RESUMO
Glioblastoma (GB) is the most common and aggressive form of primary brain tumor, in which the presence of an inflammatory environment, composed mainly by tumor-associated macrophages (TAMs), is related to its progression and development of chemoresistance. Toll-Like Receptors (TLRs) are key components of the innate immune system and their expression in both tumor and immune-associated cells may impact the cell communication in the tumor microenvironment (TME), further modeling cancer growth and response to therapy. Here, we investigated the participation of TLR4-mediated signaling as a mechanism of induced-immune escape in GB. Initially, bioinformatics analysis of public datasets revealed that TLR4 expression is lower in GB tumors when compared to astrocytomas (AST), and in a subset of TAMs. Further, we confirmed that TLR4 expression is downregulated in chemoresistant GB, as well as in macrophages co-cultured with GB cells. Additionally, TLR4 function is impaired in those cells even following stimulation with LPS, an agonist of TLR4. Finally, experiments performed in a cohort of clinical primary and metastatic brain tumors indicated that the immunostaining of TLR4 and CD45 are inversely proportional, and confirmed the low TLR4 expression in GBs. Interestingly, the cytoplasmic/nuclear pattern of TLR4 staining in cancer tissues suggests additional roles of this receptor in carcinogenesis. Overall, our data suggest the downregulation of TLR4 expression and activity as a strategy for GB-associated immune escape. Additional studies are necessary to better understand TLR4 signaling in TME in order to improve the benefits of immunotherapy based on TLR signaling.
Assuntos
Neoplasias Encefálicas/imunologia , Regulação para Baixo/imunologia , Glioblastoma/imunologia , Glioblastoma/metabolismo , Evasão da Resposta Imune/imunologia , Receptor 4 Toll-Like/imunologia , Macrófagos Associados a Tumor/imunologia , Idoso , Animais , Neoplasias Encefálicas/metabolismo , Linhagem Celular , Linhagem Celular Tumoral , Proliferação de Células/fisiologia , Feminino , Humanos , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Transdução de Sinais/imunologia , Receptor 4 Toll-Like/metabolismo , Microambiente Tumoral/imunologia , Macrófagos Associados a Tumor/metabolismoRESUMO
PURPOSE: Two cases of corneal crystal deposition are reported, both caused by a benign monoclonal gammopathy METHODS: Similar corneal pathology is identified in these two patients, both of whom presented with visual acuities of 6/6 or better Consideration of possible causes involved biochemical and haematological testing and assessment. RESULTS: Potential for malignant transformation of monoclonal gammopathy was recognized, hence the need for ongoing haematological follow-up. CONCLUSION: Corneal crystals may be the initial presentation in a patient with monoclonal gammopathy, a rare, but significant, clinical finding.
Assuntos
Córnea/patologia , Doenças da Córnea/diagnóstico , Imunoglobulina G/análise , Cadeias kappa de Imunoglobulina/análise , Paraproteinemias/diagnóstico , Sedimentação Sanguínea , Cromatografia Líquida de Alta Pressão , Doenças da Córnea/complicações , Cristalização , Eletroforese em Gel de Poliacrilamida , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Paraproteinemias/complicações , Acuidade VisualRESUMO
BACKGROUND: Aeromonas sobria causes a rare Gram-negative bacterial water-borne infection. It has been found in waters of North Queensland and South-east Asia. Of all Aeromonas species, A. sobria is the most virulent and invasive and has been reported to cause soft tissue infection and corneal ulcer. METHODS: A 14-year-old Caucasian male from North Queensland presented following a penetrating eye injury in which a water bird (cormorant species) had pecked his eye while he was fishing. A fulminant endophthalmitis developed despite treatment with intravenous, intravitreal and topical antibiotics and initial wound repair. Enucleation was performed. RESULTS: Aeromonas sobria was isolated from the vitreous aspirate. CONCLUSION: Aeromonas sobria infection should be suspected in water-contaminated penetrating eye injuries. The prognosis in this case was poor.
Assuntos
Aeromonas/isolamento & purificação , Endoftalmite/microbiologia , Infecções Oculares Bacterianas/etiologia , Ferimentos Oculares Penetrantes/microbiologia , Infecções por Bactérias Gram-Negativas/etiologia , Adolescente , Animais , Câmara Anterior/lesões , Câmara Anterior/microbiologia , Câmara Anterior/patologia , Antibacterianos , Aves , Catarata/etiologia , Córnea/patologia , Lesões da Córnea , Vias de Administração de Medicamentos , Quimioterapia Combinada/administração & dosagem , Quimioterapia Combinada/uso terapêutico , Endoftalmite/patologia , Endoftalmite/terapia , Enucleação Ocular , Infecções Oculares Bacterianas/patologia , Infecções Oculares Bacterianas/terapia , Ferimentos Oculares Penetrantes/patologia , Ferimentos Oculares Penetrantes/terapia , Seguimentos , Infecções por Bactérias Gram-Negativas/patologia , Infecções por Bactérias Gram-Negativas/terapia , Humanos , Iris/lesões , Iris/patologia , Masculino , Corpo Vítreo/microbiologiaRESUMO
BACKGROUND: Intraoperative cracking of foldable acrylic posterior chamber intraocular lenses has previously been documented. However, most cracks have resulted in no significant visual impairment. METHODS: A case report of an acrylic posterior chamber intraocular lens that cracked during folding. RESULTS: The crack in the lens resulted in significant optical disturbance and required explanation and insertion of another lens. CONCLUSIONS: Acrylic intraocular lenses must be folded carefully with appropriate forceps to prevent cracking of the optic.
Assuntos
Extração de Catarata/efeitos adversos , Lentes Intraoculares , Falha de Prótese , Seguimentos , Humanos , Complicações Intraoperatórias , Masculino , Metilmetacrilatos , Microscopia Eletrônica de Varredura , Pessoa de Meia-Idade , ReoperaçãoRESUMO
DVT is a very frequent complication of general surgery. Heparin and, more recently, LMWHs can successfully prevent post surgical thromboembolism. One thousand one hundred and twenty-two patients (533 males and 589 females; mean age 62.2 +/- 11.4 yrs) were enrolled in a multicentre controlled study, to evaluate the efficacy and safety of enoxaparin in comparison to calcium heparin in the prevention of deep venous thrombosis (DVT) following general surgery. Patients assigned to the enoxaparin and the calcium heparin groups received 1 daily dose of 20 mg (2000 I.U.) and 2 daily doses of 0.2 ml (5000 I.U.), respectively starting 2 hours before the operation. Both drugs were given by subcutaneous route. A Doppler or Duplex Scan diagnosis of DVT was made in 3 (0.5%) patients in the enoxaparin group (2 cases during treatment and 1 patient at the end of treatment) and in 6 (1.1%) patients in the calcium heparin group (5 cases during treatment and 1, bilateral, after the end of treatment). Pulmonary embolism (PE) was ascertained by angiography in 1 patient (0.18%) in the enoxaparin group and in 2 patients (0.36%) in the calcium heparin one. Hemorrhagic complications occurred in 29 patients (5.2%) in the enoxaparin group and in 34 (6.1%) in the calcium heparin group. Haematomas located in the injection site were reported in 16.1% and 25.3% in the enoxaparin and calcium heparin groups respectively (p = 0.0001). Local pain in the injection site at the 5th day of treatment was reported in 8.4% and 16.6% in the enoxaparin and calcium heparin groups respectively (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
Assuntos
Enoxaparina/uso terapêutico , Fibrinolíticos/uso terapêutico , Heparina/uso terapêutico , Complicações Pós-Operatórias/prevenção & controle , Embolia Pulmonar/prevenção & controle , Tromboflebite/prevenção & controle , Idoso , Enoxaparina/efeitos adversos , Feminino , Hemostasia Cirúrgica/métodos , Heparina/efeitos adversos , Humanos , Incidência , Injeções Subcutâneas , Itália , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/epidemiologia , Complicações Pós-Operatórias/etiologia , Embolia Pulmonar/epidemiologia , Embolia Pulmonar/etiologia , Fatores de Risco , Tromboflebite/epidemiologia , Tromboflebite/etiologiaRESUMO
Thirty patients presenting with painful shoulder syndrome were treated with i.m. ketoprofen 100 mg b.d. for 8 days to assess the efficacy and tolerance of the above treatment regime. The patients' condition was monitored by clinical, instrumental and laboratory examinations. Ketoprofen was found to be significantly effective in all cases of non calcific rotator cuff tendinitis while no improvement was noted in calcific tendinitis. The above data confirm the efficacy and tolerance of ketoprofen in the treatment of painful shoulder syndrome as an alternative to local steroid therapy.
Assuntos
Cetoprofeno/uso terapêutico , Dor/tratamento farmacológico , Articulação do Ombro , Adulto , Idoso , Avaliação de Medicamentos , Tolerância a Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Periartrite/tratamento farmacológico , Manguito Rotador , Tenossinovite/tratamento farmacológicoRESUMO
Fifty patients suffering from prostatic adenoma with asymptomatic bacteriuria, were admitted to an open non comparative trial. Enoxacin was administered at the daily dosage of 300 mg every 12 hours for 10 days. Three cycles of treatment were performed during three consecutive months. Treatment efficacy was established by assessing patient symptoms related to the infection such as pollakiuria , nocturia, decreased flow rate, stranguria, daily temperature. Cultural tests were also performed. All observations were collected at baseline and at the end of each cycle of therapy. Cure was obtained in 43 patients (87, 75%), 1 patient (2,04%) relapsed, 5 patients (10.2%) withdrew because of inefficacy of treatment and 1 patient died of heart failure. No side effects were observed. These results suggest that enoxacin may be successfully used in the treatment of asymptomatic bacteriuria.
Assuntos
Bacteriúria/tratamento farmacológico , Enoxacino/uso terapêutico , Hiperplasia Prostática/complicações , Idoso , Bacteriúria/etiologia , Bacteriúria/microbiologia , Avaliação de Medicamentos , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Twenty women with Chlamydia trachomatis genitourinary infection were treated with oral enoxacin 800 mg/day in two divided doses for 12 days starting on day 1 of the menstrual cycle. A physical examination was performed before the start and 28-30 days after the end of the treatment. At the final examination cultures of urethral and endocervical swabs and endometrial samples were negative in all cases, demonstrating that Chlamydia trachomatis infection had been eradicated. No significant results were obtained at serologic evaluation with the indirect immunofluorescence method to show specific IgM, IgG and IgA antibodies. In the four women with subjective symptomatology this was improved by the treatment with enoxacin. Only two patients presented mild side effects (headache, tachycardia, nausea). Enoxacin seems therefore a very effective and well tolerated drug in the treatment of Chlamydia trachomatis genitourinary infection.
Assuntos
Infecções por Chlamydia/tratamento farmacológico , Chlamydia trachomatis , Enoxacino/uso terapêutico , Doenças Urogenitais Femininas/microbiologia , Adulto , Anticorpos Antibacterianos/sangue , Chlamydia trachomatis/imunologia , Endométrio/microbiologia , Enoxacino/efeitos adversos , Feminino , Doenças Urogenitais Femininas/tratamento farmacológico , Humanos , Doenças Uretrais/microbiologia , Doenças do Colo do Útero/microbiologiaRESUMO
Forty-one patients suffering from postoperative pain were admitted to an open, noncomparative trial. A dose of 10 mg of Kerotolac was administered i.v. to patients complaining severe pain. The analgesic efficacy of the drug was evaluated at 5, 15, 30 minutes and at 1, 1.5, 2, 3, 4, 6 hours after injection; the patients were asked to score their pain relief on the VRS comparing the pre-injection evaluation to each post-injection period. A significant decrease of pain intensity (less than p 0.01) was observed at 45 minutes after injection. No side effects were observed. These results suggest that Ketorolac can be successfully used in the treatment of postoperative pain.
Assuntos
Analgésicos/administração & dosagem , Dor Pós-Operatória/tratamento farmacológico , Tolmetino/análogos & derivados , Adolescente , Adulto , Idoso , Avaliação de Medicamentos , Tolerância a Medicamentos , Feminino , Humanos , Cetorolaco , Masculino , Pessoa de Meia-Idade , Medição da Dor , Fatores de Tempo , Tolmetino/administração & dosagemRESUMO
Thirty-three patients suffering from acute, subacute or chronic prostatovesiculitis were admitted to an open, non comparative trial. Enoxacin was administered at the daily dosage of 400 mg every 12 hours for 10 days starting from the enrollment. A second cycle of treatment was performed if cure was not obtained with the first cycle. Treatment efficacy was established by assessing patient symptoms related to the infection, such as pollakiuria and dysuria, consistency and volume of prostate and spermatic vesicles (evaluated by rectal examination and transrectal ultra-sonography); bacterioscopical and bacteriological evaluations of prostate/vesicles secretion with sensitivity testing were also carried out. All observations were collected at baseline, 5 and 30 days after the end of the first cycle and 5 days after the end of the 2nd cycle of treatment. After the first cycle of treatment, cure was obtained in 22 subjects (67%) and clinical improvement in 24 (73%). All but one patients still infected at the end of the first treatment period, showed improvement (5; 45.5%) or cure (6; 54.5%). The end of the second cycle None of the 22 patients cured with one cycle of treatment relapsed within 30 days after the end of treatment, confirming they really achieved cure. Side effects were observed only in 1 case (mild vertigo); no drop outs were observed. These results suggest that enoxacin may be successfully used in the treatment of prostato-vesiculitis.
Assuntos
Infecções Bacterianas/tratamento farmacológico , Cistite/tratamento farmacológico , Enoxacino/uso terapêutico , Prostatite/tratamento farmacológico , Doença Aguda , Adulto , Idoso , Doença Crônica , Ensaios Clínicos como Assunto , Cistite/etiologia , Avaliação de Medicamentos , Humanos , Masculino , Pessoa de Meia-Idade , Prostatite/etiologiaAssuntos
Enoxacino/uso terapêutico , Infecções Respiratórias/tratamento farmacológico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anti-Infecciosos/efeitos adversos , Anti-Infecciosos/uso terapêutico , Bactérias/efeitos dos fármacos , Bactérias/isolamento & purificação , Infecções Bacterianas/tratamento farmacológico , Ensaios Clínicos como Assunto , Enoxacino/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeAssuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Doenças dos Genitais Femininos/tratamento farmacológico , Sulfonamidas/uso terapêutico , Adolescente , Adulto , Ensaios Clínicos como Assunto , Método Duplo-Cego , Endometrite/tratamento farmacológico , Episiotomia/efeitos adversos , Feminino , Humanos , Pessoa de Meia-Idade , Doença Inflamatória Pélvica/tratamento farmacológico , Distribuição Aleatória , Sulfonamidas/efeitos adversos , Cervicite Uterina/tratamento farmacológicoAssuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Doenças dos Genitais Femininos/tratamento farmacológico , Sulfonamidas/uso terapêutico , Adolescente , Adulto , Idoso , Ensaios Clínicos como Assunto , Método Duplo-Cego , Tolerância a Medicamentos , Endometrite/tratamento farmacológico , Episiotomia/efeitos adversos , Feminino , Humanos , Inflamação , Pessoa de Meia-Idade , Cistos Ovarianos/tratamento farmacológico , Doença Inflamatória Pélvica/tratamento farmacológico , Cervicite Uterina/tratamento farmacológico , Doenças Uterinas/tratamento farmacológicoAssuntos
Anti-Inflamatórios não Esteroides/uso terapêutico , Artrite/tratamento farmacológico , Osteoporose/tratamento farmacológico , Sulfonamidas/uso terapêutico , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Avaliação de Medicamentos , Tolerância a Medicamentos , Humanos , Pessoa de Meia-IdadeAssuntos
Alginatos/uso terapêutico , Doenças do Esôfago/tratamento farmacológico , Varizes Esofágicas e Gástricas/terapia , Soluções Esclerosantes/efeitos adversos , Adulto , Idoso , Doenças do Esôfago/etiologia , Feminino , Ácido Glucurônico , Ácidos Hexurônicos , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Úlcera/tratamento farmacológico , Úlcera/etiologiaRESUMO
After a brief examination of the recent literature on non-secretory multiple myeloma, the Authors describe the immunohistologic study (peroxidase-antiperoxidase method) of a case of truly non producing plasmacytoma, interesting because of the presence of a small polyclonal plasma cell population within the neoplastic clone. Several possible explanations are considered.
Assuntos
Mieloma Múltiplo/patologia , Idoso , Medula Óssea/patologia , Citoplasma/patologia , Humanos , Técnicas Imunoenzimáticas , Masculino , Mieloma Múltiplo/imunologia , Osteólise/patologia , Plasmócitos/patologia , Polimorfismo Genético , Crânio/patologiaRESUMO
A comparative study between nefopam (Acupan) and pentazocine was carried out in 90 patients for treatment of postoperative pain following gynaecological operations. The results show that nefopam has an analgesic activity comparable with that of pentazocine, but its duration of action seems to be longer-lasting, even if with a longer period of latency. At equieffective analgesic action, nefopam shows a lower interference with the respiratory function. As far as side-effects are concerned a significant increase in drowsiness was observed with both types of treatment; sweating was observed only in nefopam group.