, breed, weight, CT date, and reported diagnosis. Shunts were classified based upon (1) the shunt portal vessel(s) of origin, (2) the shunt systemic vessel(s) of insertion, and (3) any substantial portal vessels contributing to the shunt. Additionally, hepatic portal perfusion was subjectively scored between 1 (poor/none) and 5 (good/normal) based on the caliber of the intrahepatic PVs. A total of 264 CT scans were submitted from 29 institutions. Due to exclusion criteria, 33 (13%) were removed, leaving 231 CT scans to be included. Twenty-five different EHPSS anatomies were identified with five classifications accounting for 78% of all shunts (LGP [53%], LGC-post [11%], LCG [7%], LGC-pre [4%], and PC [4%]). Shunt origin involved the left gastric vein in 75% of the described classifications. Significant differences were identified among the five most common shunt types with respect to age at the time of CT scan (P = .002), breed (P < .001), and subjective portal perfusion score (P < .001). This refined anatomical classification system for feline EHPSS may enable improved understanding, treatment comparisons, and outcome prediction for cats with these anomalies.

2.
Expert Opin Emerg Drugs ; 27(2): 103-110, 2022 06.
Artigo em Inglês | MEDLINE | ID: mdl-35876094

RESUMO

INTRODUCTION: Hereditary angioedema due to C1-inhibitor (C1-INH-HAE) is a rare disease characterized by unpredictable swelling attacks that may be life-threatening when affecting the upper airways. Understanding the pathophysiology of HAE and the mechanism of bradykinin-mediated angioedema allowed the development of new therapies for the treatment of HAE: clinical trials are ongoing to expand the number of drugs available for on-demand treatment and prophylaxis. AREAS COVERED: Authors discuss the products that have been used to treat this disease for many years and present the most recently marketed products and those which are under development. EXPERT OPINION: Significant therapeutic progress has been made in HAE. In particular, drugs targeting specific molecules involved in the angioedema formation were developed and studies with new drugs are ongoing. In the coming years, more effective therapies with easier administration route options for on-demand treatment and long-term prophylaxis will be available to treat this disease and the variety of patients. Gene therapy strategies may offer a definitive treatment. High costs of current and new drugs may be a limiting factor for their availability, especially in developing countries.


Assuntos
Angioedema , Angioedemas Hereditários , Angioedemas Hereditários/tratamento farmacológico , Bradicinina/uso terapêutico , Humanos , Preparações Farmacêuticas
3.
BMC Nephrol ; 23(1): 390, 2022 12 07.
Artigo em Inglês | MEDLINE | ID: mdl-36476330

RESUMO

BACKGROUND: Hepatitis C virus (HCV) may play a pathogenic role in several forms of immune complex glomerulonephritis (GN). We present a patient whose initial clinical presentation instilled suspicion of HCV-related renal involvement. Yet, histopathologic data oriented towards a different diagnosis. CASE PRESENTATION: A 68-year old man presented with kidney dysfunction, cryoglobulins, low C4 level, high HCV-RNA and cutaneous vasculitis. The first hypothesis was a hepatitis C-related cryoglobulinemic glomerulonephritis. Renal biopsy revealed endocapillary and mesangial cells hypercellularity with complement C3 and IgM deposits. The echocardiography showed an infectious endocarditis (IE) on aortic valve. Appropriate antibiotic therapy and a prosthetic valve replacement were performed, obtaining recovery of renal function. CONCLUSION: HCV infection may be linked to multiple renal manifestations, often immune-complex GN such as cryoglobulinemic membrano-proliferative GN. Renal disease due to IE is usually associated to focal, segmental or diffuse proliferative GN, with prominent endocapillary proliferation. The most common infectious agents are Staphylococcus aureus and Streptococcus species. This case report may be relevant because the renal dysfunction was highly suggestive of a cryoglobulinemic GN on a clinical ground, but the histologic pattern after performing the renal biopsy oriented towards a different cause of the underlying disease, that required a specific antibiotic treatment. The renal biopsy is always required to confirm a clinical suspicious in patients affected by multiple comorbidities.


Assuntos
Hepatite C , Humanos , Idoso , Hepatite C/complicações
4.
Vet Surg ; 50(3): 579-587, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33638933

RESUMO

OBJECTIVE: To compare complications of dogs treated with mandibular and sublingual sialoadenectomy for sialocele using a lateral (LAT) or ventral paramedian (VPM) approach. STUDY DESIGN: Retrospective multicenter study. ANIMALS: Dogs (140) with mandibular and sublingual sialocele. METHODS: Medical records of dogs that underwent mandibular and sublingual sialoadenectomy through a LAT or VPM approach from 2004 to 2020 were reviewed. Clinical and histopathological findings were analyzed to compare the groups. RESULTS: Seventy dogs were included in each group. The most represented breed was crossbreed (26%), and males (99/140 [71%], intact/neutered) were overrepresented. Dogs in the VPM approach group were more likely to undergo digastricus tunnelization and placement of a drain or a bandage. Dogs in the LAT approach group were heavier and more likely to undergo excision of an inflammatory pseudocapsule. No difference was detected in complication rates between groups (LAT [20%], VPM [31%], P = .116). Recurrences were more likely after LAT approach (5/70 vs 0/70, respectively; P = .029), whereas wound-related complications were more likely after VPM approach (20/70 vs 9/70, respectively; P = .018). Prolonged duration of surgery was associated with an increased risk of recurrence, and none of the other variables affected the complication rate. CONCLUSION: Ventral paramedian approach for mandibular and sublingual sialoadenectomy was associated with a lower risk of recurrence but a higher risk of wound-related complications compared with LAT approach. CLINICAL SIGNIFICANCE: Ventral paramedian approach for mandibular and sublingual sialoadenectomy may be preferred to reduce recurrence in dogs with sialoceles, but wound-related complications are common.


Assuntos
Cistos/veterinária , Doenças do Cão/cirurgia , Mucocele/veterinária , Complicações Pós-Operatórias/veterinária , Doenças da Glândula Submandibular/veterinária , Animais , Cistos/cirurgia , Cães , Feminino , Masculino , Mucocele/cirurgia , Complicações Pós-Operatórias/epidemiologia , Estudos Retrospectivos , Doenças da Glândula Submandibular/patologia , Doenças da Glândula Submandibular/cirurgia
5.
Allergy ; 75(6): 1394-1403, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31860755

RESUMO

BACKGROUND: Hereditary angioedema (HAE) comprises HAE with C1-inhibitor deficiency (C1-INH-HAE) and HAE with normal C1-INH activity (nl-C1-INH-HAE), due to mutations in factor XII (FXII-HAE), plasminogen (PLG-HAE), angiopoietin 1 (ANGPT1-HAE), kininogen 1 genes (KNG1-HAE), or angioedema of unknown origin (U-HAE). The Italian network for C1-INH-HAE (ITACA) created a registry including different forms of angioedema without wheals. OBJECTIVE: We analyzed clinical and laboratory features of a cohort of Italian subjects with nl-C1-INH-HAE followed by ITACA to identify specific biomarkers. METHODS: A total of 105 nl-C1-INH-HAE patients were studied. Plasma concentrations of cleaved high-molecular-weight kininogen (cHK), vascular endothelial growth factors (VEGFs), angiopoietins (Angs), and secreted phospholipase A2 enzymes (sPLA2 ) were evaluated. RESULTS: We identified 43 FXII-HAE patients, 58 U-HAE, and 4 ANGPT1-HAE. We assessed a prevalence of 1:1.4 × 106 for FXII-HAE and 1:1.0 × 106 for U-HAE. cHK levels in U-HAE patients were similar to controls in plasma collected using protease inhibitors cocktail (PIC), but they significantly increased in the absence of PIC. In FXII-HAE patients, cHK levels, in the absence of PIC, were significantly higher than in controls. We found a significant increase of VEGF-A, VEGF-C, and Ang1 levels in U-HAE patients compared to controls. In FXII-HAE, only VEGF-C levels were increased. Ang2 concentrations and sPLA2 activity were not modified. The levels of these mediators in ANGPT1-HAE patients were not altered. CONCLUSIONS: Our results suggest that pathogenesis of FXII-, ANGPT1-, and U-HAE moves through an unbalanced control of kallikrein activity, with bradykinin as most likely mediator. VEGFs and Ang1 participate in the pathophysiology of U-HAE increasing the basal vascular permeability.


Assuntos
Angioedema , Angioedemas Hereditários , Angioedemas Hereditários/diagnóstico , Angioedemas Hereditários/epidemiologia , Angioedemas Hereditários/genética , Angiopoietina-2 , Bradicinina , Proteína Inibidora do Complemento C1 , Fator XII/genética , Humanos
6.
Vet Surg ; 49(2): 339-346, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31769048

RESUMO

OBJECTIVE: To describe the surgical technique for nasal planum reconstruction with a lip-to-nose flap after curative intent surgical excision of squamous cell carcinoma (SCC) in cats and to report the surgical outcomes. STUDY DESIGN: Short case series. ANIMALS: Seven cats with SCC of the lateral (n = 6) or dorsal (n = 1) aspect of the nasal planum. METHODS: After tumor excision, a mucocutaneous lip-to-nose flap was harvested from the upper lip and transposed to reconstruct the nasal planum. Variables recorded included surgical time, surgical complications, healing complications, flap success rate, and cosmetic and long-term functional outcomes. RESULTS: Median surgical time was 67.5 minutes (range 49-80), and no intraoperative complications occurred. Postoperatively, six cats developed self-limiting edema of the muzzle, and one cat had nasal discharge for 2 days. No major complications occurred during the healing process, and all cats went on to achieve successful healing of their flap. A small area of partial-thickness necrosis developed at the cranial edge of the flap in three cats and healed spontaneously in all cases within a few days. According to owner satisfaction and periodic clinical assessment, cosmetic and long-term functional of outcomes were considered good in all cats. CONCLUSION: The lip-to-nose flap allowed for aesthetic and functional reconstruction of the nasal planum after curative intent surgical excision of feline SCC. CLINICAL SIGNIFICANCE: The lip-to-nose flap is an option for a single-stage reconstruction of the nasal planum following partial nasal planectomy in cats.


Assuntos
Carcinoma de Células Escamosas/veterinária , Face/cirurgia , Neoplasias Nasais/veterinária , Procedimentos de Cirurgia Plástica/veterinária , Retalhos Cirúrgicos/veterinária , Animais , Carcinoma de Células Escamosas/cirurgia , Gatos/cirurgia , Feminino , Humanos , Lábio/cirurgia , Masculino , Nariz/cirurgia , Neoplasias Nasais/cirurgia , Cicatrização
7.
Infection ; 47(1): 141-168, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30255389

RESUMO

Hepatitis C virus (HCV) infection is now considered a systemic disease due to the occurrence of extra-hepatic manifestations. Among these, the renal involvement is frequent. HCV infection, in fact, is strongly associated with proteinuria and chronic kidney disease (CKD) and negatively affects the prognosis of renal patients. In the last few years, availability of more specific and effective drugs against HCV has dramatically changed the clinical course of this disease. These drugs may provide further advantages in the CKD population as a whole by reducing progression of renal disease, mortality rate and by increasing the survival of graft in renal transplant recipients. The strict pathogenetic and prognostic link between HCV infection and CKD requires an ongoing relationship among the healthcare professionals involved in the treatment of both HCV infection and CKD. Therefore, Scientific Societies involved in the care of this high-risk population in Italy have organized a joint expert panel. The aim of the panel is to produce a position statement that can be used in daily clinical practice for the management of HCV infected patients across the whole spectrum of renal disease, from the conservative phase to renal replacement treatments (dialysis and transplantation). Sharing specific evidence-based expertise of different professional healthcare is the first step to obtain a common ground of knowledge on which to instate a model for multidisciplinary management of this high-risk population. Statements cover seven areas including epidemiology of CKD, HCV-induced glomerular damage, HCV-related renal risk, staging of liver disease in patients with CKD, prevention of transmission of HCV in hemodialysis units, treatment of HCV infection and management of HCV in kidney transplantation.


Assuntos
Hepatite C/terapia , Insuficiência Renal Crônica/terapia , Hepacivirus/fisiologia , Hepatite C/virologia , Humanos , Itália , Insuficiência Renal Crônica/virologia
8.
Vet Pathol ; 56(3): 358-368, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-30595108

RESUMO

Pheochromocytoma is frequent in dogs and carries a guarded prognosis. Current histological criteria may not predict malignant behavior in dogs, similar to humans. In humans, characterization of tumors has been refined using the pheochromocytoma of the adrenal gland scaled score (PASS) and by immunohistochemistry. The study aim was to investigate PASS and immunohistochemical markers used in humans in 24 dogs with pheochromocytoma that underwent adrenalectomy. Dogs with pheochromocytomas were reviewed and tumors collected. Histological sections were evaluated to apply the PASS and were single-labeled for chromogranin A, Ki-67, COX-2, p53, BCL-2, c-erbB-2, vascular endothelial growth factor, and S100. Survival, age, and vascular and capsular invasion were compared for PASS and immunohistochemical markers; results of PASS were also compared for each marker. Associations between markers were tested. PASS and immunohistochemical markers did not differ for survival, age, and vascular and capsular invasion. Tumors showing BCL-2 expression in >50% cells had lower PASS than those with lower expression (PASS: 7 ± 2 vs 9 ± 2; P = .011). Tumors positive for S100 had higher PASS than those that were negative (PASS: 10 ± 2 vs 7 ± 2; P = .001). Results of the different markers were not associated. In conclusion, in the context of canine pheochromocytoma, PASS and the selected immunohistochemical markers are not associated with survival, age, or vascular or capsular invasion. The higher PASS in S100-positive tumors may indicate that pheochromocytomas developing morphologic changes acquire S100 expression. The significance of lower PASS in tumors with elevated BCL-2 expression is uncertain. Overall, the use of PASS and the present immunohistochemical markers may not be useful in dogs with pheochromocytoma.


Assuntos
Neoplasias das Glândulas Suprarrenais/veterinária , Adrenalectomia/veterinária , Doenças do Cão/cirurgia , Feocromocitoma/veterinária , Neoplasias das Glândulas Suprarrenais/diagnóstico , Neoplasias das Glândulas Suprarrenais/patologia , Neoplasias das Glândulas Suprarrenais/cirurgia , Glândulas Suprarrenais/patologia , Animais , Biomarcadores Tumorais , Doenças do Cão/diagnóstico , Doenças do Cão/patologia , Cães , Feminino , Masculino , Feocromocitoma/diagnóstico , Feocromocitoma/patologia , Feocromocitoma/cirurgia , Prognóstico
9.
J Allergy Clin Immunol ; 142(3): 883-891, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-29729940

RESUMO

BACKGROUND: Hereditary angioedema (HAE) caused by C1-inhibitor deficiency is a lifelong illness characterized by recurrent acute attacks of localized skin or mucosal edema. Activation of the kallikrein/bradykinin pathway at the endothelial cell level has a relevant pathogenetic role in acute HAE attacks. Moreover, other pathways are involved given the variable clinical expression of the disease in different patients. OBJECTIVE: We sought to explore the involvement of other putative genes in edema formation. METHODS: We performed a PBMC microarray gene expression analysis on RNA isolated from patients with HAE during an acute attack and compared them with the transcriptomic profile of the same patients in the remission phase. RESULTS: Gene expression analysis identified 23 genes significantly modulated during acute attacks that are involved primarily in the natural killer cell signaling and leukocyte extravasation signaling pathways. Gene set enrichment analysis showed a significant activation of relevant biological processes, such as response to external stimuli and protein processing (q < 0.05), suggesting involvement of PBMCs during acute HAE attacks. Upregulation of 2 genes, those encoding adrenomedullin and cellular receptor for urokinase plasminogen activator (uPAR), which occurs during an acute attack, was confirmed in PBMCs of 20 additional patients with HAE by using real-time PCR. Finally, in vitro studies demonstrated the involvement of uPAR in the generation of bradykinin and endothelial leakage. CONCLUSIONS: Our study demonstrates the increase in levels of adrenomedullin and uPAR in PBMCs during an acute HAE attack. Activation of these genes usually involved in regulation of vascular tone and in inflammatory response might have a pathogenic role by amplifying bradykinin production and edema formation in patients with HAE.


Assuntos
Adrenomedulina/genética , Angioedemas Hereditários/genética , Ativador de Plasminogênio Tipo Uroquinase/genética , Doença Aguda , Adolescente , Adulto , Idoso , Células Cultivadas , Feminino , Células Endoteliais da Veia Umbilical Humana , Humanos , Células Jurkat , Leucócitos Mononucleares/imunologia , Masculino , Pessoa de Meia-Idade , Transcriptoma
10.
New Microbiol ; 41(1): 1-25, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-28994444

RESUMO

HIV-positive individuals are more vulnerable to poor health than HIV-negative individuals. This vulnerability is characterized by a higher risk of several common, age-related health problems, even after adjustment for established risk factors. This expert opinion report aims at identifying the optimal biomarkers for monitoring the structural integrity and function of physiological systems at risk across aging in HIV-seropositive subjects. These biomarkers, readily available locally and relatively cost-effective for clinicians in primary and secondary care, should allow early detection of the first preclinical structural and functional changes in renal, brain, cardiovascular, and skeleton systems or apparatus in HIV subjects across aging. A particular interest of this report is the definition of the concept of biomarker of the "organ functional reserve". This definition emphasizes the fact that some biomarkers for monitoring the molecular, structural and functional integrity of a given organ reflect a level of impairment that is basically irremediable despite effective pharmacological or nonpharmacological intervention.


Assuntos
Infecções por HIV/complicações , Envelhecimento , Antirretrovirais/efeitos adversos , Antirretrovirais/uso terapêutico , Biomarcadores , Densidade Óssea/efeitos dos fármacos , Transtornos Cognitivos/etiologia , Transtornos Cognitivos/patologia , Infecções por HIV/tratamento farmacológico , Humanos , Rim/patologia , Rim/fisiologia , Nefropatias/etiologia , Fatores de Risco , Prevenção Secundária
11.
Vet Surg ; 47(8): 1101-1105, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30302778

RESUMO

OBJECTIVE: To describe a local interpolation flap based on the upper lip for the reconstruction of the dorsal aspect of the nasal plane in dogs. STUDY DESIGN: Ex vivo and in vivo case report. ANIMALS: A 2-year-old medium-sized spayed female mixed-breed dog and a canine cadaver of a medium-sized mixed-breed dog. METHODS: A dorsal defect of the nasal plane of uncertain origin in a dog was reconstructed with a unilateral interpolation flap obtained from the caudal upper lip skin and mucosa (lip-to-nose flap). The procedure was first performed in a cadaveric model to assess its feasibility. RESULTS: The lip-to-nose flap allowed the reconstruction of a dorsal nasal plane defect with a satisfactory cosmetic outcome. The incorporation of the labial mucosa guaranteed a complete and uncomplicated wound healing of the flap; a small area of necrosis occurred at the donor site, which resolved in a few days. CONCLUSION: The use of a lip-to-nose flap was feasible in these 2 medium-sized dogs and led to satisfactory cosmetic outcome. CLINICAL SIGNIFICANCE: A lip-to-nose flap may be considered to reconstruct dorsal nasal plane defects in dogs and allows for a cosmetic outcome.


Assuntos
Cães/lesões , Lábio/cirurgia , Nariz/lesões , Procedimentos de Cirurgia Plástica/veterinária , Retalhos Cirúrgicos/veterinária , Ferimentos e Lesões/veterinária , Animais , Cadáver , Cães/cirurgia , Estudos de Viabilidade , Feminino , Nariz/cirurgia , Ferimentos e Lesões/cirurgia
12.
J Antimicrob Chemother ; 70(4): 1150-4, 2015 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-25525197

RESUMO

OBJECTIVES: Nucleotide analogues may promote renal and bone toxicity. The aim of the present study was to evaluate markers of osteorenal toxicity in patients affected by hepatitis B virus-related chronic hepatitis treated with lamivudine plus adefovir who were switched to tenofovir. PATIENTS AND METHODS: We evaluated 60 consecutive patients at the time of the switch of treatment and after 1, 3, 6, 9 and 12 months. The mean baseline estimated glomerular filtration rate (eGFR) was 89.3 ± 19.0 mL/min/1.73 m(2). RESULTS: During the study period we observed a reduction in mean eGFR up to 6 months after switching to tenofovir, and this remained stable for the last two timepoints. At the end of study, the mean eGFR was 82.6 ± 21.5 mL/min/1.73 m(2), a reduction of 7.5%. The mean baseline proteinuria was 202.6 ± 237.6 mg/24 h. Microhaematuria was observed in 22.6% of patients and hypophosphataemia in 18.6%. After 1 month of tenofovir, we observed a worsening of serum phosphate and parathyroid hormone levels, haemoglobinuria and 24 h proteinuria. After 3 and 12 months of tenofovir, these data tended to recover to baseline levels. A total of 92.6% of patients at baseline had hypovitaminosis D. After supplementation with cholecalciferol, this percentage decreased significantly. We observed a reduced bone mineral density (BMD) in 52.7% of patients at baseline; this increased to 77.8% after 6 months of tenofovir, but at the last timepoint the percentage of patients with a reduced BMD had fallen to a level above the baseline. CONCLUSIONS: In conclusion, patients exposed to lamivudine plus adefovir showed relevant osteorenal damage. The switch to tenofovir provoked a slight reduction in eGFR that stabilized after 6 months. The reduced BMD at baseline did not worsen under tenofovir treatment.


Assuntos
Antivirais/efeitos adversos , Doenças Ósseas/induzido quimicamente , Doenças Ósseas/epidemiologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Hepatite B Crônica/tratamento farmacológico , Nefropatias/induzido quimicamente , Nefropatias/epidemiologia , Adenina/efeitos adversos , Adenina/análogos & derivados , Adenina/uso terapêutico , Adulto , Idoso , Antivirais/uso terapêutico , Doenças Ósseas/patologia , Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/patologia , Feminino , Taxa de Filtração Glomerular , Hematúria/induzido quimicamente , Hematúria/epidemiologia , Humanos , Hipofosfatemia/induzido quimicamente , Hipofosfatemia/epidemiologia , Nefropatias/patologia , Lamivudina/efeitos adversos , Lamivudina/uso terapêutico , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Organofosfonatos/efeitos adversos , Organofosfonatos/uso terapêutico , Proteinúria/induzido quimicamente , Proteinúria/epidemiologia , Deficiência de Vitamina D/induzido quimicamente , Deficiência de Vitamina D/epidemiologia
13.
Vet Surg ; 44(5): 642-7, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25367401

RESUMO

OBJECTIVE: To describe the frequency and extent of complications associated with lateral caudal axial pattern flaps used to cover large traumatic or excision skin defects on the dorsum, gluteal, and perineal region in 13 dogs. STUDY DESIGN: Case series. ANIMALS: Thirteen client-owned dogs. METHODS: Medical records from 8 institutions were reviewed for dogs treated with a lateral caudal axial pattern flap, including cases in which the procedure was combined with other reconstructive techniques. The flap length relative to the tail length, location of tail skin incision, size and cause of the defect, and short- and long-term complications were recorded. RESULTS: Thirteen dogs were included, 11 with tumors and 2 with traumatic skin loss. The mean estimated length of the flap relative to tail length was 51% (range 33-70%). Four dogs had wound complications. This included 2 dogs with minor postoperative wound complications (mild distal dehiscence) that did not require surgical revision and 2 dogs with major complications that required surgical revision. Two of these 4 dogs had distal flap necrosis, one was revised surgically and one was managed conservatively. In these 2 dogs, the flap length was estimated as 80% and 65% of the tail length, respectively. At 30 days, flaps in all dogs were completely healed. No long-term complications were recorded in any dog. For some dogs, the reconstruction was not obvious, with only the change in hair direction and color noticeable. CONCLUSION: Lateral caudal axial pattern flap is a reconstructive option for gluteal, dorsal, and perineal skin defects in dogs. Distal flap necrosis and dehiscence due to wound infection occurred in 4 dogs that required additional wound care but not always surgical revision.


Assuntos
Doenças do Cão/cirurgia , Cães/lesões , Retalhos Cirúrgicos/veterinária , Animais , Nádegas/cirurgia , Feminino , Masculino , Períneo/cirurgia , Complicações Pós-Operatórias/veterinária , Período Pós-Operatório , Estudos Retrospectivos , Pele/lesões , Neoplasias Cutâneas/cirurgia , Neoplasias Cutâneas/veterinária , Deiscência da Ferida Operatória/veterinária , Resultado do Tratamento , Ferimentos e Lesões/cirurgia , Ferimentos e Lesões/veterinária
14.
Ann Hum Genet ; 78(2): 73-82, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24456027

RESUMO

Hereditary angioedema (HAE) is an autosomal dominant disease due to mutations in the C1 inhibitor gene (C1NH) that affects protein synthesis (HAE type I) or function (HAE type II). In 45 subjects affected by HAE diagnosed through clinical features and C1 inhibitor deficiency from the south of Italy (38 with type I and 7 with type II HAE), the whole C1NH coding region was screened for mutations by direct DNA sequencing. A severity score based on clinical manifestation, age at disease onset, and need for long-term prophylaxis was used to investigate possible genotype-phenotype correlations. A series of 22 different mutations was identified: nine missense (40.9%), five nonsense (22.7%), six frameshift (27.3), one small deletion (4.5%), and one splicing defect (4.5%). Nine C1NH mutations have not been previously described. No correlation was found between C1 inhibitor function level and severity score or age at first attack. Moreover, there was no correlation between different types of mutations and clinical phenotype. The number of different mutations identified highlights the heterogeneity of C1 inhibitor deficiency and supports the hypothesis that HAE clinical phenotype is not strictly related to the type of mutation but rather depends on unknown factors.


Assuntos
Angioedemas Hereditários/genética , Proteínas Inativadoras do Complemento 1/genética , Mutação , Adolescente , Adulto , Idoso , Angioedemas Hereditários/metabolismo , Criança , Estudos de Coortes , Proteína Inibidora do Complemento C1 , Feminino , Estudos de Associação Genética , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Deleção de Sequência , Adulto Jovem
15.
HIV Clin Trials ; 15(3): 87-91, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24947532

RESUMO

Chronic kidney disease (CKD) is currently considered a major comorbidity in patients affected by HIV infection. In addition, new generation antiretroviral drugs that interact with creatinine transporters were recently introduced. Rilpivirine, dolutegravir, and cobicistat, with different mechanisms, inhibit the amount of tubular secretion of creatinine causing a slight increase in serum creatinine levels and consensual eGFRcreat reduction. This will require an unprecedented attention to renal issues, because the new drugs can also be associated to old antiretroviral drugs that may exert renal toxic effects. Owing to the interference of these drugs with creatinine secretion, an alternative way of estimating GFR would be desirable. At the moment, methods of direct GFR measurement have a high impact on the patient, are not readily available, or are not reliable in HIV patients. Consequently, use of classic formulas to estimate GFR is still recommended, considering the apparent reduction of eGFRcreat due to these drugs. Tubular function needs to be carefully monitored with simple tests such as proteinuria, phosphatemia, urinary excretion of phosphate, normoglycemic glycosuria, and excretion of uric acid. More specific and sensitive markers of tubular damage are still not readily available in all clinical labs. HIV patients treated by the novel drugs need to be monitored on a monthly basis for the first 3 months. Subsequent monitoring should be performed on a quarterly basis or guided by comorbidities.


Assuntos
Antirretrovirais/efeitos adversos , Taxa de Filtração Glomerular/efeitos dos fármacos , Infecções por HIV/tratamento farmacológico , Infecções por HIV/complicações , Infecções por HIV/fisiopatologia , Humanos , Monitorização Fisiológica , Insuficiência Renal Crônica/etiologia
16.
Nephrol Dial Transplant ; 29(4): 799-808, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24463188

RESUMO

BACKGROUND: Increasing evidence demonstrates a phenotypic plasticity of endothelial cells (ECs). Endothelial-to-mesenchymal transition (EndMT) contributes to the development of tissue fibrosis. However, the pathogenic factors and signalling pathways regulating this process in ischaemia/reperfusion (I/R) injury are still poorly understood. METHODS: We investigated the possible role of complement in the induction of this endothelial dysfunction in a swine model of renal I/R injury by using recombinant C1 inhibitor in vivo. RESULTS: Here, we showed that I/R injury reduced the density of renal peritubular capillaries and induced tissue fibrosis with generation of CD31(+)/α-SMA(+) and CD31(+)/FPS-1(+) cells indicating EndMT. When we inhibited complement, the process of EndMT became rare, with preserved density of peritubular capillaries and significant reduction in renal fibrosis. When we activated ECs by anaphylatoxins in vitro, C3a and C5a led to altered endothelial phenotype with increased expression of fibroblast markers and decrease expression of specific endothelial markers. The activation of Akt pathway was pivotal for the C3a and C5a-induced EndMT in vitro. In accordance, inhibition of complement in vivo led to the abrogation of Akt signalling, with hampered EndMT and tissue fibrosis. CONCLUSIONS: Our data demonstrate a critical role for complement in the acute induction of EndMT via the Akt pathway. Therapeutic inhibition of these systems may be essential to prevent vascular damage and tissue fibrosis in transplanted kidney.


Assuntos
Anafilatoxinas/metabolismo , Células Endoteliais/metabolismo , Nefropatias/patologia , Rim/patologia , Proteínas Proto-Oncogênicas c-akt/metabolismo , Traumatismo por Reperfusão/complicações , Animais , Células Cultivadas , Modelos Animais de Doenças , Células Endoteliais/patologia , Feminino , Fibroblastos/metabolismo , Fibroblastos/patologia , Fibrose/complicações , Fibrose/metabolismo , Fibrose/patologia , Humanos , Rim/metabolismo , Nefropatias/etiologia , Nefropatias/metabolismo , Traumatismo por Reperfusão/metabolismo , Traumatismo por Reperfusão/patologia , Transdução de Sinais , Suínos
17.
Vet Comp Oncol ; 22(2): 198-203, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38327132

RESUMO

Osteosarcoma is the most common malignant primary bone cancer, but it is infrequently reported in cats. Feline appendicular osteosarcoma typically exhibits good prognosis when treated with surgery alone. A retrospective multi-institutional study was conducted to identify possible prognostic factors. Cats diagnosed with appendicular osteosarcoma were included if initial staging and follow-up information were available. Data including signalment, tumour characteristics, treatment modalities, and survival outcomes were collected and analysed. Fifty-six cats were included; the femur was the most frequently affected bone. Eight cats had distant metastasis at admission and an additional 9 developed metastatic disease during follow-up, resulting in an overall metastatic rate of 30%. Forty-nine (87.5%) cats underwent surgery, and 4 also received adjuvant chemotherapy. Among operated cats, median time to local progression (TTLP), time to distant progression and tumour-specific survival (TSS) were not reached. One- and 2-year survival rates were 66% and 55%, respectively. Seven (12.5%) cats received no treatment; 1- and 2-year survival rates were 25% and 0%, respectively. Operated cats had significantly longer TTLP (P < .001) and TSS (P = .001) compared with non-operated cats. Among operated cats, young age negatively impacted local tumour progression, while the presence of distant metastasis at diagnosis was associated with a higher risk of tumour-related death. This study reaffirms the good prognosis for cats with appendicular osteosarcoma undergoing surgery, but sheds light on some additional factors to consider. Accurate initial staging is recommended, as the metastatic rate may exceed many previous estimations. Surgery substantially extends survival time, whereas the role of chemotherapy remains uncertain.


Assuntos
Doenças do Gato , Osteossarcoma , Animais , Osteossarcoma/veterinária , Osteossarcoma/terapia , Osteossarcoma/patologia , Gatos , Doenças do Gato/patologia , Estudos Retrospectivos , Masculino , Feminino , Neoplasias Ósseas/veterinária , Neoplasias Ósseas/patologia , Neoplasias do Apêndice/veterinária , Neoplasias do Apêndice/patologia , Itália
18.
Vet Surg ; 42(8): 943-50, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24433298

RESUMO

OBJECTIVE: To report signalment, clinical signs, preoperative staging tests, histologic diagnosis, surgical, and oncologic outcomes including postoperative limb use, in dogs with scapular tumors treated by scapulectomy. STUDY DESIGN: Retrospective case series ANIMALS: Dogs (n = 42) with scapular tumors. METHODS: Medical records (1995-2010) from 6 hospitals were searched for dogs with scapular tumors treated by scapulectomy. Data retrieved were: signalment, weight, percentage of scapula removed, histologic diagnosis, postoperative limb use, adjunctive therapy, disease free interval (DFI), and survival time (ST). Individual variables were modeled with a Cox proportional hazard model accounting for censoring to determine risk factors for decreased DFI and ST. For categorical variables, Kaplan-Meier survival plots as well as mean and median survival times (MSTs) were calculated. RESULTS: Subtotal scapulectomy was performed in 18 dogs (42.9%). Osteosarcoma (OSA) was diagnosed in 27 dogs (64.3%). Limb use was evaluated immediately after surgery in 41 dogs. Information on limb use at other times (1, 2, 3, and >3 months) postoperatively was also available for some dogs and was good to excellent overall. Only adjunctive chemotherapy had a positive significant effect on DFI (P = .00011) and ST (P = .0003). CONCLUSION: Canine scapular tumors can be treated effectively by scapulectomy and limb use is fair to excellent for most dogs. OSA was the most common scapular tumor. Overall prognosis for scapular OSA is similar to appendicular OSA at other sites and use of adjunctive chemotherapy prolonged the overall DFI and MST.


Assuntos
Neoplasias Ósseas/veterinária , Doenças do Cão/cirurgia , Osteossarcoma/veterinária , Escápula/cirurgia , Animais , Antineoplásicos/uso terapêutico , Neoplasias Ósseas/tratamento farmacológico , Neoplasias Ósseas/cirurgia , Quimioterapia Adjuvante/veterinária , Condrossarcoma/tratamento farmacológico , Condrossarcoma/cirurgia , Condrossarcoma/veterinária , Doenças do Cão/tratamento farmacológico , Doenças do Cão/patologia , Cães , Feminino , Hemangiossarcoma/tratamento farmacológico , Hemangiossarcoma/cirurgia , Hemangiossarcoma/veterinária , Masculino , Osteossarcoma/tratamento farmacológico , Osteossarcoma/cirurgia , Estudos Retrospectivos , Sarcoma/tratamento farmacológico , Sarcoma/cirurgia , Sarcoma/veterinária , Escápula/patologia , Resultado do Tratamento
19.
Can Vet J ; 54(6): 591-4, 2013 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24155451

RESUMO

A 15-year-old female beagle dog was presented for a lingual liposarcoma. Full staging of the disease did not show any evidence of metastasis. A tongue rotation for reconstruction after rostral hemiglossectomy was performed after removal of the mass. This surgical technique may be useful in tongue reconstruction after trauma or tumor excision.


Rotation de la langue pour une reconstruction après une hémiglossectomie rostrale pour l'excision d'un liposarcome du quadrant rostral de la langue d'un chien. Une chienne Beagle âgée de 15 ans a été présentée pour un liposarcome lingual. La pleine stadification de la maladie n'a pas montré de preuves de métastase. Une rotation de la langue pour la reconstruction subséquente à une hémiglossectomie rostrale a été réalisée après l'enlèvement de la masse. Cette technique chirurgicale peut être utile dans la reconstruction de la langue après un traumatisme ou l'excision d'une tumeur.(Traduit par Isabelle Vallières).


Assuntos
Doenças do Cão/cirurgia , Lipossarcoma/veterinária , Procedimentos de Cirurgia Plástica/veterinária , Neoplasias da Língua/veterinária , Língua/cirurgia , Animais , Cães , Feminino , Lipossarcoma/cirurgia , Língua/patologia , Neoplasias da Língua/cirurgia
20.
Can Vet J ; 54(7): 683-6, 2013 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-24155463

RESUMO

Nephrectomy was performed in a 3-month-old intact female golden retriever dog for a renal nephroblastoma. The dog has remained disease-free for 19 months with nephrectomy alone. The adoption of human Wilms' tumor grading criteria may be useful in determining clinical stage, adjuvant treatment options, and prognosis in this rare disease.


Néphroblastome rénal chez un Golden Retriever âgé de 3 mois. Une néphrectomie a été réalisée sur une chienne Golden Retriever intacte âgée de 3 mois pour un néphroblastome rénal. La chienne est demeurée exempte de maladie pendant 19 mois, seulement à l'aide de la néphrectomie. L'adoption du critère humain de Wilms pour la classification des tumeurs peut être utile pour déterminer le stade clinique, les options de traitement auxiliaire et le pronostic de cette maladie rare.(Traduit par Isabelle Vallières).


Assuntos
Doenças do Cão/cirurgia , Neoplasias Renais/veterinária , Tumor de Wilms/veterinária , Animais , Doenças do Cão/patologia , Cães , Feminino , Neoplasias Renais/patologia , Neoplasias Renais/cirurgia , Tumor de Wilms/patologia , Tumor de Wilms/cirurgia
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