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1.
Ann Ig ; 35(6): 707-714, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37476887

RESUMO

Abstract: The Erice 58 Charter titled "The Health of Migrants: a Challenge of Equity for the Public Health System", was unanimously approved at the conclusion of the 58th Residential Course of the School of Epidemiology and Preventive Medicine 'Giuseppe D'Alessandro' entitled "The Health of Migrants: a Challenge of Equity for the Public Health System. Epidemiological, clinical-relational, regulatory, organisational, training and public communication aspects at international, national and local level', which took place from 28 March to 2 April 2022 in Erice (Sicily, Italy), at the 'Ettore Majorana' Foundation and Centre for Scientific Culture. The Course was promoted by the Italian Society of Migration Medicine (S.I.M.M.) and the Italian Society of Hygiene, Preventive Medicine and Public Health (SItI), with the collaboration and patronage of the Istituto Superiore di Sanità (ISS). 72 learners participated (mainly resident doctors in 'Hygiene and Preventive Medicine' but also other health service professionals), whose average age was 37 years; on the basis of territorial origin, 13 of the 20 Italian regions were represented. During the intense learning experience, which consisted of 18 frontal lessons (with 20 lecturers from the bio-medical, socio-anthropological and journalistic fields) and 7 working group sessions (supported by 4 classroom tutors in addition to the lecturers) in 'blended learning' mode, the various dimensions and critical issues related to the possibility of guaranteeing truly inclusive health policies for foreigners/migrants, throughout the country, were identified and discussed from an 'Health Equity' perspective. This enabled a small editorial group to draw up the basic document that, in the last session of the Course, was discussed and modified by all participants into the version of the 'Erice 58 Charter' presented here.


Assuntos
Saúde Pública , Migrantes , Humanos , Adulto , Saúde Pública/educação , Higiene , Itália , Sicília , Instituições Acadêmicas
2.
Nat Prod Res ; 35(24): 5737-5743, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33032453

RESUMO

Alcohol and its metabolites are responsible for damage both within the gastrointestinal tract and other organs. Alcohol abuse promote intestinal inflammation, that may be the cause of multiple organ dysfunctions and chronic disorders. In this research, the effect of astaxanthin, a powerful antioxidant with several biological effects, on alcohol damage-induced in the intestine of Carassius auratus, was investigated. In the fishes exposed to ethanol, an increase of the intestinal epithelium mucous cells and circulating macrophages, with intestinal mucosa disorganization was observed. In contrast, in the fishes treated with astaxanthin intestinal morphology was restored. By immunohistochemical analysis, using α-Smooth Muscle Actin (α-SMA) and Vasoactive intestinal polypeptide (VIP) antibodies, a reduction of inflammatory states alcohol-induced was evident, with more regular muscularis submucosa and more organized intestinal mucosa without inflammatory cells. The results suggest that astaxanthin treatments can be a good candidate for preventing damage within the gastrointestinal associated with excessive alcohol consumption.


Assuntos
Carpa Dourada , Xantofilas , Animais , Etanol , Modelos Teóricos , Xantofilas/farmacologia
3.
Public Health ; 186: 52-56, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32771661

RESUMO

OBJECTIVES: Lockdown measures in response to the coronavirus disease 2019 (COVID-19) pandemic can have serious mental health effects on the population, especially in vulnerable groups, such as those living in poor socio-economic conditions, those who are homeless, migrant workers and asylum seekers/refugees. In addition, these vulnerable groups frequently have greater difficulty accessing health services and in treatment adherence. The aim of this study is to estimate the impact of the COVID-19-related lockdown on service utilisation and follow-up adherence in an Italian mental health outpatient service for migrants and individuals in socio-economic difficulties. STUDY DESIGN: The design of this study is a retrospective cross-sectional study. METHODS: All patients who visited the mental health outpatient service in the months of February and March in the years 2017-2020 were included in the study. To compare service utilisation before and after the lockdown, the number of patients who visited the mental health outpatient service for psychiatric interview were recorded. Follow-up adherence was calculated as the percentage of patients who visited in February and subsequently attended a follow-up visit in March of the same year. RESULTS: The number of patients who visited the outpatient service between February 2017 and February 2020 was continuously increasing. In March 2020, fewer patients visited the service for psychiatric interview, in line with the introduction of lockdown measures. In addition, the number of the patients who visited in February 2020 and returned for their follow-up visits in March 2020 declined from approximately 30% over the same months in 2017-2019 to 17.53% in March 2020. CONCLUSIONS: The lockdown-related reduction in numbers of patients accessing the mental health service makes it difficult to help vulnerable populations during a period of time in which their mental health needs are expected to increase. Moreover, the reduction seen in follow-up compliance increases the risk of treatment discontinuation and possible relapse. Proactive alternative strategies need to be developed to reach these vulnerable populations.


Assuntos
Infecções por Coronavirus/prevenção & controle , Emigrantes e Imigrantes/psicologia , Utilização de Instalações e Serviços/estatística & dados numéricos , Acessibilidade aos Serviços de Saúde/estatística & dados numéricos , Serviços de Saúde Mental/estatística & dados numéricos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Pobreza , Cooperação e Adesão ao Tratamento/estatística & dados numéricos , Adulto , COVID-19 , Infecções por Coronavirus/epidemiologia , Estudos Transversais , Emigrantes e Imigrantes/estatística & dados numéricos , Feminino , Pessoas Mal Alojadas/psicologia , Pessoas Mal Alojadas/estatística & dados numéricos , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/epidemiologia , Refugiados/psicologia , Refugiados/estatística & dados numéricos , Estudos Retrospectivos , Populações Vulneráveis , Adulto Jovem
4.
Diabetes Res Clin Pract ; 166: 108309, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32650034

RESUMO

AIMS: This study evaluates the adherence to postpartum type 2 diabetes mellitus (T2DM) screening in women with previous gestational diabetes (GDM) and identifies elements associated with poor attendance. METHODS: We retrospectively collected data from 650 consecutive women with GDM between 2016 and 2018, who should had 75 g-OGTT, 4-12 weeks after delivery. Impaired glucose regulation (IGR) was defined according with ADA criteria. RESULTS: Only 41% of women had postpartum OGTT. Of these, 1.9% received T2DM diagnosis, with IGR prevalence of 18%. After introducing a recommendation letter, adherence to screening increased (47% in 2017 and 43% in 2018 vs. 32% in 2016). Screening procedure was less common in women with: no-family history of T2DM (38% vs. 46%; p < 0.05), age <35 (33% vs. 47%; p < 0.01), lower level of education (32% no-high-school-diploma vs. 35% high-school-diploma vs. 49% university-degree; p < 0.01) and unstable employment (35% vs. 44%; p < 0.05). At multivariate logistic regression analysis, age <35 years (OR 1.61; 95%CI: 1.14-2.28) and lowest educational level (OR 1.64; 95% CI: 1.13-2.37, compared to University degree) were independently associated with non-adherence. CONCLUSION: Only 41% of women had postpartum T2DM screening. Women with lower attendance are those with age <35 years or low educational level. Further strategies are needed to implement postpartum test.


Assuntos
Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Gestacional/epidemiologia , Período Pós-Parto/fisiologia , Adulto , Feminino , Humanos , Gravidez , Estudos Retrospectivos
5.
Histochem Cell Biol ; 154(5): 495-505, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32435910

RESUMO

In the last decade, zebrafish has been used as a model for the study of several human skin diseases. The epidermis of Danio rerio is composed of keratinocytes and two types of secretory cells: mucous cells and club cells. Club cells have multiple biological functions and among them may be important in the protection against ultraviolet damage through the proliferative response or through the increased production of protective substances. Calcium-binding proteins such as calbindin D28K and calretinin are used as markers of nervous and enteric nervous systems, but they are present in numerous other cells. These proteins are involved in a wide variety of cell activities, such as cytoskeletal organization, cell motility and differentiation, cell cycle regulation and neuroprotective function. In this study we demonstrated, for the first time, the presence of calretinin and calbindin D28K in skin club cells of Danio rerio exposed to different wavelengths by immunohistochemistry analysis. Exposure to white-blue light and blue light causes the expression and colocalization of calbindin-D28K and calretinin. These proteins were moderately expressed and no colocalization was observed in the club cells of the control fish. In zebrafish exposed to continuous darkness for 10 days, in the club cells the two antibodies did not detect any proteins specifically. These results demonstrate that calbindin and calretinin could be involved in the pathophysiology of skin injury due to exposure to short-wavelength visible light spectrums.


Assuntos
Calbindina 2/biossíntese , Calbindinas/biossíntese , Luz , Pele/metabolismo , Peixe-Zebra/metabolismo , Animais , Calbindina 2/análise , Calbindinas/análise , Pele/citologia
6.
Ann Ig ; 32(2): 157-165, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31944210

RESUMO

BACKGROUND: Among asylum seekers and refugees in European countries, several studies have shown a high burden of mental disorders, including post-traumatic stress disorder, anxiety, depression and psychoses. The present study compares hospitalization for mental disorders among migrants arriving from countries typically linked to the refugee phenomenon (putative asylum seekers), migrants arriving from other countries, and natives. METHODS: The study is based on hospital discharge data collected at the national level by the Italian Ministry of Health. Age-standardized hospitalization rates for mental health diagnoses are calculated for the three groups during the period 2008-2015. Differences in type of admission (urgent or planned) and length of stay in hospital are also assessed. RESULTS: Temporal trends show a general decrease of hospitalization rates for mental disorders among both immigrants and natives; however, an increase is observed among young male putative asylum seekers (from 30.3 in 2010 to 43.6 per 10,000 in 2015), mainly due to admissions for "other nonorganic psychoses". CONCLUSION: These findings suggest that in Italy a higher burden of mental disorders might derive from the landing phenomenon, and the increase of hospitalization ascribed to "other nonorganic psychoses" (which is a general and unspecific diagnostic label) might conceal diagnostic difficulties by Italian psychiatrists to recognize atypical pictures associated with traumatic experiences.


Assuntos
Emigrantes e Imigrantes/psicologia , Transtornos Mentais/epidemiologia , Refugiados/psicologia , Adolescente , Adulto , Feminino , Humanos , Itália/epidemiologia , Masculino , Alta do Paciente , Adulto Jovem
7.
Acta Histochem ; 122(2): 151471, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31784234

RESUMO

The airways and lungs of vertebrates are an entrance way for several microbial pathogens. Cetaceans present an upper and lower respiratory anatomy that allows the rapid flow of large air volumes, which may lead to high susceptibility to respiratory infections. Mortality and stranding rate of Cetaceans increased dramatically, so wide the knowledge about the immune system and specific antibodies identifying immune cells populations, is of fundamental importance to monitor and document cetacean health. The aim of this study was to identify the localization of dendritic cells marked by Langerin/CD207 in airways, lungs and associated lymph nodes, of the striped dolphin Stenella coeruleoalba. Samples of trachea, bronchi, lungs and lung-associated lymph nodes were obtained from a stranded adult male of Stenella coeruleoalba. Our results showed abundant lymphoid aggregates (LAs) in the lung of S. ceruleoalba. Langerhans-like dendritic cells were well distributed along the epithelium and interstitium of respiratory tract and in associated lymph nodes. The present study deepens the knowledge about the cetacean's immune system and report about the exploitability of a commercial antibody (Langerin/CD207) for cetacean species.


Assuntos
Pulmão/metabolismo , Linfonodos/metabolismo , Linfócitos/metabolismo , Sistema Respiratório/metabolismo , Animais , Cetáceos/metabolismo , Golfinhos , Masculino , Stenella/metabolismo
8.
Funct Integr Genomics ; 19(5): 811-826, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31104179

RESUMO

Breeding for resistance is the most effective tool for controlling the corky root disease of tomato caused by Pyrenochaeta lycopersici. A comparative RNA-Seq-based transcriptomic analysis was conducted at 96 hpi (hours post infection) on two tomato cultivars: resistant Mogeor and its genetic background, and susceptible Moneymaker to investigate the differences in their transcriptomic response and identify the molecular bases of this plant-pathogen interaction. The number of differentially expressed genes (DEGs) identified was much higher in the susceptible than in the resistant genotype; however, the proportion of upregulated genes was higher in Mogeor (70.81%) than in Moneymaker (52.95%). Gene Ontology (GO) analysis enabled identification of 24 terms shared by the two cultivars that were consistent with responses to external stimulus, such as fungal infection. On the other hand, as many as 54 GO were enriched solely in Moneymaker, including terms related to defense response and cell wall metabolism. Our results could support the previous observations in other pathosystems, that susceptibility and resistance have overlapping signaling pathways and responses, suggesting that the P. lycopersici resistance gene pyl might be a recessive allele at a susceptibility locus, for which different candidate genes were identified based on the differences in induction or expression levels, observed between the resistant and susceptible genotype. MapMan analysis highlighted a complex hormone and transcription factors interplay where SA- and JA-induced pathways are modulated in a similar way in both genotypes and thus take part in a common response while the ethylene signaling pathways, induced mainly in susceptible Moneymaker, seem putatively contribute to its susceptibility.


Assuntos
Ascomicetos/patogenicidade , Resistência à Doença/genética , Suscetibilidade a Doenças , Regulação da Expressão Gênica de Plantas , Doenças das Plantas/genética , Proteínas de Plantas/genética , Solanum lycopersicum/genética , Solanum lycopersicum/microbiologia , Perfilação da Expressão Gênica , Doenças das Plantas/microbiologia , Transdução de Sinais , Transcriptoma
9.
Nutr Metab Cardiovasc Dis ; 29(6): 598-603, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30954416

RESUMO

BACKGROUND AND AIMS: Screening for Gestational Diabetes (GDM) is usually recommended between 24 and 28 weeks of pregnancy; however available evidence suggests that GDM may be already present before recommended time for screening, in particular among high-risk women as those with prior GDM or obesity. The purpose of this retrospective study was to evaluate whether early screening (16-18 weeks) and treatment of GDM may improve maternal and fetal outcomes. METHODS AND RESULTS: In 290 women at high-risk for GDM, we analyzed maternal and fetal outcomes, according to early or standard screening and GDM diagnosis time. Early screening was performed by 50% of high-risk women. The prevalence of GDM was 62%. Among those who underwent early screened, GDM was diagnosed at the first evaluation in 42.7%. Women with early diagnosis were more frequently treated with insulin and had a slightly lower HbA1c than women with who were diagnosed late. No differences were observed in the prevalence of Cesarean section, operative delivery, gestational age at the delivery, macrosomia, neonatal weight, Ponderal Index and Large-for-Gestational-Age among women with early or late GDM diagnosis or NGT. However, compared to NGT women, GDM women, irrespective of the time of diagnosis, had a lower gestational weight gain, lower prevalence of macrosomia (3.9% vs. 11.4%), small (1.7% vs. 8.3%) as well as large for gestational age (3.3% vs. 16.7%), but higher prevalence of pre-term delivery (8.9% vs. 2.7%). CONCLUSION: Early vs. standard screening and treatment of GDM in high-risk women is associated with similar short-term maternal-fetal outcomes, although women with an early diagnosis were treated to a greater extent with insulin therapy.


Assuntos
Diabetes Gestacional/diagnóstico , Diabetes Gestacional/tratamento farmacológico , Intervenção Médica Precoce , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Programas de Rastreamento , Cuidado Pré-Natal/métodos , Adulto , Diabetes Gestacional/sangue , Diabetes Gestacional/epidemiologia , Diagnóstico Precoce , Feminino , Humanos , Itália/epidemiologia , Valor Preditivo dos Testes , Gravidez , Resultado da Gravidez , Prevalência , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Resultado do Tratamento
10.
Tissue Cell ; 56: 1-6, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30736897

RESUMO

Cetacean mechanical senses, such as hearing, echolocation, active touch and the perception of water movements, are essential for their survival. Dolphins skin possesses dense packing of dermal papillae associated with the cutaneous ridges that suggests a sensory function, furthermore they are well innervated and very sensitive to touch. This is mediated by mechanoreceptors, abundant in the region of the head and in the dorsal part of the body. Most odontocetes possess vibrissae (i.e., sensory hair) that have been well described in literature and present a microanatomy similar to that of terrestrial mammals. The aim of this study was to characterize Merkel cell through use of specific antibodies: Substance P, Anti-calbindin DK28, Anti-5HT, Leu- enkephalin, Protein Gene Product 9.5 (PGP9.5) and Anti-Human Neuronal Protein, for the first time. Merkel cells (MCs) in the dolphin skin are specialized skin receptors, characterized by their particular location and close association with nerve terminals. The presence of neuroendocrine markers and different neuropeptides confirms that MCs play also neuroendocrine function and are considered as part of the diffuse neuroendocrine system. Furthermore, the presence of Leu-enkephalin in Merkel cells could involve these cells in inflammatory responses in the skin.


Assuntos
Golfinhos/metabolismo , Células de Merkel/metabolismo , Pele/metabolismo , Animais , Anticorpos/imunologia , Anticorpos/metabolismo , Humanos , Neurônios/metabolismo
11.
Fish Shellfish Immunol ; 87: 490-498, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30711492

RESUMO

The present study describes histochemical and immunohistochemical characteristics of the spiral valve and its associated lymphoid tissue (GALT) in the dogfish Scyliorhinus canicula. The mucosal surface of the spiral valve represents the first line of defense against pathogens coming from the external environment through food. Epithelial, mucus and immune cells play a key role in controlling the inflammatory response. Valve intestine of S. canicula had many folds lined by simple columnar cells and goblet cells, which later reacted positive to PAS, AB and AB-PAS, histochemical stains differentiated the different types of mucins; lectin histochemistry (PNA and WGA), detected neutral and acid mucins secreted that plays an important role in protection against invading pathogens. Integrin α5ß1 was expressed in enterocytes that line the valve's folds with greater marking in the apical part of the cells. Laminin was found on the apical side of the epithelium, in fibrillar and cellular elements of the lamina propria and in the muscularis mucosa. In the spiral valve gut-associated lymphoid tissue (GALT) has been studied. For the first time, massive leucocytes aggregates were identified by confocal immunofluorescence techniques, using the following antibodies: TLR2, S100, Langerin/CD207. Our results expand knowledge about Dogfish valve intestine giving important news in understanding comparative immunology.


Assuntos
Cação (Peixe)/imunologia , Intestinos/imunologia , Tecido Linfoide/imunologia , Animais , Cação (Peixe)/anatomia & histologia , Histocitoquímica/veterinária , Imuno-Histoquímica/veterinária , Microscopia Confocal/veterinária , Mucinas/metabolismo
12.
Fish Shellfish Immunol ; 74: 380-385, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29337248

RESUMO

Giant Mudskipper, Periophthalmodon schlosseri (Pallas, 1770), is euryhaline, amphibious, and air-breathing fish. These fishes live in close association to mangrove forests and often spend over 90% of time out of water, in adjacent mudflats. They have developed morphological and physiological adaptations to satisfy their unique lifestyles. The skin is the primary interface between the body and the environment, and has a central role in host defence. The initiation of immune responses to antigens in the vertebrate skin has often been attributed to epidermal Langerhans'cells (LC) that are dendritic cells (DC), antigen-presenting cells (APC) which reside in the epidermis. Dendritic cells have been characterized morphologically and functionally in the teleost fish tissues such as rainbow trout, salmonids, medaka, African catfish and zebrafish. However, there is no evidence of the presence of DCs and their role in mudskippers immunity. The aim of this preliminary study was to characterize, through use of specific antibodies: Toll-like receptor 2, S100, serotonin (5-HT), and Vesicular acetylcholine transporter VAChT, a specific DC-like subpopulation in Pn. schlosseri's epidermis.


Assuntos
Proteínas de Peixes/metabolismo , Células de Langerhans/química , Perciformes/fisiologia , Animais , Imuno-Histoquímica/veterinária , Proteínas S100/metabolismo , Serotonina/metabolismo , Receptor 2 Toll-Like/metabolismo , Proteínas Vesiculares de Transporte de Acetilcolina/metabolismo
13.
Ecotoxicol Environ Saf ; 150: 96-103, 2018 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-29268120

RESUMO

Polycyclic aromatic hydrocarbons (PAHs) are lipophilic compounds able to accumulate in the food chain. Mussels showed to bioaccumulate contaminants, such as PAHs, so that recurrent consumption of such contaminated food represents a risk for human health. This study was aimed to elucidate if acute exposure of Mediterranean blue mussel (Mytilus galloprovincialis), a bivalve of great economic importance in several countries, to a PAH, benzo[a]pyrene (B[a]P), at doses able to induce cytochrome P450 1A (CYP1A) and pathological changes in mussel gills, can produce accumulation in soft tissue. We explored the cytotoxic effects (cell viability, DNA laddering, and glutathione levels) of in vitro exposure of human peripheral blood mononuclear cells (PBMCs) to organic extracts obtained from blue mussels previously exposed for 12 and 72h via water to B[a]P (0.5-1mg/L). In our experimental conditions, B[a]P induced CYP1A induction and morphological changes in mussel gills and a significant B[a]P accumulation in soft tissue. Conversely, exposing PBMCs to organic extracts obtained from contaminated mussels, resulted in a significant reduction of cell viability and cell glutathione content, and in an increase in DNA laddering. This confirms that consumption of mussels from B[a]P polluted waters might affect human health. Our data lead us to suggest that CYP1A activity in mussel gills may be useful (more than the amount of detected PAHs in the mussel edible tissue) as a marker in assessment of risk for health of consumers exposed to PAHs through ingestion of shellfish.


Assuntos
Benzo(a)pireno/toxicidade , Mytilus edulis/efeitos dos fármacos , Poluentes Químicos da Água/toxicidade , Animais , Benzo(a)pireno/análise , Sobrevivência Celular/efeitos dos fármacos , Células Cultivadas , Relação Dose-Resposta a Droga , Brânquias/química , Brânquias/efeitos dos fármacos , Brânquias/patologia , Humanos , Leucócitos Mononucleares/efeitos dos fármacos , Medição de Risco , Poluentes Químicos da Água/análise
14.
Nat Prod Res ; 32(17): 2037-2049, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28805459

RESUMO

Plants with beneficial properties are known in traditional medicine. Nowadays, in spite of widespread availability of synthetic compounds, the search goes towards natural compounds to lower cost and few side effects. The increasing interest in preventive medicine encourages use of nutraceuticals, bioactive compounds of vegetable origin with important nutritional values. Among the medicinal plants, Opuntia ficus-indica (L.) Miller (Family Cactaceae, subfamily Opuntiodeae, Genus Opuntia, subgenus Platyopuntia, species Opuntia ficus-indica (L.) Miller) is widely known for its beneficial properties. The aim of the present review is to stress the major classes of Opuntia components and their medical interest through emphasis on some of their biological effects, particularly those having the most promising expected health benefits and therapeutic impacts on fish and mammals.


Assuntos
Valor Nutritivo , Opuntia/química , Plantas Medicinais/química , Animais , Humanos , Medicina Tradicional , Extratos Vegetais/uso terapêutico
15.
Urologe A ; 56(12): 1559-1571, 2017 Dec.
Artigo em Alemão | MEDLINE | ID: mdl-29170788

RESUMO

Postprostatectomy incontinence (PPI) is a rare complication of radical prostatectomy, and it may lead to severe limitations for the patient and loss of quality of life. Several different surgical options for the therapy of PPI are available and may be chosen depending on severity of incontinence, residual urethral sphincter function, and previous history of radiotherapy. Alternatives to artificial urinary sphincters which over the last few decades have represented the gold standard for treatment of PPI are fixed slings and adjustable devices. In cases of mild or moderate incontinence, male slings can be used. Adjustable devices can also be adopted in irradiated patient with good results. Artificial urinary sphincters represent the ideal option in case of severe incontinence. Absolute contraindications for the implant of this device are impaired dexterity and cognitive capacity of the patients that may make use of the pump difficult. One type of therapy for all patients does not exist and must be individually determined. It is influenced by the grade of incontinence, the anatomical conditions, and the patient's expectations. Thus, appropriate counselling is mandatory. A common opinion is that these devices are direct competitors in the treatment of PPI. In reality, these devices are completely different surgical methods that rely on different principles and therefore have different indications.


Assuntos
Complicações Pós-Operatórias/cirurgia , Prostatectomia/efeitos adversos , Slings Suburetrais , Incontinência Urinária/cirurgia , Esfíncter Urinário Artificial , Diagnóstico Diferencial , Seguimentos , Humanos , Masculino , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Desenho de Prótese , Reoperação , Fatores de Risco , Incontinência Urinária/diagnóstico , Incontinência Urinária/etiologia
16.
Nutr Metab Cardiovasc Dis ; 27(8): 717-722, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28755805

RESUMO

BACKGROUND AND AIM: In 2011, the Italian National Health System guidelines introduced a selective screening for gestational diabetes (GDM) based on risk factors, recommending early evaluation in high risk women. The present study examined to which extent guidelines are applied, and analyzed the effectiveness of GDM diagnosis according to risk profile. METHODS AND RESULTS: We analyzed 1338 pregnant women, consecutively screened for GDM with a 75 g OGTT between January 2013 and December 2015, according to national guidelines. Diagnosis of GDM was based on IADPSG/WHO 2013 criteria. As many as 14.4% of screened women was at high risk, 64% at medium, 21.6% did not have any risk factor. Only 50% of high-risk women were appropriately screened at 16th-18th gestational weeks; 28% of them repeated the OGTT due to NGT. The overall prevalence of GDM was 39.9%, higher in high risk women (67% vs. 40% medium risk vs. 22% low risk; p < 0.0001). An early GDM diagnosis was performed in 40.7% of high-risk women. In low risk women, gestational weight gain at the screening time was independently associated with GDM. CONCLUSIONS: The recommendations for the screening of GDM are still insufficiently implemented, especially for early evaluation in high risk women. Considering the high proportion of early GDM diagnosis, the poor adherence to screening recommendation may result in late diagnosis of GDM. Finally, our finding of a 22% prevalence of GDM among low risk women suggests the need to consider additional risk factors, such as excessive weight gain during pregnancy.


Assuntos
Diabetes Gestacional/diagnóstico , Fidelidade a Diretrizes/normas , Guias de Prática Clínica como Assunto/normas , Padrões de Prática Médica/normas , Cuidado Pré-Natal/normas , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/fisiopatologia , Feminino , Pesquisas sobre Atenção à Saúde , Humanos , Itália/epidemiologia , Fenômenos Fisiológicos da Nutrição Materna , Estado Nutricional , Valor Preditivo dos Testes , Gravidez , Prevalência , Prognóstico , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Aumento de Peso
17.
Microsc Res Tech ; 80(9): 1018-1027, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28543786

RESUMO

Serotonin [5-hydroxytryptamine (5-HT)] is an important neuromodulator involved in a wide range of physiological functions. The effects of serotonin are mediated by an extended family of receptors coupled to multiple heterotrimeric G-proteins, associated with cellular membrane. G proteins connect receptors to effectors and thus trigger intracellular signaling pathways. These cellular processes several regulate systemic functions such as embryonic development, gonadal development, learning and memory, and organismal homeostasis. Generally, elasmobranch fish dwell a hypersaline environment and utilize a specialized extrarenal salt secreting organ, the rectal gland, to face ionic homeostasis. In this study in addition to the morphological, histochemical and immunohistochemical description of the Scyliorhinus canicula rectal gland, for the first time, the presence of serotonin (5-HT), and distribution of different types of G protein alpha subunits (Gα o, Gα q/11, and Gα s/olf) has been investigated in the rectal gland epithelium by confocal immunofluorescence techniques. Colocalization G proteins and 5-HT in the secretory epithelium of the gland suggests serotonin acts as a hormone and involves G proteins in an autocrine-paracrine control of rectal gland homeostasis.


Assuntos
Subunidades alfa de Proteínas de Ligação ao GTP/análise , Glândula de Sal , Serotonina/análise , Tubarões/metabolismo , Animais , Subunidades alfa de Proteínas de Ligação ao GTP/química , Subunidades alfa de Proteínas de Ligação ao GTP/metabolismo , Imuno-Histoquímica , Glândula de Sal/química , Glândula de Sal/citologia , Glândula de Sal/metabolismo , Serotonina/química , Serotonina/metabolismo
18.
World J Urol ; 35(7): 1119-1124, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27864619

RESUMO

INTRODUCTION: Advanced Peyronie's disease (PD) with severe penile deviation demands grafting procedures following plaque incision or partial plaque excision in order to avoid penile shortening and to improve quality of life of affected patients. Small intestinal submucosa (SIS) is an established xenograft. The objective of the present study was to validate external results in a bicentric prospective manner. METHODS: Patient selection criteria, surgical technique and standards for pre- and postoperative care were defined. Consecutively, patients with severe penile deviation in stable disease and sufficient erectile function were included between 2007 and 2015. After plaque incision, grafting was performed using SIS in a standardized manner. The postoperative evaluation using a non-validated questionnaire included complications, correction of curvature, pre- and postoperative erectile function, change in penile length and general satisfaction with the procedure. RESULTS: Forty-three patients underwent surgery between 2007 and 2015. The mean degree of preoperative curvature was 73.8° (range 60-90°). No intraoperative or major postoperative complications were reported. After a mean follow-up of 33.0 months (range 10-59), complete straightening of the penis was achieved in 74.4%. 88.4% of all patients were able to achieve satisfying sexual intercourse (67.4% unaided, 21.0% with assistance). The IIEF-5 score was improved in 69.8% (mean improvement 4.0 points). Overall 86.0% were satisfied with the surgical treatment. CONCLUSION: Corporoplasty with SIS in patients with PD and severe penile curvature is a safe approach and shows good long-term results. A thorough patient selection and a standardized pre-, intra- and postoperative procedure are decisive for a satisfying outcome.


Assuntos
Intestino Delgado/transplante , Induração Peniana , Pênis , Procedimentos de Cirurgia Plástica , Complicações Pós-Operatórias , Qualidade de Vida , Transplante de Tecidos/métodos , Procedimentos Cirúrgicos Urológicos Masculinos , Adulto , Animais , Dissecação/métodos , Humanos , Masculino , Pessoa de Meia-Idade , Satisfação do Paciente , Seleção de Pacientes , Ereção Peniana , Induração Peniana/diagnóstico , Induração Peniana/cirurgia , Pênis/patologia , Pênis/fisiopatologia , Pênis/cirurgia , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Procedimentos de Cirurgia Plástica/efeitos adversos , Procedimentos de Cirurgia Plástica/métodos , Inquéritos e Questionários , Suínos , Resultado do Tratamento , Procedimentos Cirúrgicos Urológicos Masculinos/efeitos adversos , Procedimentos Cirúrgicos Urológicos Masculinos/métodos
19.
Braz. j. biol ; 76(4): 1054-1057, Oct.-Dec. 2016. tab, graf
Artigo em Inglês | LILACS | ID: biblio-828111

RESUMO

Abstract Pseudoryzomys simplex is a small to medium sized terrestrial rodent confined to lowland open areas with strong seasonal rainfall throughout the Chaco, Cerrado and Caatinga. Despite its extensive range, the species is difficult to trap. In this report we provide the first record of P. simplex in the Pantanal, where three specimens were collected in a pasture of exotic grass. The specimens are morpometrically similar to the population from Paraguay (Chaco). In this sense, our report shows how interesting a taxonomic review of the species would be to better understand the real significance of the geographic variation herein observed.


Resumo Pseudoryzomys simplex é um roedor terrestre de pequeno a médio porte que ocorre em áreas abertas de planícies com fortes precipitações sazonais ao longo dos Chaco, Cerrado e Caatinga. Apesar de sua extensa distribuição, a espécie é difícil de ser capturada. No presente estudo, fornecemos o primeiro registro de P. simplex no Pantanal, onde três espécimes foram coletados em uma pastagem de capim exótico. Os espécimes são morfometricamente semelhantes à da população do Paraguai (Chaco). Neste sentido, o nosso relatório mostra quão interessante seria uma revisão taxonômica das espécies para melhor compreender o significado real da variação geográfica aqui observada.


Assuntos
Animais , Sigmodontinae , Arvicolinae , Inundações , Brasil
20.
Braz J Biol ; 76(4): 1054-1057, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27166568

RESUMO

Pseudoryzomys simplex is a small to medium sized terrestrial rodent confined to lowland open areas with strong seasonal rainfall throughout the Chaco, Cerrado and Caatinga. Despite its extensive range, the species is difficult to trap. In this report we provide the first record of P. simplex in the Pantanal, where three specimens were collected in a pasture of exotic grass. The specimens are morpometrically similar to the population from Paraguay (Chaco). In this sense, our report shows how interesting a taxonomic review of the species would be to better understand the real significance of the geographic variation herein observed.


Assuntos
Arvicolinae , Inundações , Sigmodontinae , Animais , Brasil
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