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1.
Lymphology ; 53(3): 118-135, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33350286

RESUMEN

Lymphedema is one of the most dreaded complications related to breast cancer surgery, commonly resulting in upper limb functional, esthetic, and psychological impairment. The necessity to improve the efficacy of conventional treatments and the promising effect of extracorporeal shock wave therapy (ESWT) on lymphangiogenesis in vitro and animal models, has prompted studies involving women affected by breast cancer-related lymphedema. Since intervention modalities and treatment protocols used are different, a review is necessary to verify the effectiveness of ESWT, evaluating the quality of existing studies and the eventual need for further research. Data were obtained from PubMed, Scopus, Google Scholar, Cochrane Library and PEDro, including articles published until January 2019. Five studies met the inclusion criteria. Evident heterogeneity emerged among selected studies permitting only a purely descriptive analysis of their data and strongly limiting their comparison. When compared to other treatment modalities, ESWT showed a significant effect on measured outcomes. It is clear that further high quality research is necessary to assert with confidence the effects and possible superiority of ESWT over other conservative therapies in the management of breast cancer-related lymphedema.


Asunto(s)
Linfedema del Cáncer de Mama/terapia , Tratamiento con Ondas de Choque Extracorpóreas , Animales , Linfedema del Cáncer de Mama/diagnóstico , Linfedema del Cáncer de Mama/rehabilitación , Manejo de la Enfermedad , Susceptibilidad a Enfermedades , Tratamiento con Ondas de Choque Extracorpóreas/métodos , Femenino , Humanos , Resultado del Tratamiento
2.
J Biol Regul Homeost Agents ; 34(5 Suppl. 3): 79-86. Technology in Medicine, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33386037

RESUMEN

Few studies investigated the effects of a robotic treatment in hand motor recovery after stroke. Aim of the present study was to evaluate the efficacy of treatment by means of Gloreha Sinfonia® robotic glove in hand motor recovery of a chronic stroke sample of patients with different impairment severity. Thirteen chronic stroke subjects were assigned to either active-assisted robotic treatment or passive robotic treatment according to their ability to actively extend wrist for at least 20 degrees. All subjects underwent 20 sessions of treatment with Gloreha Sinfonia® and were evaluated before (T0), after treatment (T1) and after one month (T2) with clinical scales testing motor performance [Motor Power (MP); Fugl Meyer Upper-Extremity (FMUE)] and spasticity [Modified Ashworth Scale (MAS)]. Both groups showed significant motor recovery and spasticity reduction. Further randomized controlled trials with larger samples are needed to confirm our results.


Asunto(s)
Rehabilitación de Accidente Cerebrovascular , Accidente Cerebrovascular , Enfermedad Crónica , Mano , Humanos , Proyectos Piloto , Recuperación de la Función , Robótica , Accidente Cerebrovascular/terapia , Resultado del Tratamiento
3.
Annu Int Conf IEEE Eng Med Biol Soc ; 2017: 893-896, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29060016

RESUMEN

Cognitive Rehabilitation Therapy refers to any systemic therapy specifically designed to enhance cognitive performance. Recent studies have shown that physical exercise is beneficial for cognitive activity in patients with degenerative diseases. Therefore, the objective of the present study is to provide training for cognitive functions that take advantage of the physical activity in the execution of the task. A feasibility study concerning the application of a new bioengineering technique in cognitive rehabilitation is presented and it divided into two parts. The first one aims at developing a new cognitive tool, called SmartTapestry (ST), for motor and cognitive rehabilitation. The second part aims at understanding its technical viability and its level of sensitivity in measuring the same cognitive domains covered by the standardized tests. The hypothesis of this study is that, despite the introduction of this new variable, the proposed system has the same sensitivity of the traditional tests. The results suggest a good correlation between the two approaches and that SmartTapestry can train the same cognitive functions of traditional cognitive tasks.


Asunto(s)
Memoria Episódica , Cognición , Comprensión , Ejercicio Físico , Estudios de Factibilidad , Humanos
4.
Annu Int Conf IEEE Eng Med Biol Soc ; 2017: 897-900, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29060017

RESUMEN

Dementia and other cognitive disorders affect more than 35 million people worldwide. Over the last years, cognitive training tools were used to improve the brain functioning, thus to slow down the cognitive decline. Recently, research studies have demonstrated that aerobic exercise could play an important restorative role toward cognitive impairments. Therefore, the aim of this work is to present an innovative sensorized approach which combines aerobic exercise and traditional cognitive tools for daily training.


Asunto(s)
Atención , Disfunción Cognitiva , Ejercicio Físico , Estudios de Factibilidad , Voluntarios Sanos , Humanos , Caminata
5.
Annu Int Conf IEEE Eng Med Biol Soc ; 2017: 4431-4434, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-29060880

RESUMEN

Electropalatography (EPG) is a clinical technique used to monitor contacts between the tongue and the hard palate, thus promoting correct articulation mechanisms. Currently, employed commercial tools have a good resolution but they do not provide contact pressure information. In this work, textile-based sensing technologies were employed to realize an innovative EPG tool able to both maintain the proper spatial resolution and perform quantitative pressure detection. The single sensing unit was developed using a thin polymeric sheet with a central hole, sandwiched between two piezoresistive fabric layers. Under load application, the two textile layers come into contact and the resistance of the sensor reduces significantly, measuring pressure in the range from 0 to 30 kPa. The complete prototype is composed of 62 sensing units disposed in a matrix structure: the dielectric layer contains all the sites arranged in rows and columns, according to the topography of the traditional tools, and this layer presents on both sides strips of piezoresistive textile. The entire system was covered with a thin latex membrane and fixed on a hard custom acrylic palate for the experimental characterization. The system was tested on a healthy subject, confirming the adequacy and effectiveness of the soft sensing technologies for the measuring of the tongue pressure during speech.


Asunto(s)
Habla , Voluntarios Sanos , Humanos , Hueso Paladar , Presión , Lengua
6.
Nutr Metab Cardiovasc Dis ; 26(1): 27-35, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26643208

RESUMEN

BACKGROUND AND AIMS: Serum uric acid (SUA) is the end-product of purine metabolism in humans, and its levels often increase in subjects with metabolic syndrome (MetS). Despite several studies demonstrating a relationship between increased SUA levels and the prevalence of MetS, prospective data on SUA as a predictor of the incidence of MetS in the elderly are limited. Our aim was to conduct a prospective study on the association between SUA concentrations and the onset of MetS in an elderly Italian cohort. METHODS AND RESULTS: This is a cohort study (Progetto Veneto Anziani; Pro.V.A.) involving community-dwelling subjects aged ≥65 years and followed up for a mean 4.4 years. We included 1128 participants (aged 74.7 ± 7.1 years) without MetS at the baseline. Gender-specific SUA groups according to the standard deviation (SD) from the mean were considered, taking the incidence of MetS as the main outcome. The mean SUA level was significantly higher in men than in women (5.4 ± 1.2 vs. 4.5 ± 1.2 mg/dl; p < 0.0001). Over the 4.4-year follow-up, 496 individuals developed MetS. After adjusting for potential confounders, Cox's regression analysis revealed no relationship between higher baseline SUA concentrations and the incidence of MetS in men or in the sample as whole, while women with SUA levels more than 1 SD above the mean (≥5.7 mg/dl) carried a 58% higher risk (95%CI: 1.03-2.40; p = 0.03) of being newly diagnosed with MetS during the follow-up. CONCLUSION: High SUA levels significantly and independently predicted MetS in older women, but not in men, over a 4.4-year follow-up.


Asunto(s)
Hiperuricemia/epidemiología , Síndrome Metabólico/epidemiología , Ácido Úrico/sangre , Factores de Edad , Anciano , Anciano de 80 o más Años , Biomarcadores/sangre , Femenino , Estudios de Seguimiento , Humanos , Hiperuricemia/sangre , Hiperuricemia/diagnóstico , Incidencia , Italia/epidemiología , Modelos Lineales , Modelos Logísticos , Estudios Longitudinales , Masculino , Síndrome Metabólico/diagnóstico , Modelos de Riesgos Proporcionales , Estudios Prospectivos , Medición de Riesgo , Factores Sexuales , Factores de Tiempo , Regulación hacia Arriba
7.
Theriogenology ; 82(9): 1287-95, 2014 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-25263483

RESUMEN

This in vitro study investigates the modulatory effect of three antibiotics (amoxicillin, enrofloxacin, and rifaximin) on contractility of the bovine uterine tissue in follicular and luteal phases. The effects of these antibiotics at three single doses (10(-6), 10(-5), and 10(-4) M) on their basal contractility were evaluated in isolated organ bath. The functionality of the strip throughout the experiment was evaluated by a dose of carbachol (10(-5) M); the obtained effect had to be repeatable (difference of ≤20%) that is comparable to that induced by the previous administration of the same substance. The results demonstrate the different modulatory activities of these antibiotics on uterine contractility in follicular and luteal phases. The effects induced by amoxicillin and enrofloxacin are opposite: the first relaxes and the second increases the uterine contractility in both cycle phases. Instead, the activity of rifaximin varies depending on the phase of estrous cycle: it increases in the follicular phase and relaxes in the luteal phase. The obtained data provide the hypothesis of possible implications of these drugs in the pharmacologic modulation of uterine contractions. Their action at this level, associated with their specific antimicrobial effects, could suggest using these antibiotics for the treatment of diseases related to postpartum or infections that may occur in pregnant cattle, by virtue of their effects on myometrial contractility too.


Asunto(s)
Amoxicilina/farmacología , Antibacterianos/farmacología , Fluoroquinolonas/farmacología , Rifamicinas/farmacología , Contracción Uterina/efectos de los fármacos , Útero/efectos de los fármacos , Animales , Bovinos , Enrofloxacina , Femenino , Fase Folicular , Técnicas In Vitro , Fase Luteínica , Embarazo , Rifaximina
8.
Nutr Metab Cardiovasc Dis ; 24(8): 914-20, 2014 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-24548664

RESUMEN

BACKGROUND AND AIMS: Physiological aging can lead to an increase in blood pressure (BP) over time even in regularly exercising elders. Office BP measurements (OBPM) might be unable to detect these BP variations. The aim of this study was to analyze BP changes over 3.5 years in active elders using ABPM. METHODS AND RESULTS: The study involved 80 active subjects ≥65 years old who exercised regularly. At baseline and again 3.5 years later, all subjects had lab tests, weight, body mass index (BMI), body composition, resting energy expenditure (REE) recorded; they underwent OBPM, ABPM and physical activity assessment. Over 3.5 years, our sample's mean weight, BMI, body composition, REE, albumin, and physical activity levels, did not change significantly. The prevalence of hypertension detected by OBPM dropped from 68.8% to 61.3%. ABPM revealed an increase in mean 24-h BP (Δsystolic: 5.3 ± 13.6 mmHg; p = 0.001; Δdiastolic: 1.8 ± 6.7 mmHg; p = 0.018) and mean daytime BP (Δsystolic: 5.8 ± 13.5 mmHg; p = 0.001; Δdiastolic: 1.9 ± 7.1 mmHg; p = 0.022); the prevalence of hypertension detected by ABPM increased from 50% to 65%, also due to an increase (from 8.8% to 16.3%) in masked hypertension. There was no correlation between BP changes and changes in body composition and REE. CONCLUSION: BP tends to increase over time in active elders, regardless of changes in body composition or level of physical activity. ABPM is an appropriate method for detecting these BP variations in active elders and to reveal cases of masked hypertension that might otherwise escape detection by OBPM.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial/métodos , Presión Sanguínea , Hipertensión/diagnóstico , Anciano , Anciano de 80 o más Años , Metabolismo Basal , Composición Corporal , Índice de Masa Corporal , Peso Corporal , Femenino , Estudios de Seguimiento , Humanos , Masculino , Actividad Motora , Prevalencia , Estudios Prospectivos , Factores de Riesgo , Albúmina Sérica/metabolismo , Circunferencia de la Cintura
9.
Neurogastroenterol Motil ; 24(9): 867-e399, 2012 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-22672206

RESUMEN

BACKGROUND: Differences in the actions of enteric neurotransmitters on colonic circular and longitudinal muscle layers have not been clearly determined, nor the possible existence of intrinsic myogenic phenotypes that might contribute to regional differences in human colon motor activity. The aim of this study was to analyze the direct pharmaco-mechanical coupling of carbachol (CCh) and vasoactive intestinal polypeptide (VIP) on human colonic smooth muscle strips and cells. METHODS: Circular and longitudinal muscle strips and cells were obtained from 15 human specimens of ascending and sigmoid colon. Both isometric tension on muscle strips and contraction and relaxation on cells were measured in response to increasing CCh and VIP concentrations. KEY RESULTS: Circular muscle strips of ascending colon were more sensitive to the effect of CCh than that of sigmoid colon, EC(50) values being, respectively, 4.15µmolL(-1) and 8.47µmolL(-1) (P<0.05), although there were no differences in maximal responses. No regional differences were observed in longitudinal muscle strips or in smooth muscle cells. Maximal responses to CCh were higher on circular than longitudinal muscle strips and cells throughout the colon. A greater sensitivity to VIP was observed in ascending colon compared with sigmoid colon, both in circular (EC(50:) 0.041 and 0.15µmolL(-1) , respectively, P<0.01) and longitudinal (EC(50:) 0.043 and 0.09µmolL(-1) , respectively, P<0.05) strips, and similar differences were observed in longitudinal smooth muscle cells (EC(50:) 44.85 and 75.24nmolL(-1) , respectively, P<0.05). CONCLUSIONS & INFERENCES: Regional myogenic differences in pharmaco-mechanical coupling between the enteric neurotransmitters and smooth muscle contribute to the complex regional motor patterns of human colon.


Asunto(s)
Carbacol/farmacología , Agonistas Colinérgicos/farmacología , Colon/efectos de los fármacos , Fármacos Gastrointestinales/farmacología , Miocitos del Músculo Liso/efectos de los fármacos , Péptido Intestinal Vasoactivo/farmacología , Anciano , Anciano de 80 o más Años , Colon Ascendente/efectos de los fármacos , Colon Sigmoide/efectos de los fármacos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Contracción Muscular/efectos de los fármacos , Relajación Muscular/efectos de los fármacos , Músculo Liso/efectos de los fármacos
10.
Dig Dis Sci ; 56(2): 352-8, 2011 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-20658192

RESUMEN

BACKGROUND: Gender- and age-related differences in muscular and nerve-mediated responses in human colon are poorly characterized. We studied carbachol-induced motor responses and electrically evoked contractions in sigmoid circular muscle from adult and elderly patients of different gender. METHODS: Sigmoid colon segments were obtained from 24 men and 16 women undergoing left hemicolectomy for colon cancer. Isometric tension was measured on muscle strips exposed to increasing carbachol concentrations. The effects of atropine, guanethidine, L-nitro arginine methyl ester (L-NAME), and tetrodotoxin on electrically evoked contractions were also studied. RESULTS: Female patients showed higher maximal response to carbachol than male patients, elderly females being the most sensitive to carbachol among all patient groups. Electrically evoked contractions were linearly related to stimulation frequency and abolished by tetrodotoxin. Electrically evoked contractions were significantly more pronounced in elderly male patients; they were reduced by atropine and guanethidine and increased by L-nitro arginine methyl ester in the presence of atropine and guanethidine (P < 0.05). The effect of L-NAME was most marked in elderly male patients and least pronounced in elderly females. CONCLUSIONS: The response to carbachol and the role of nitrergic pathways differ according to age and gender; this may depend on muscarinic receptor upregulation or humoral factors affecting nitric oxide release, respectively.


Asunto(s)
Envejecimiento , Colon/fisiología , Caracteres Sexuales , Anciano , Anciano de 80 o más Años , Atropina/administración & dosificación , Atropina/farmacología , Carbacol/administración & dosificación , Carbacol/farmacología , Colon/efectos de los fármacos , Relación Dosis-Respuesta a Droga , Electrofisiología , Femenino , Guanetidina/administración & dosificación , Guanetidina/farmacología , Humanos , Masculino , Persona de Mediana Edad , Contracción Muscular/efectos de los fármacos , Contracción Muscular/fisiología , Músculo Liso/efectos de los fármacos , Músculo Liso/fisiología , Tetrodotoxina/administración & dosificación , Tetrodotoxina/farmacología
11.
Acta Gastroenterol Latinoam ; 40(2): 128-33, 2010 Jun.
Artículo en Español | MEDLINE | ID: mdl-20645560

RESUMEN

BACKGROUND: The pancreas is a mixed gland that takes part in the digestion of nutrients and in the homeostasis ofglycemia. Chronic pancreopathy is the cause of secretory insufficiency, characterized by an inflammatory process that leads to fibrosis of the pancreas, with a progressive loss of both exocrine and endocrine functions of the gland. OBJECTIVE: To study both the exocrine and endocrine pancreatic relationship in patients with pancreatopathies and other non-pancreatic digestive alterations, by means of serum pancreolauril (sPL) and oral glucose tolerance tests (OGTT). Glycemia and insulin, basal and at 30, 60 and 120 minutes; amylase and lipase; and the HOMA index (homeostatic model) were determined in serum. MATERIAL AND METHODS: Thirty-two patients were evaluated: normal OGTT (n=11, control group) and pathologic OGTT (n=21). From the latter group, a subgroup (n=11) with a diagnosis of chronic pancreatitis (CP) was studied. RESULTS: Patients with pathologic OGTT in relation with normal OGTT presented a significant increase of glycemia at the four periods of time and of insulin at 120 minutes (P < 0.05), and a significant decrease of sPL (P < 0.05). In patients with CP, men were more than women, and all of them presented a pathologic OGTT and the sPL was significantly lower (P < 0.001). CONCLUSION: By the biochemical tests used, pancreas functionality corresponds with a close relationship between exocrine and endocrine pancreas. Thus, we suggest the use of the sPL test as a helpful tool for the diagnosis of CP.


Asunto(s)
Fluoresceínas , Prueba de Tolerancia a la Glucosa , Glucosa/análisis , Páncreas Exocrino/fisiopatología , Pancreatitis Crónica/sangre , Amilasas/sangre , Estudios de Casos y Controles , Femenino , Homeostasis , Humanos , Lipasa/sangre , Masculino , Persona de Mediana Edad , Pruebas de Función Pancreática/métodos , Pancreatitis Crónica/diagnóstico , Pancreatitis Crónica/fisiopatología
12.
Arch Gerontol Geriatr ; 49 Suppl 1: 125-8, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19836625

RESUMEN

Blood pressure (BP) measurement in clinical assessment by means of a mercury sphygmomanometer (MS) has numerous drawbacks. It has been proposed that non-invasive, 24-hr ambulatory blood pressure monitoring (NIABPM) should provide more appropriate BP values for both the diagnosis of hypertension and for its subsequent monitoring during treatment. The aim of the present study was to investigate, in 100 ambulatory and 250 hospitalized elderly subjects, the prevalence of white coat hypertension (WCH) and masked hypertension (MH) in a cohort of older subjects, by using both clinical readings (MS) and NIABPM. The results of our analyses indicate that a higher prevalence of old-old subjects regarded as normotensive at anamnesis or with normal BP values at MS are true hypertensive (50% of ambulatory patients and 17.1% of hospitalized patients) or masked hypertensive (10.3% of ambulatory patients and 28.6% of hospitalized patients), and consequently at higher risk of cardiovascular morbidity and mortality.


Asunto(s)
Monitoreo Ambulatorio de la Presión Arterial/métodos , Presión Sanguínea/fisiología , Hipertensión/diagnóstico , Pacientes Internos , Pacientes Ambulatorios , Factores de Edad , Anciano , Anciano de 80 o más Años , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/epidemiología , Hipertensión/fisiopatología , Incidencia , Italia/epidemiología , Masculino , Factores de Riesgo , Índice de Severidad de la Enfermedad
13.
Neurogastroenterol Motil ; 18(11): 1009-18, 2006 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-17040412

RESUMEN

Vasoactive intestinal peptide (VIP) relaxes smooth muscle by interacting with receptors coupled to cAMP- or cGMP-signalling pathways. Their relative contribution to human gastric relaxation is unknown. This study aimed at investigating, in terms of biological activity, receptor expression and related signalling pathways, the action of VIP separately on the human fundus and the antrum. VIP caused greater relaxation of smooth muscle cells (SMC) and strips of the antrum presenting on the former a higher efficacy and potency (ED(50): 0.53 +/- 0.17 nmol L(-1)) than on the fundus (ED(50): 3.4 +/- 1.4 nmol L(-1)). On both fundus and antrum strips, its effect was tetrodotoxin insentitive. Reverse transcriptase-polymerase chain reaction analysis showed the sole expression of VPAC2 and natriuretic peptide clearance receptors, with VPAC2 being more abundant in the antrum. Functional regional differences in receptor-related signalling pathways were found. Activation of the cAMP-pathway by forskolin or its inhibition by adenylate cyclase (2'5'-dideoxyadenosine) or kinase (Rp-cAMPs) inhibitors had more pronounced effects on antrum SMC. Activation of the cGMP-pathway by sodium nitroprusside or its inhibition by guanylate cyclase (LY83583) or kinase (KT5823) inhibitors had more effects on fundus SMC, on which a higher expression of endothelial nitric oxide synthase was found. In conclusion, regional differences in VIP action on human stomach are related to distinct myogenic properties of SMC of the antrum and the fundus.


Asunto(s)
Fundus Gástrico/fisiología , Relajación Muscular/fisiología , Músculo Liso/fisiología , Antro Pilórico/fisiología , Receptores de Péptido Intestinal Vasoactivo/metabolismo , Transducción de Señal/fisiología , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Técnicas de Cultivo de Órganos , Isoformas de Proteínas/fisiología , ARN Mensajero/análisis , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa
14.
Genet Test ; 9(2): 133-7, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-15943553

RESUMEN

The aim of this work was to perform genetic analysis on 18 different blood-spot samples collected from neonates detected as hyperphenylalaninemic by Northeastern Italian screening program. DNA was extracted from blood-spots. Exons/introns of PAH gene were amplified by polymerase chain reaction (PCR), and PCR products were purified and sequenced with both forward and reverse primers. The most frequent mutations were IVS12nt1g>a (16.7%) and R408W, P281L and L48S (all together 11.1%). As expected, compound heterozygosity was the usual finding; homozygosity was found only in two patients with R158Q and IVS2nt5g>c mutations. The V230I mutation was reported for the first time in Italy. We found six previously described polymorphisms (V245V, IVS4nt47c>t, IVS2nt19t>c, IVS3nt-22c>t, IVS5nt-54a>g, and E280>Q280). To our knowledge, four genotypes were not previously described: R158Q/V230I present in one patient with classical PKU; and L48S/R408Q, A403V/IVS2nt-13t>g, and G272X/V230I present in patients showing HPA phenotype. Most of the mutations were located in the exons 12 and 7 and in exon/intron 2 (83.3% detection of total mutations in PKU or HPA patients of Northeastern Italy). From a practical viewpoint, the genetic analysis of blood-spots collected on Guthrie cards for neonatal screening for PKU could be a simple method to establish the genotype of neonates. Consequently, the genotype/phenotype correlation could lead to a more accurate diagnosis and prognosis for families.


Asunto(s)
ADN/sangre , Tamizaje Neonatal , Fenilalanina Hidroxilasa/genética , Fenilcetonurias/genética , Sustitución de Aminoácidos , Genotipo , Humanos , Recién Nacido , Italia , Mutación , Fenilalanina Hidroxilasa/deficiencia , Reacción en Cadena de la Polimerasa , Polimorfismo Genético
15.
Dig Liver Dis ; 36(5): 348-54, 2004 May.
Artículo en Inglés | MEDLINE | ID: mdl-15191205

RESUMEN

BACKGROUND: Little is known about the pathophysiology of diverticular disease. AIM: To compare passive and active stress and the response to carbachol of colonic smooth muscle specimens from patients with diverticular disease and patients with colon cancer. The effect of the NK2 receptor antagonist, SR48968, on electrically evoked contractions of circular muscle was also investigated. PATIENTS: Sigmoid colon segments were obtained from 16 patients (51-83 years) undergoing elective sigmoid resection for diverticular disease and 39 patients (50-88 years) undergoing left hemicolectomy for non-obstructive sigmoid colon cancer. METHODS: Isometric tension was measured on circular or longitudinal taenial muscle. Strips were stretched gradually to Lo (length allowing the development of optimal active tension with carbachol) and were also exposed to increasing carbachol concentrations. The effects of atropine, tetrodotoxin and SR48968 on electrically evoked (supramaximal strength, 0.3 ms, 0.1-10 Hz) contractions of circular strips from 8 patients with diverticular disease and 19 patients with colon cancer were also studied. RESULTS: Both passive and active stress in circular muscle strips obtained from patients with diverticular disease was higher than in patients with colon cancer (P < 0.05). Electrically evoked contractions were significantly reduced by atropine in all preparations and were virtually suppressed by combined SR48968 and atropine. Tetrodotoxin suppressed electrically evoked contractions only in patients with colon cancer, whereas a tetrodotoxin-resistant component was identified in patients with diverticular disease. CONCLUSIONS: The changes in both passive and active stress in specimens from patients with diverticular disease may reflect circular smooth muscle dysfunction. Acetylcholine and tachykinins are the main excitatory neurotransmitters mediating electrically evoked contractions in human sigmoid colon circular muscle.


Asunto(s)
Benzamidas/farmacología , Colon Sigmoide/fisiología , Diverticulitis del Colon/fisiopatología , Contracción Isométrica/fisiología , Músculo Liso/fisiología , Piperidinas/farmacología , Anciano , Anciano de 80 o más Años , Anestésicos Locales/farmacología , Atropina/farmacología , Carbacol/farmacología , Estudios de Casos y Controles , Agonistas Colinérgicos/farmacología , Colon Sigmoide/efectos de los fármacos , Neoplasias del Colon/cirugía , Diverticulitis del Colon/cirugía , Estimulación Eléctrica , Femenino , Humanos , Técnicas In Vitro , Contracción Isométrica/efectos de los fármacos , Masculino , Persona de Mediana Edad , Músculo Liso/efectos de los fármacos , Parasimpatolíticos/farmacología , Receptores de Neuroquinina-2/antagonistas & inhibidores , Estrés Mecánico , Tetrodotoxina/farmacología
16.
J AOAC Int ; 87(2): 395-410, 2004.
Artículo en Inglés | MEDLINE | ID: mdl-15164834

RESUMEN

A multilaboratory study was conducted to compare the automated BAX system and the standard cultural methods for detection of Listeria monocytogenes in foods. Six food types (frankfurters, soft cheese, smoked salmon, raw, ground beef, fresh radishes, and frozen peas) were analyzed by each method. For each food type, 3 inoculation levels were tested: high (average of 2 CFU/g), low (average of 0.2 CFU/g) and uninoculated controls. A total of 25 laboratories representing government and industry participated. Of the 2335 samples analyzed, 1109 were positive by the BAX system and 1115 were positive by the standard method. A Chi square analysis of each of the 6 food types, at the 3 inoculation levels tested, was performed. For all foods, except radishes, the BAX system performed as well as or better than the standard reference methods based on the Chi square results.


Asunto(s)
Microbiología de Alimentos , Listeria monocytogenes/aislamiento & purificación , Reacción en Cadena de la Polimerasa/métodos , Distribución de Chi-Cuadrado
17.
Am J Hum Genet ; 74(6): 1314-20, 2004 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15108121

RESUMEN

Glaucoma is a leading cause of blindness worldwide. The disease is characterized by a degeneration of the optic nerve, which is usually associated with elevated intraocular pressure. The common form of adult-onset primary open-angle glaucoma is inherited as a complex trait, whereas the rarer early-onset juvenile open-angle glaucoma (JOAG) exhibits autosomal dominant inheritance. Of all cases of JOAG, approximately 10%-20% are caused by mutations in the myocilin gene. We have identified 25 pedigrees that are affected with typical JOAG and that demonstrate autosomal dominant inheritance. We sequenced the myocilin gene in probands from each family and found mutations in 8% of this population. To identify novel genes responsible for JOAG, we used families that did not have myocilin mutations for a genomewide screen. Markers located on chromosomes 9q22 and 20p12 showed evidence for linkage, identifying two novel loci for early-onset open-angle glaucoma.


Asunto(s)
Mapeo Cromosómico , Cromosomas Humanos Par 20/genética , Cromosomas Humanos Par 9/genética , Genoma Humano , Glaucoma de Ángulo Abierto/genética , Edad de Inicio , Proteínas del Citoesqueleto , Proteínas del Ojo/genética , Femenino , Ligamiento Genético , Glicoproteínas/genética , Humanos , Escala de Lod , Masculino , Repeticiones de Microsatélite , Mutación/genética , Linaje
18.
Minerva Cardioangiol ; 52(1): 55-60, 2004 Feb.
Artículo en Inglés, Italiano | MEDLINE | ID: mdl-14765039

RESUMEN

The anatomic anomalies of the supra-aortic trunks and their branches are comparatively frequent observations. They often remain asymptomatic throughout life although in some cases, especially if nothing is known of them, they may complicate surgical interventions involving that anatomical region. The case of a female patient who, during thyroidectomy, suffered the ligature of her external carotid artery which was taken mistakenly for the thyroid, is reported. Dissection of the area made it possible to identify an anomaly of the vascular structures with a carotid bifurcation which turned out to be very low, a very deep internal carotid artery on the prevertebral fascia and an absent lower thyroid artery. In the postoperative period, the patient was subjected to MR of the neck. This showed an anatomical anomaly of the left carotid bifurcation which was much lower than normal. An attempt was made to reconstruct the external carotid artery with a saphenous vein but unsuccessfully. The incident did not have serious complications for the patient but it might be asked whether, given the low cost and the absolute non-invasiveness of the examination, it might not be worth while to carry out a duplex scan of the supra-aortic trunks before going ahead with any operation in the cervical region, in consideration above all of the dangerous nature of these vascular structures and of the usefulness of studying pathologies that often remain silent until the occurrence of an event which might well be catastrophic.


Asunto(s)
Arteria Carótida Común/anomalías , Tiroidectomía , Arteria Carótida Externa/cirugía , Femenino , Bocio Nodular/cirugía , Humanos , Ligadura , Angiografía por Resonancia Magnética , Persona de Mediana Edad
19.
J Cardiovasc Surg (Torino) ; 44(2): 255-8, 2003 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-12813394

RESUMEN

Cystic adventitial disease (CAD) of the popliteal artery is a rare but well-known cause of intermittent claudication, especially in young patients. The etiology of the disease is still controversial and the literature reports various hypotheses for its origin. Diagnosis starts with thorough history taking and physical examination; non invasive diagnostic studies comprise color duplex scanner (ECD), computed tomography (CT), better if elicoidal (3D CT) and magnetic resonance imaging (MRI), which can aid in establishing correct recognition of the disease in most cases. A 48-year-old man presented with intermittent right calf claudication that had begun 4 months earlier; the symptom-free interval was about 100 m. MRI and MR angiography of right popliteal fossa revealed the presence of an oval cystic (maximum diameter 45 mm). The caudal aspect of the cyst showed pedicles protruding between the popliteal vein and the popliteal artery that compressed the artery, causing complete occlusion of its lumen. Surgery was performed through the posterior approach using an S-shaped incision; the affected segment of the popliteal artery was successfully excised and replaced with an autogenous external saphenous vein graft. A follow-up is underway, both clinical and with; no cyst recurrence has so far been detected either clinically or by duplex scanner during the 15-month postoperative follow-up period; the graft is patent and the patient is completely symptom free. Severe claudication in young patients, possibly without significant vascular risk factors, should prompt the clinical suspicion of adventitial cystic disease of the popliteal artery. Medical history, clinical examination and non invasive instrumental investigations, such as duplex scanner, elicoidal CT and/or MRI, may aid in establishing the correct diagnosis.


Asunto(s)
Claudicación Intermitente/cirugía , Enfermedades Vasculares Periféricas/cirugía , Arteria Poplítea , Humanos , Claudicación Intermitente/etiología , Angiografía por Resonancia Magnética , Masculino , Persona de Mediana Edad , Enfermedades Vasculares Periféricas/complicaciones , Enfermedades Vasculares Periféricas/diagnóstico , Arteria Poplítea/diagnóstico por imagen , Radiografía
20.
Minerva Cardioangiol ; 51(1): 71-7, 2003 Feb.
Artículo en Italiano | MEDLINE | ID: mdl-12652263

RESUMEN

BACKGROUND: The different therapeutic approaches to unilateral occlusive iliac artery disease are analyzed. METHODS: In the period from September 1999 to September 2001, a total of 43 patients (38 males and 5 females) has been treated for unilateral iliac artery occlusive disease. Thirty-four cases (79%) underwent an endovascular procedure, and the remaining 9 cases (21%) had a surgical intervention. Endovascular techniques included 11 cases of percutaneous transluminal angioplasty (PTA) of common iliac artery (25.6% of whole series), 5 PTA of external iliac artery (11.6%), 8 PTA+stenting of common iliac artery (18.6%) and 10 PTA+stenting of external iliac artery (23.2%). In 9 cases a surgical revascularization was performed: 6 patients underwent a femoro-femoral cross-over bypass (14%); 2 cases were treated with aorto-bifemoral reconstruction (4.7%) and one patient was operated with ilio-femoral graft (2.3 %). RESULTS: The analysis of the follow-up of our series showed, in the group of 34 patients treated with endovascular procedures, successful results were obtained in 79.4% (27 cases); in the 9 patients operated with surgical revascularization the success rate was 88.9% (8 cases ); failure rate was 20.6% for endovascular procedures and 11.1% for surgical interventions. CONCLUSIONS: The conclusion is drawn that endovascular approach (PTA, stenting) is usually the procedure of choice in the treatment of unilateral well localised lesions of the iliac artery. Conventional surgical intervention is effective for revascularizing an extensive involvement of the iliac segment or in case of bilateral disease.


Asunto(s)
Arteriopatías Oclusivas/terapia , Arteria Ilíaca , Adulto , Angioplastia de Balón , Arteriopatías Oclusivas/cirugía , Procedimientos Quirúrgicos Cardíacos , Femenino , Estudios de Seguimiento , Humanos , Masculino , Insuficiencia del Tratamiento
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