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There is a growing interest for cost-effective and nondestructive analytical techniques in both research and application fields. The growing approach by near-infrared spectroscopy (NIRs) pushes to develop handheld devices devoted to be easily applied for in situ determinations. Consequently, portable NIR spectrometers actually result definitively recognized as powerful instruments, able to perform nondestructive, online, or in situ analyses, and useful tools characterized by increasingly smaller size, lower cost, higher robustness, easy-to-use by operator, portable and with ergonomic profile. Chemometrics play a fundamental role to obtain useful and meaningful results from NIR spectra. In this review, portable NIRs applications, published in the period 2019-2022, have been selected to indicate starting references. These publications have been chosen among the many examples of the most recent applications to demonstrate the potential of this analytical approach which, not having the need for extraction processes or any other pre-treatment of the sample under examination, can be considered the "true green analytical chemistry" which allows the analysis where the sample to be characterized is located. In the case of industrial processes or plant or animal samples, it is even possible to follow the variation or evolution of fundamental parameters over time. Publications of specific applications in this field continuously appear in the literature, often in unfamiliar journal or in dedicated special issues. This review aims to give starting references, sometimes not easy to be found.
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OBJECTIVE: Analyzing the available evidence by comparing the role of arthroscopic surgery and conservative treatment in the management of degenerative meniscopathy. MATERIALS AND METHODS: A literature search was carried out on the PubMed, EMBASE, Scopus, and PEDro databases in May 2019 to identify all the randomized controlled trials (RCTs) comparing arthroscopic surgery to conservative management of painful but stable degenerated menisci. The quality of the RCTs was assessed using the Cochrane Risk of Bias Assessment. RESULTS: A total of 10 studies, including 1525 patients and dealing with conservative treatment vs. arthroscopic surgery were included in this review. In eight studies the effectiveness of exercise therapy was compared to surgery; in one study the effectiveness of intra-articular steroid injection was compared to surgery; in one study the effectiveness of placebo surgery was compared to partial meniscectomy. In all studies, no significant inter-group difference in terms of knee pain and knee function were observed at any follow-up evaluation. CONCLUSIONS: Degenerative meniscal tears, without symptoms of locking and catching, can be successfully managed by a proper regimen of physical therapy as a first line treatment. Surgical approach might be considered in case of poor response after conservative treatment.
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Artroscopía , Meniscectomía , Esteroides/uso terapéutico , Lesiones de Menisco Tibial , Humanos , Ensayos Clínicos Controlados Aleatorios como Asunto , Esteroides/administración & dosificación , Lesiones de Menisco Tibial/tratamiento farmacológico , Lesiones de Menisco Tibial/cirugíaRESUMEN
PURPOSE: To highlight the most relevant contributions of the Italian Renaissance surgeon Girolamo Fabrizi d'Acquapendente in the field of orthopaedics and traumatology. METHODS: An extensive research on the life and achievements of Girolamo Fabrizi was conducted on University Libraries as well as on electronic databases like PubMed. RESULTS: Girolamo Fabrizi d'Acquapendente is known for his embryology and physiology studies, particularly on sensory organs and blood circulation. He founded the world's first permanent anatomical theater established at the University of Padua and inaugurated in 1595. His most notable publications include surgical and definitely orthopedics works such as "De fracturis" (On fractures) and "De luxationibus" (On joint displacement). He outlined some principles of treatment that are still valid nowadays such as anatomical reduction and stabilization of the fracture, that were applied using the equipment available at that time. He described and illustrated maneuvers and instruments, such as pulleys, winches, splint, and bandages. He further depicted the famous "Oplomochlion" ("the armored man"), which is actually a collection of all of the braces used at the time to correct congenital and post-traumatic deformities. CONCLUSION: Bracing and prosthetic replacements have accompanied medical history throughout the centuries, from Ancient Egypt to the present, but it was the ingenuity of Renaissance surgeons that pushed biomedical technology to new heights: Girolamo Fabrizi d'Acquapendente was one of the most illustrious contributors to these great achievements.
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Fracturas Óseas/historia , Equipo Ortopédico/historia , Ortopedia/historia , Disciplinas de las Ciencias Biológicas/historia , Fracturas Óseas/cirugía , Cirugía General/historia , Historia del Siglo XVI , Historia del Siglo XVII , Humanos , Italia , Procedimientos Ortopédicos/historia , Procedimientos Ortopédicos/instrumentación , Procedimientos Ortopédicos/métodos , Traumatología/historiaAsunto(s)
Puente de Arteria Coronaria/efectos adversos , Deficiencia del Factor VII/congénito , Deficiencia del Factor VII/cirugía , Factor VII/farmacología , Atención Perioperativa , Anciano , Deficiencia del Factor VII/complicaciones , Hemorragia/etiología , Hemorragia/prevención & control , Humanos , Masculino , Resultado del TratamientoRESUMEN
A versatile synthetic route based on magnetic Fe3O4 nanoparticle (MNP) prefunctionalization with a phosphonic acid monolayer has been used to covalently bind the gH625 peptide on the nanoparticle surface. gH625 is a membranotropic peptide capable of easily crossing the membranes of various cells including the typical human blood-brain barrier components. A similar synthetic route was used to prepare another class of MNPs having a functional coating based on PEG, rhodamine, and folic acid, a well-known target molecule, to compare the performance of the two cell-penetrating systems (i.e., gH625 and folic acid). Our results demonstrate that the uptake of gH625-decorated MNPs in immortalized human brain microvascular endothelial cells after 24 h is more evident compared to folic acid-functionalized MNPs as evidenced by confocal laser scanning microscopy. On the other hand, both functionalized systems proved capable of being internalized in a brain tumor cell line (i.e., glioblastoma A-172). These findings indicate that the functionalization of MNPs with gH625 improves their endothelial cell internalization, suggesting a viable strategy in designing functional nanostructures capable of first crossing the BBB and, then, of reaching specific tumor brain cells.
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Background: The diagnostic and therapeutic approach to grass pollen allergy is now possible by detecting specific IgE (sIgE) to its allergenic components. Aim: To evaluate the correlation between the sensitisation to different molecular Phleum pratense (Phl p) allergens and clinical efficacy of SLIT. Methods: The pilot study included 36 patients affected by allergic rhinoconjunctivitis, all treated with SLIT actively. We performed serum analysis of sIgE to Phl p 1, 2, 4, 5, 6, 7, 11 and 12. The Average Rhinoconjunctivitis Total Symptom Score (ARTSS) and the Average Combined Score (ACS) were evaluated before and after one year of immunotherapy. Results: Three different groups of sensitisation were defined based on the range of IgE reactivity to Phleum pratense allergens at baseline: group I (sIgE reactive to 1-3 allergens); group II (sIgE reactive to 4-5 allergens); and group III (sIgE reactive to 6-8 allergens). At T0 ACS was 1.79 ± 0.18 in group I; 1.81 ± 0.23 in group II; and 1.95 ± 0.34 in group III. At T1 ACS was 0.85 ± 0.55 in group I; 1.01 ± 0.31 in group II; and 1.44 ± 0.39 in group III. At T1 there was a significant improvement of ARTSS and ACS for group I (p = 0.001). Conclusions: Sublingual immunotherapy with a grass pollen is efficacious irrespective of the patients baseline sensitisation to either single or multiple grass pollen molecular allergens. We found that patients with few sensitisations have a greater improvement in combined symptom and medication score. SLIT improves the clinical course of allergic patients although new sensitisations may appear (AU)
No disponible
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Humanos , Masculino , Femenino , Niño , Adolescente , Rinitis Alérgica/terapia , Conjuntivitis Alérgica/terapia , Inmunoterapia Sublingual/métodos , Resultado del Tratamiento , Polen/efectos adversos , Alérgenos/uso terapéuticoRESUMEN
A method for the separation of a mixture of terbutaline and non-steroidal anti-inflammatory drugs was developed using capillary electrophoresis with a new hemispherodextrin, ad hoc designed, the lysine - bridged hemispherodextrin (THLYSH). The use of lysine residues to bridge the trehalose capping unit moiety to the cyclodextrin cavity gives rise to a receptor with two long chains with amine nitrogen atoms, whose charge can be easily tuned as a function of the solution pH. The new hemispherodextrin was accurately characterised by ESI-MS and NMR spectroscopy, also highlighting its protonation behaviour. Circular dichroism and ESR spectroscopy measurements were also carried out to test its inclusion ability towards anthraquinone-3-sulfonate and its metal coordination ability towards copper(II) ion, respectively. Analogously to the other hemispherodextrins, the main skill of this new derivative lies in its chiral selector properties, as shown by the separation of the enantiomeric pairs of terbutaline and ibuprofen, flurbiprofen, suprofen and tiaprofenic acid by capillary electrophoresis. The focused use of the solution equilibria involved in the separations made it possible to understand the phenomena occurring in solution, and to finely tune the charge status of the receptor. In this way the chiral separation of the racemic mixture was successfully obtained, even if the receptor was individually used, differently by the other hemispherodextrins previously studied whose chiral separation capabilities are present only if used as binary mixtures.
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Electroforesis Capilar , Ciclodextrinas , Concentración de Iones de Hidrógeno , Lisina , Estereoisomerismo , TerbutalinaRESUMEN
BACKGROUND: The diagnostic and therapeutic approach to grass pollen allergy is now possible by detecting specific IgE (sIgE) to its allergenic components. AIM: To evaluate the correlation between the sensitisation to different molecular Phleum pratense (Phl p) allergens and clinical efficacy of SLIT. METHODS: The pilot study included 36 patients affected by allergic rhinoconjunctivitis, all treated with SLIT actively. We performed serum analysis of sIgE to Phl p 1, 2, 4, 5, 6, 7, 11 and 12. The Average Rhinoconjunctivitis Total Symptom Score (ARTSS) and the Average Combined Score (ACS) were evaluated before and after one year of immunotherapy. RESULTS: Three different groups of sensitisation were defined based on the range of IgE reactivity to Phleum pratense allergens at baseline: group I (sIgE reactive to 1-3 allergens); group II (sIgE reactive to 4-5 allergens); and group III (sIgE reactive to 6-8 allergens). At T0 ACS was 1.79±0.18 in group I; 1.81±0.23 in group II; and 1.95±0.34 in group III. At T1 ACS was 0.85±0.55 in group I; 1.01±0.31 in group II; and 1.44±0.39 in group III. At T1 there was a significant improvement of ARTSS and ACS for group I (p=0.001). CONCLUSIONS: Sublingual immunotherapy with a grass pollen is efficacious irrespective of the patients' baseline sensitisation to either single or multiple grass pollen molecular allergens. We found that patients with few sensitisations have a greater improvement in combined symptom and medication score. SLIT improves the clinical course of allergic patients although new sensitisations may appear.
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Alérgenos/uso terapéutico , Antígenos de Plantas/uso terapéutico , Conjuntivitis/terapia , Rinitis Alérgica/terapia , Inmunoterapia Sublingual/métodos , Adolescente , Alérgenos/inmunología , Antígenos de Plantas/inmunología , Niño , Conjuntivitis/diagnóstico , Conjuntivitis/inmunología , Femenino , Humanos , Inmunización , Inmunoglobulina E/sangre , Masculino , Phleum , Polen , Valor Predictivo de las Pruebas , Rinitis Alérgica/diagnóstico , Rinitis Alérgica/inmunologíaRESUMEN
Nepeta cataria L.,commonly known as Catnip, is an aromatic plant belonging to the mint family, Limiaceae. Nematicidal activity of Catnip essential oil (CEO), was assayed in vitro against L3 larvae of Anisakis type 1. Anisakidosis is one of the most important fishborne zoonotic diseases related to the ingestion of nematode larvae belonging to the genus Anisakis, Contraceacum and more rarely Pseudoterranova and Hysterothylacium. In vitro tests revealed a complete inactivation of parasites after 6 and 12 h of treatment, at 10 and 5% respectively, in saline solution. In marinating solution a complete inactivation of parasites was observed after 12 and 18 hours at 10 and 5% concentrations respectively. The data obtained showing a significant activity against Anisakis larvae and suggest further investigations on CEO as a larvicidal agent.
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We search for single-photon events in 53 fb^{-1} of e^{+}e^{-} collision data collected with the BABAR detector at the PEP-II B-Factory. We look for events with a single high-energy photon and a large missing momentum and energy, consistent with production of a spin-1 particle A^{'} through the process e^{+}e^{-}âγA^{'}; A^{'}âinvisible. Such particles, referred to as "dark photons," are motivated by theories applying a U(1) gauge symmetry to dark matter. We find no evidence for such processes and set 90% confidence level upper limits on the coupling strength of A^{'} to e^{+}e^{-} in the mass range m_{A^{'}}≤8 GeV. In particular, our limits exclude the values of the A^{'} coupling suggested by the dark-photon interpretation of the muon (g-2)_{µ} anomaly, as well as a broad range of parameters for the dark-sector models.
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In this paper we report the synthesis and characterization of biocompatible multi-functional magnetic nanoparticles (MNPs) able to enhance the intracellular transport of N-methylated drugs. The Fe3O4 magnetic core was first functionalized with a mixed monolayer consisting of two different phosphonic acids having terminal acetylenic and amino groups, which provide an active platform for further functionalization with organic molecules. Then, a tetraphosphonate cavitand receptor (Tiiii) bearing an azide moiety and the N-hydroxysuccinimide (NHS) activated forms of poly(ethylene glycol) (PEG), folic acid (FA) and carboxy-X-rhodamine (Rhod) were covalently anchored on alkyne and amine moieties respectively, through 1,3-dipolar cycloaddition and EDC/NHS coupling reactions. The obtained MNPs are biocompatible and possess magnetic, luminescence and recognition properties which make them suitable for multimodal theranostic applications. In particular, combined confocal microscopy and cytotoxicity experiments showed that these multi-functional MNPs are able to recognize a specific drug "in situ" and promote its cellular internalization, thus enhancing its efficiency.
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Evidence suggests the involvement of the cannabinoid system in the pathogenesis of multiple sclerosis (MS). We studied cannabinoid receptor (CB)1 and CB2 receptor gene expression in B, natural killer (NK) and T cells from MS patients before and after 1 year of interferon beta therapy, and compared these levels to those of healthy controls. We also measured the production of the endocannabinoids anandamide (AEA) and 2-arachidonoylglycerol (2-AG) and the gene expression of the endocannabinoid-degrading enzyme fatty acid amide hydrolase (FAAH) in these cells. Prior to interferon therapy, MS patients showed significantly elevated CB2 expression in B cells, but not in T or NK cells. These levels decreased gradually within 6 months to 1 year of interferon treatment. CB1 expression was elevated in all cell subsets, but only reached statistical significance in T cells; all levels decreased progressively over time. Before treatment, AEA but not 2-AG levels were significantly elevated in the three cell populations; after 1 year of treatment, all values decreased to control levels. The expression of FAAH was unchanged. The different expression of cannabinoid receptor genes and the increased level of AEA in lymphocytes point to a possible role of the cannabinoid system in MS immune response and its modulation by interferon.
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Endocannabinoides/metabolismo , Regulación de la Expresión Génica/efectos de los fármacos , Interferón beta/farmacología , Subgrupos Linfocitarios/metabolismo , Esclerosis Múltiple/genética , Esclerosis Múltiple/metabolismo , Receptores de Cannabinoides/genética , Adolescente , Adulto , Amidohidrolasas/genética , Amidohidrolasas/metabolismo , Femenino , Humanos , Interferón beta/uso terapéutico , Estudios Longitudinales , Subgrupos Linfocitarios/inmunología , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/tratamiento farmacológico , Esclerosis Múltiple/inmunología , Esclerosis Múltiple Recurrente-Remitente/genética , Esclerosis Múltiple Recurrente-Remitente/inmunología , Esclerosis Múltiple Recurrente-Remitente/metabolismo , ARN Mensajero/genética , Receptor Cannabinoide CB1/genética , Receptor Cannabinoide CB2/genética , Adulto JovenRESUMEN
Long-term administration of l-3,4-dihydroxyphenylalanine (levodopa), the mainstay treatment for Parkinson's disease (PD), is accompanied by fluctuations in its duration of action and motor complications (dyskinesia) that dramatically affect the quality of life of patients. Levodopa-induced dyskinesias (LID) can be modeled in rats with unilateral 6-OHDA lesions via chronic administration of levodopa, which causes increasingly severe axial, limb, and orofacial abnormal involuntary movements (AIMs) over time. In previous studies, we showed that the direct activation of CB1 cannabinoid receptors alleviated rat AIMs. Interestingly, elevation of the endocannabinoid anandamide by URB597 (URB), an inhibitor of endocannabinoid catabolism, produced an anti-dyskinetic response that was only partially mediated via CB1 receptors and required the concomitant blockade of transient receptor potential vanilloid type-1 (TRPV1) channels by capsazepine (CPZ) (Morgese et al., 2007). In this study, we showed that the stimulation of peroxisome proliferator-activated receptors (PPAR), a family of transcription factors activated by anandamide, contributes to the anti-dyskinetic effects of URB+CPZ, and that the direct activation of the PPARγ subtype by rosiglitazone (RGZ) alleviates levodopa-induced AIMs in 6-OHDA rats. AIM reduction was associated with an attenuation of levodopa-induced increase of dynorphin, zif-268, and of ERK phosphorylation in the denervated striatum. RGZ treatment did not decrease striatal levodopa and dopamine bioavailability, nor did it affect levodopa anti-parkinsonian activity. Collectively, these data indicate that PPARγ may represent a new pharmacological target for the treatment of LID.
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Antidiscinéticos/farmacología , Discinesia Inducida por Medicamentos/tratamiento farmacológico , Levodopa/toxicidad , PPAR gamma/agonistas , Trastornos Parkinsonianos/metabolismo , Tiazolidinedionas/farmacología , Animales , Antidiscinéticos/farmacocinética , Antidiscinéticos/toxicidad , Cuerpo Estriado/efectos de los fármacos , Cuerpo Estriado/metabolismo , Dopamina/metabolismo , Dinorfinas/metabolismo , Discinesia Inducida por Medicamentos/metabolismo , Proteína 1 de la Respuesta de Crecimiento Precoz/metabolismo , Quinasas MAP Reguladas por Señal Extracelular/metabolismo , Levodopa/farmacocinética , Levodopa/farmacología , Masculino , Oxidopamina , PPAR gamma/metabolismo , Trastornos Parkinsonianos/tratamiento farmacológico , Fosforilación/efectos de los fármacos , Ratas Sprague-Dawley , Ratas Wistar , RosiglitazonaRESUMEN
Primary Snoring (PS) has been positioned at the milder end of the Sleep-Disordered Breathing severity continuum characterized by snoring and it is usually underestimated. PS is defined as snoring without apnea, frequent arousals, or gas exchange abnormalities and recent studies demonstrated that children with PS have increased blood pressure and reduced arterial distensibility. The association between adipokines and SDB has been recently investigated, though most of the studies were focused on OSAS where intermittent hypoxia characterizing the disease may lead to an inflammatory cascade and to the release of several adipokines, contributing to oxidative stress. Resistin, initially described s an adipokine increasing insulin resistance, has been recently identified as a novel important member of the cytokine family involved in the regulation of inflammation. The aim of our study was to investigate circulating resistin levels in normal weight children with PS. Sixty-five children of normal weight aged between 4 and 14 years of age were selected for habitual snoring. Children with positive polysomnography were excluded from the study. Serum resistin levels were detected in all children with PS. Thirty-three healthy non-snorer children with similar age, sex and BMI were selected as a control group. A significantly higher level of resistin was observed in patients with PS compared to the control group (4.67±1.91 ng/ml vs 3.98±1.58 ng/ml; p<0.01). Patients with inconclusive pulse oximetry showed significantly higher resistin levels than those with negative recordings recordings (5.29±1.91 ng/ml vs 4.20±1.93 ng/ml; p<0.008). Moreover, there was a significant increasing trend between sieric adipokine level and the frequency of snoring (p<0.006). Our results suggest that systemic inflammation and oxidative stress may also play a significant role in the pathophysiology of PS.
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Resistina/sangre , Ronquido/sangre , Adolescente , Niño , Preescolar , Femenino , Humanos , Inflamación/complicaciones , Masculino , Estrés Oxidativo , Apnea Obstructiva del Sueño/sangre , Ronquido/etiologíaRESUMEN
Anisakiasis is an important food-borne disease especially in countries with high fish consumption. The increase of cases of human disease and the virtual absence of effective treatments have prompted the research on new active compounds against Anisakis larvae. As well known, the disease is related to the consumption of raw or almost raw seafood products, but also marinated and/or salted fishery products, if the processing is insufficient to destroy nematode larvae can represent a risks for the consumers. In the light of the biocidal efficacy against different pathogens demonstrated for various essential oils, the aim of this work is to evaluate the effect of Thymus vulgaris essential oil (TEO) against anisakidae larvae. The TEO at 10% and 5% concentration in oil sunflower seeds, caused in vitro the death of all larvae within 14 h, with cuticle and intestinal wall damages. The results obtained showing a significant activity against Anisakis larvae, suggest further investigation on TEO as a larvicidal agent and on its potential use in the industrial marinating process.
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Anisakis/efectos de los fármacos , Aceites Volátiles/farmacología , Aceites de Plantas/farmacología , Thymus (Planta)/química , Animales , Anisakis/ultraestructura , Peces , Larva/efectos de los fármacos , Microscopía Electrónica de Rastreo , Alimentos Marinos/parasitología , Aceite de GirasolRESUMEN
Factor XI (FXI) deficiency is a rare inherited bleeding disorder invariably caused by mutations in the FXI gene. The disorder is rather frequent in Ashkenazi Jews, in whom around 98% of the abnormal alleles is represented by Glu117X and Phe283Leu mutations. A wide heterogeneity of causative mutations has been previously reported in a few FXI deficient patients from Italy. In this article, we enlarge the knowledge on the genetic background of FXI deficiency in Italy. Over 4 years, 22 index cases, eight with severe deficiency and 14 with partial deficiency, have been evaluated. A total of 21 different mutations in 30 disease-associated alleles were identified, 10 of which were novel. Among them, a novel Asp556Gly dysfunctional mutation was also identified. Glu117X was also detected, as previously reported from other patients in Italy, while again Phe283Leu was not identified. A total of 34 heterozygous relatives were also identified. Bleeding tendency was present in very few cases, being inconsistently related to the severity of FXI deficiency in plasma. In conclusion, at variance with other populations, no single major founder effect is present in Italian patients with FXI deficiency.
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Deficiencia del Factor XI/genética , Factor XI/genética , Empalme Alternativo , Secuencia de Aminoácidos , Sustitución de Aminoácidos , Factor XI/química , Deficiencia del Factor XI/sangre , Deficiencia del Factor XI/diagnóstico , Femenino , Heterogeneidad Genética , Genotipo , Humanos , Italia , Masculino , Modelos Moleculares , Datos de Secuencia Molecular , Mutación , Mutación Missense , Sistemas de Lectura Abierta , Conformación Proteica , Estabilidad Proteica , Alineación de Secuencia , Población Blanca/genéticaRESUMEN
Although a number of studies have analysed so far the causes of death and the life expectancy in haemophilic populations, no investigations have been conducted among Italian haemophilia centres. Thus, the aim of this study was to investigate mortality, causes of deaths, life expectancy and co-morbidities in Italian persons with haemophilia (PWH). Data pertaining to a total of 443 PWH who died between 1980 and 2007 were retrospectively collected in the 30 centres who are members of the Italian Association of Haemophilia Centres that chose to participate. The mortality rate ratio standardized to the male Italian population (SMR) was reduced during the periods 1990-1999 and 2000-2007 such that during the latter, death rate overlapped that of the general population (SMR 1990-1999: 1.98 95% CI 1.54-2.51; SMR 2000-2007: 1.08 95% CI 0.83-1.40). Similarly, life expectancy in the whole haemophilic population increased in the same period (71.2 years in 2000-2007 vs. 64.0 in 1990-1999), approaching that of the general male population. While human immunodeficiency virus infection was the main cause of death (45%), 13% of deaths were caused by hepatitis C-associated complications. The results of this retrospective study show that in Italian PWH improvements in the quality of treatment and global medical care provided by specialized haemophilia centres resulted in a significantly increased life expectancy.
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Hemofilia A/mortalidad , Hemofilia B/mortalidad , Esperanza de Vida , Adolescente , Adulto , Anciano , Causas de Muerte , Niño , Preescolar , Femenino , Infecciones por VIH/complicaciones , Infecciones por VIH/mortalidad , Hemofilia A/complicaciones , Hemofilia B/complicaciones , Hepatitis C/complicaciones , Hepatitis C/mortalidad , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto JovenRESUMEN
After the first outbreak identified in Mexico in late March 2009, influenza A sustained by a modified H1N1 virus ("swine flu") rapidly spread to all continents. This article describes the first Italian case of life-threatening ARDS associated with H1N1 infection, treated with extracorporeal respiratory assistance (venovenous extracorporeal membrane oxygenation [ECMO]). A 24-year-old, previously healthy man was admitted to the Intensive Care Unit (ICU) of the local hospital for rapidly progressive respiratory failure with refractory impairment of gas exchange unresponsive to rescue therapies (recruitment manoeuvres, pronation and nitric oxide inhalation). An extracorporeal respiratory assistance (venovenous ECMO) was performed. It allowed a correction of the respiratory acidosis and made possible the transportation of the patient to the ICU (approximately 150 km from the first hospital). A nasal swab tested positive for H1N1 infection and treatment with oseltamivir was started. The chest computed tomography scan showed bilateral massive, patchy consolidation of lung parenchyma; lab tests showed leukopenia, elevated CPK levels and renal failure. The patient required high dosages of norepinephrine for septic shock and continuous renal replacement therapy. The clinical course was complicated by Pseudomonas aeruginosa superinfection, treated with intravenous and aerosolised colistin. ECMO was withheld after 15 days, while recovery of renal and respiratory function was slower. The patient was discharged from the ICU 34 days after admission. In this case, ECMO was life-saving and made the inter-hospital transfer of the patient possible.
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Subtipo H1N1 del Virus de la Influenza A , Gripe Humana/complicaciones , Respiración Artificial , Síndrome de Dificultad Respiratoria/etiología , Síndrome de Dificultad Respiratoria/terapia , Humanos , Masculino , Adulto JovenRESUMEN
Anecdotal reports of painful synovitis after implantation of the Artelon spacer (Small Bone Innovations, Inc., Morrisville, PA) have emerged. The manufacturer claims that this type of reaction is related to the method of fixation and/or to suture material. This report illustrates one case in which a patient exhibited sustained painful synovitis after implantation of the Artelon spacer in the scaphotrapezio-trapezoidal joint, which clinically resolved on removal of the implant. Furthermore, pathology specimens of the soft tissue, synovium, and bone demonstrated an exuberant granulomatous foreign body giant cell reaction to the implant material. Patients should be made aware of the potential of the Artelon spacer to cause a foreign body reaction that may necessitate reoperation for removal of the implant.
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Implantes Absorbibles/efectos adversos , Artroplastia/métodos , Materiales Biocompatibles/efectos adversos , Reacción a Cuerpo Extraño/etiología , Osteoartritis/cirugía , Poliuretanos/efectos adversos , Complicaciones Posoperatorias/etiología , Hueso Escafoides/cirugía , Sinovitis/etiología , Hueso Trapecio/cirugía , Hueso Trapezoide/cirugía , Reacción a Cuerpo Extraño/diagnóstico , Reacción a Cuerpo Extraño/patología , Reacción a Cuerpo Extraño/cirugía , Células Gigantes de Cuerpo Extraño/patología , Humanos , Masculino , Persona de Mediana Edad , Osteosclerosis/diagnóstico , Osteosclerosis/etiología , Osteosclerosis/patología , Osteosclerosis/cirugía , Complicaciones Posoperatorias/diagnóstico , Complicaciones Posoperatorias/patología , Complicaciones Posoperatorias/cirugía , Reoperación , Hueso Escafoides/patología , Suturas/efectos adversos , Sinovectomía , Membrana Sinovial/patología , Sinovitis/diagnóstico , Sinovitis/patología , Sinovitis/cirugía , Hueso Trapecio/patología , Hueso Trapezoide/patologíaRESUMEN
Bacteria were isolated from 12 of 25 hydatid cysts collected from the lungs and livers of cattle, sheep and goats slaughtered in the province of Messina, Sicily, Italy. Citrobacter freundii was isolated from seven of the cysts, Aeromonas hydrophila from three, Staphylococcus species from two, Salmonella species from two and Escherichia coli and Proteus vulgaris from one.