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1.
Oncology ; 86(1): 33-43, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24401539

RESUMEN

OBJECTIVE: Soluble mesothelin-related peptide (SMRP) may be useful in the diagnosis and detection of early stage mesothelioma. We investigated the SMRP upfront predictive role for mesothelioma in asbestos-exposed workers. METHODS: A total of 1,715 subjects underwent a first visit and were invited for a follow-up after 1 and 2 years, with a clinical examination and blood sampling. SMRP was measured by an ELISA assay. RESULTS: Median SMRP at the first visit was 0.45 [interquartile range (IQR) i.e. 25th-75th percentile: 0.30-0.67 nmol/l]. In all, 1,676 subjects (97.8%) were followed up for a median period of 47.1 months. SMRP was measured at the first visit and at both follow-up visits in 1,536 subjects. At follow-up, 3 subjects were diagnosed with an epithelioid mesothelioma. In these cases, SMRP at the first visit ranged from 0.17 to 0.52 nmol/l. Malignant pleural mesothelioma was diagnosed 9-17 months after the last SMRP evaluation. No SMRP variation was observed during the follow-up. Other 61 miscellaneous cancers were diagnosed (median SMRP at first visit: 0.50 nmol/l, IQR: 0.34-0.71 nmol/l). CONCLUSIONS: Our results did not support the usefulness of SMRP as an early marker for the detection of the disease for a time interval of 1 year.


Asunto(s)
Amianto/efectos adversos , Biomarcadores de Tumor/sangre , Proteínas Ligadas a GPI/sangre , Neoplasias Pulmonares/diagnóstico , Mesotelioma/diagnóstico , Exposición Profesional , Neoplasias Pleurales/diagnóstico , Anciano , Estudios de Seguimiento , Humanos , Neoplasias Pulmonares/sangre , Mesotelina , Mesotelioma/sangre , Mesotelioma Maligno , Persona de Mediana Edad , Neoplasias Pleurales/sangre , Estudios Prospectivos
2.
BMC Infect Dis ; 13: 443, 2013 Sep 23.
Artículo en Inglés | MEDLINE | ID: mdl-24059355

RESUMEN

BACKGROUND: The screening of both healthcare workers and students attending teaching hospitals for latent tuberculosis infection (LTBI) is recommended in hospitals of many countries with a low-incidence of TB, including Italy, as a fundamental tool of tuberculosis (TB) control programs. The aim of the study was to estimate the prevalence of LTBI and evaluate the main risk-factors associated with this condition in a cohort of healthcare Italian students. METHODS: In a cross-sectional study, performed between January and May 2012, 881 undergraduate students attending the Medical, Nursing, Pediatric Nursing and Midwifery Schools of the University of Genoa, trained at the IRCCS San Martino-IST Teaching Hospital of Genoa, were actively called to undergo the Tuberculin Skin Test (TST). All the TST positive cases were also tested with an Interferon-Gamma Release Assay (IGRA) to confirm the diagnosis of LTBI. A standardized questionnaire was collected for risk-assessment analysis. RESULTS: Seven hundred and thirty-three (83.2%) subjects underwent TST testing. The prevalence of TST positives was 1.4%, and in 4 (0.5%) out of 10 TST positive cases LTBI diagnosis was confirmed by IGRA. No difference in the prevalence of subjects who tested positive to TST emerged between pre-clinical (n = 138) and clinical (n = 595) students. No statistically significant association between TST positivity and age, gender, and BCG vaccination was observed. The main independent variable associated with TST positivity was to be born in a country with a high TB incidence (i.e., ≥20 cases per 100,000 population) (adjusted OR 102.80, 95% CI 18.09-584.04, p < 0.001). CONCLUSIONS: The prevalence of LTBI among healthcare students resulted very low. The only significant association between TST positivity and potential risk factors was to be born in high TB incidence areas. In countries with a low incidence of TB, the screening programs of healthcare students before clinical training can be useful for the early identification and treatment of the sporadic cases of LTBI.


Asunto(s)
Tuberculosis Latente/epidemiología , Adolescente , Adulto , Estudios Transversales , Femenino , Personal de Salud/educación , Fuerza Laboral en Salud/estadística & datos numéricos , Humanos , Ensayos de Liberación de Interferón gamma , Italia/epidemiología , Tuberculosis Latente/diagnóstico , Tuberculosis Latente/microbiología , Masculino , Factores de Riesgo , Estudiantes/estadística & datos numéricos , Prueba de Tuberculina , Adulto Joven
3.
Med Oncol ; 30(1): 422, 2013 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-23277285

RESUMEN

The soluble mesothelin-related peptide (SMRP), a candidate marker for screening of subjects with asbestos exposure, is influenced by some individual and clinical factors. The aim of this study was to quantify the role of age, smoking, weight, presence of diseases and exposure to asbestos on serum SMRP levels in a large series of subjects exposed to asbestos, possible candidates for mesothelioma screening. One thousand seven hundred and four participants underwent clinical examination and were interviewed on medical anamnesis, occupation, smoking and weight. SMRP was measured by an ELISA assay. Overall, median SMRP was 0.4 (IQR 25-75: 0.3-0.7) nmol/l. It was higher in current smokers and in subjects with a cumulative asbestos exposure >50 ff/cc/years than in all the other subjects (p < 0.001 and p = 0.002, respectively). SMRP was positively correlated with age (ρ = 0.11, p < 0.001) and, inversely, with BMI (ρ = -0.15, p < 0.001). SMRP was lower in healthy subjects (n = 1,217: median 0.4 nmol/l) than in subjects with malignant tumors (n = 118: 0.5 nmol/l; p = 0.01), asbestos-related pleural lesions (plaques or thickenings, n = 152: 0.6 nmol/l; p < 0.001) and other benign diseases (n = 182: 0.5 nmol/l; p = 0.04). Multivariate analysis revealed significant predictors of increased SMRP: age >57 years, current smoking, a positive anamnesis for cancer and for asbestos-related pleural lesions, and BMI < 25. Some clinical and demographic variables are associated with serum SMRP levels. The degree of these associations is low, nevertheless they should be accounted for in the interpretation of SMPR as a candidate marker predictive of mesothelioma. The potential predictive value of serum SMRP in screening/surveillance programs must be validated in prospective studies.


Asunto(s)
Biomarcadores de Tumor/sangre , Detección Precoz del Cáncer/métodos , Proteínas Ligadas a GPI/sangre , Mesotelioma/diagnóstico , Anciano , Amianto/efectos adversos , Ensayo de Inmunoadsorción Enzimática , Humanos , Masculino , Mesotelina , Mesotelioma/sangre , Persona de Mediana Edad , Exposición Profesional/efectos adversos , Fumar
4.
Mutat Res ; 721(1): 114-7, 2011 Mar 18.
Artículo en Inglés | MEDLINE | ID: mdl-21238604

RESUMEN

Inhalation of asbestos, a mineral extensively used in a variety of applications, is strongly associated with malignant mesothelioma (MM), a fatal cancer of the pleura. Soluble mesothelin-related peptides (SMRP) are a promising biomarker suggested for the screening of MM in healthy asbestos-exposed subjects. In the present study a comparison of micronucleus (Mn) frequencies in peripheral blood lymphocytes (PBL) between 44 asbestos-exposed and 22 control individuals has been performed, and the correlation with serum SMRP has been examined. SMRP levels were found to be significantly higher in subjects exposed to asbestos and in their various subgroups than in controls. Concerning micronucleated lymphocytes, a statistically significant difference from controls was seen in the percentages of both micronucleated mononucleated lymphocytes (MnMNL) and micronucleated binucleated lymphocytes (MnBNL), but the difference was markedly higher for the percentage of micronucleated polynucleated lymphocytes (MnPNL). With respect to the correlation between the frequency of the three types of micronucleated lymphocytes and serum-SMRP values of asbestos-exposed subjects, it was statistically significant for MnMNL, but not for MnBNL and MnPNL.


Asunto(s)
Amianto/toxicidad , Glicoproteínas de Membrana/sangre , Micronúcleos con Defecto Cromosómico/inducido químicamente , Exposición a Riesgos Ambientales , Proteínas Ligadas a GPI/sangre , Humanos , Linfocitos/ultraestructura , Mesotelina , Persona de Mediana Edad
5.
Clin Neurol Neurosurg ; 110(3): 259-61, 2008 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-17920188

RESUMEN

The diagnosis of decompression sickness may be difficult, particularly when patients present with atypical clinical manifestations after dives going on uneventfully and with full adherence to safety parameters. The case reports involve two divers who presented with transient global amnesia (TGA) immediately after surfacing from otherwise regular dives during which they had been breathing hyperoxic mixtures (Nitrox). A wide spectrum of symptoms of neural dysfunction following hyperoxic mixtures have been reported, including cases of memory impairment related to previous generalized convulsions. After a review of the literature, however, we found no previous reports of TGA, which is very unlikely to result from an epileptic mechanism, as an adverse effect of breathing hyperoxic mixtures.


Asunto(s)
Amnesia Global Transitoria/etiología , Buceo/efectos adversos , Oxígeno/efectos adversos , Administración por Inhalación , Anciano , Presión Sanguínea/fisiología , Encéfalo/diagnóstico por imagen , Confusión/etiología , Confusión/psicología , Electroencefalografía , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Pruebas Neuropsicológicas , Tomografía Computarizada por Rayos X
6.
Clin Neurol Neurosurg ; 107(4): 347-50, 2005 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-15885398

RESUMEN

We report on a patient with delayed carbon monoxide encephalopathy who presented with severe cognitive impairment associated with MRI findings of extensive demyelination of the cerebral white matter after a silent period of three weeks from acute intoxication. Despite the severe signs of structural and functional cerebral impairment in the sub-acute stage, the clinical course was favorable but for residual mild dysfunction of the frontal lobes.


Asunto(s)
Encefalopatías/etiología , Encefalopatías/psicología , Intoxicación por Monóxido de Carbono/complicaciones , Trastornos del Conocimiento/etiología , Lóbulo Frontal , Humanos , Masculino , Persona de Mediana Edad , Recuperación de la Función , Índice de Severidad de la Enfermedad , Factores de Tiempo
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