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1.
Ultrasound Obstet Gynecol ; 62(4): 594-602, 2023 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-37204769

RESUMO

OBJECTIVE: To evaluate the performance of subjective assessment and the Assessment of Different NEoplasias in the adneXa (ADNEX) model in discriminating between benign and malignant adnexal tumors and between metastatic and primary adnexal tumors in patients with a personal history of breast cancer. METHODS: This was a retrospective single-center study including patients with a history of breast cancer who underwent surgery for an adnexal mass between 2013 and 2020. All patients had been examined with transvaginal or transrectal ultrasound using a standardized examination technique and all ultrasound reports had been stored and were retrieved for the purposes of this study. The specific diagnosis suggested by the original ultrasound examiner in the retrieved report was analyzed. For each mass, the ADNEX model risks were calculated prospectively and the highest relative risk was used to categorize each into one of five categories (benign, borderline, primary Stage I, primary Stages II-IV or metastatic ovarian cancer) for analysis of the ADNEX model in predicting the specific tumor type. The performance of subjective assessment and the ADNEX model in discriminating between benign and malignant adnexal tumors and between primary and metastatic adnexal tumors was evaluated, using final histology as the reference standard. RESULTS: Included in the study were 202 women with a history of breast cancer who underwent surgery for an adnexal mass. At histology, 93/202 (46.0%) masses were benign, 76/202 (37.6%) were primary malignancies (four borderline and 72 invasive tumors) and 33/202 (16.3%) were metastases. The original ultrasound examiner classified correctly 79/93 (84.9%) benign adnexal masses, 72/76 (94.7%) primary adnexal malignancies and 30/33 (90.9%) metastatic tumors. Subjective ultrasound evaluation had a sensitivity of 93.6%, specificity of 84.9% and accuracy of 89.6%, while the ADNEX model had higher sensitivity (98.2%) but lower specificity (78.5%), with similar accuracy (89.1%), in discriminating between benign and malignant ovarian masses. Subjective evaluation had a sensitivity of 51.5%, specificity of 88.8% and accuracy of 82.7% in distinguishing metastatic and primary tumors (including benign, borderline and invasive tumors), and the ADNEX model had a sensitivity of 63.6%, specificity of 84.6% and similar accuracy (81.2%). CONCLUSIONS: The performance of subjective assessment and the ADNEX model in discriminating between benign and malignant adnexal masses in this series of patients with history of breast cancer was relatively similar. Both subjective assessment and the ADNEX model demonstrated good accuracy and specificity in discriminating between metastatic and primary tumors, but the sensitivity was low. © 2023 International Society of Ultrasound in Obstetrics and Gynecology.


Assuntos
Doenças dos Anexos , Neoplasias da Mama , Neoplasias Ovarianas , Humanos , Feminino , Neoplasias da Mama/diagnóstico por imagem , Estudos Retrospectivos , Sensibilidade e Especificidade , Anexos Uterinos/patologia , Neoplasias Ovarianas/patologia , Doenças dos Anexos/patologia , Ultrassonografia/métodos , Diagnóstico Diferencial
2.
J Endocrinol Invest ; 45(1): 43-51, 2022 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-34142364

RESUMO

PURPOSE: To investigate the relationship between the single-point insulin sensitivity estimator (SPISE) index, an insulin sensitivity indicator validated in adolescents and adults, and metabolic profile in overweight/obese children, and to evaluate whether basal SPISE is predictive of impaired glucose regulation (IGR) development later in life. METHODS: The SPISE index (= 600 × HDL0.185/Triglycerides0.2 × BMI1.338) was calculated in 909 overweight/obese children undergoing metabolic evaluations at University of Cagliari, Italy, and in 99 normal-weight, age-, sex-comparable children, selected as a reference group, together with other insulin-derived indicators of insulin sensitivity/resistance. 200 overweight/obese children were followed-up for 6.5 [3.5-10] years, data were used for longitudinal retrospective investigations. RESULTS: At baseline, 96/909 (11%) overweight/obese children had IGR; in this subgroup, SPISE was significantly lower than in normo-glycaemic youths (6.3 ± 1.7 vs. 7 ± 1.6, p < 0.001). The SPISE index correlated positively with the insulin sensitivity index (ISI) and the disposition index (DI), negatively with age, blood pressure, HOMA-IR, basal and 120 min blood glucose and insulin (all p values < 0.001). A correlation between SPISE, HOMA-IR and ISI was also reported in normal-weight children. At the 6.5-year follow-up, lower basal SPISE-but not ISI or HOMA-IR-was an independent predictor of IGR development (OR = 3.89(1.65-9.13), p = 0.002; AUROC: 0.82(0.72-0.92), p < 0.001). CONCLUSION: In children, low SPISE index is significantly associated with metabolic abnormalities and predicts the development of IGR in life.


Assuntos
Glicemia/metabolismo , Transtornos do Metabolismo de Glucose , Resistência à Insulina , Metaboloma , Sobrepeso , Obesidade Pediátrica , Adolescente , Adulto , Fatores Etários , Índice de Massa Corporal , Feminino , Transtornos do Metabolismo de Glucose/sangue , Transtornos do Metabolismo de Glucose/diagnóstico , Transtornos do Metabolismo de Glucose/epidemiologia , Transtornos do Metabolismo de Glucose/metabolismo , Humanos , Secreção de Insulina , Itália/epidemiologia , Masculino , Sobrepeso/diagnóstico , Sobrepeso/epidemiologia , Sobrepeso/metabolismo , Obesidade Pediátrica/diagnóstico , Obesidade Pediátrica/epidemiologia , Obesidade Pediátrica/metabolismo , Valor Preditivo dos Testes , Puberdade/metabolismo , Fatores de Risco , Triglicerídeos/sangue
3.
BMC Pregnancy Childbirth ; 20(1): 117, 2020 Feb 19.
Artigo em Inglês | MEDLINE | ID: mdl-32075598

RESUMO

BACKGROUND: Pelvic floor muscles (PFM) and rectus abdominis muscles (RAM) of pregnant diabetic rats exhibit atrophy, co-localization of fast and slow fibers and an increased collagen type I/III ratio. However, the role of similar PFM or RAM hyperglycemic-related myopathy in women with gestational diabetes mellitus (GDM) remains poorly investigated. This study aims to assess the frequency of pelvic floor muscle disorders and pregnancy-specific urinary incontinence (PS-UI) 12 months after the Cesarean (C) section in women with GDM. Specifically, differences in PFM/RAM hyperglycemic myopathy will be evaluated. METHODS: The Diamater is an ongoing cohort study of four groups of 59 pregnant women each from the Perinatal Diabetes Research Centre (PDRC), Botucatu Medical School (FMB)-UNESP (São Paulo State University), Brazil. Diagnosis of GDM and PS-UI will be made at 24-26 weeks, with a follow-up at 34-38 weeks of gestation. Inclusion in the study will occur at the time of C-section, and patients will be followed at 24-48 h, 6 weeks and 6 and 12 months postpartum. Study groups will be classified as (1) GDM plus PS-UI; (2) GDM without PS-UI; (3) Non-GDM plus PS-UI; and (4) Non-GDM without PS-UI. We will analyze relationships between GDM, PS-UI and hyperglycemic myopathy at 12 months after C-section. The mediator variables to be evaluated include digital palpation, vaginal squeeze pressure, 3D pelvic floor ultrasound, and 3D RAM ultrasound. RAM samples obtained during C-section will be analyzed for ex-vivo contractility, morphological, molecular and OMICS profiles to further characterize the hyperglycemic myopathy. Additional variables to be evaluated include maternal age, socioeconomic status, educational level, ethnicity, body mass index, weight gain during pregnancy, quality of glycemic control and insulin therapy. DISCUSSION: To our knowledge, this will be the first study to provide data on the prevalence of PS-UI and RAM and PFM physical and biomolecular muscle profiles after C-section in mothers with GDM. The longitudinal design allows for the assessment of cause-effect relationships between GDM, PS-UI, and PFMs and RAMs myopathy. The findings may reveal previously undetermined consequences of GDM.


Assuntos
Diabetes Gestacional/fisiopatologia , Doenças Musculares/fisiopatologia , Incontinência Urinária/fisiopatologia , Adulto , Brasil , Cesárea , Estudos de Coortes , Feminino , Idade Gestacional , Ganho de Peso na Gestação , Humanos , Idade Materna , Contração Muscular/fisiologia , Força Muscular/fisiologia , Palpação , Diafragma da Pelve/fisiopatologia , Período Pós-Parto , Gravidez , Reto do Abdome/fisiopatologia , Vagina
4.
Water Res ; 161: 517-530, 2019 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-31229732

RESUMO

This paper presents a review of the current state of the art of real time control (RTC) of water distribution networks (WDNs). After proving the basic concept and terms of RTC and presenting sensors, regulation devices and controllers typically used in WDNs, the paper goes on by describing the most frequent control objectives, which mainly include service pressure regulation, control of tank filling and energy production in each WDN district. Various control methodologies recently proposed in the scientific literature are presented and discussed, along with experimental and numerical results achieved. Also, aspects related to the cost-effectiveness of RTC are critically analyzed. The paper ends by giving an outlook into potential future developments in the area of RTC for WDNs.


Assuntos
Abastecimento de Água , Água , Análise Custo-Benefício , Previsões , Modelos Teóricos
5.
Acta Otorhinolaryngol Ital ; 38(SUPPL. 1): S1-S106, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29967548

RESUMO

SUMMARY: Emerging and re-emerging infectious disease in otorhinolaryngology (ENT) are an area of growing epidemiological and clinical interest. The aim of this section is to comprehensively report on the epidemiology of key infectious disease in otorhinolaryngology, reporting on their burden at the national and international level, expanding of the need of promoting and implementing preventive interventions, and the rationale of applying evidence-based, effective and cost- effective diagnostic, curative and preventive approaches. In particular, we focus on i) ENT viral infections (HIV, Epstein-Barr virus, Human Papilloma virus), retrieving the available evidence on their oncogenic potential; ii) typical and atypical mycobacteria infections; iii) non-specific granulomatous lymphadenopathy; iv) emerging paediatric ENT infectious diseases and the prevention of their complications; v) the growing burden of antimicrobial resistance in ENT and the strategies for its control in different clinical settings. We conclude by outlining knowledge gaps and action needed in ENT infectious diseases research and clinical practice and we make references to economic analysis in the field of ENT infectious diseases prevention and care.


Assuntos
Doenças Transmissíveis Emergentes , Otorrinolaringopatias , Algoritmos , Doenças Transmissíveis Emergentes/diagnóstico , Doenças Transmissíveis Emergentes/epidemiologia , Doenças Transmissíveis Emergentes/terapia , Farmacorresistência Bacteriana , Infecções por Vírus Epstein-Barr/diagnóstico , Infecções por Vírus Epstein-Barr/terapia , Infecções por HIV/diagnóstico , Infecções por HIV/terapia , Neoplasias de Cabeça e Pescoço/virologia , Humanos , Linfadenite/diagnóstico , Linfadenite/terapia , Infecções por Mycobacterium/diagnóstico , Infecções por Mycobacterium/terapia , Otorrinolaringopatias/diagnóstico , Otorrinolaringopatias/epidemiologia , Otorrinolaringopatias/terapia , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/terapia
6.
Braz J Med Biol Res ; 51(4): e7035, 2018 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-29513796

RESUMO

The urethral muscle of diabetic pregnant rats is affected by long-term mild diabetes and short-term severe diabetes, which plays a crucial role in the pathogenesis of pelvic floor disorders. We hypothesized that muscles outside the pelvis are subject to similar changes. The current study aimed at analyzing the effects of long-term mild and short-term severe diabetes on the structure and ultrastructure of fiber muscles and collagen in rats' rectus abdominis (RA) muscle. Therefore, the RA muscle of virgin, pregnant, long-term mild diabetic, short-term severe diabetic, long-term mild diabetic pregnant and short-term severe diabetic pregnant 3-month-old Wistar rats were collected. The structure was analyzed by picrosirius red staining, immunohistochemistry for fast and slow muscle fibers and transmission electron microscopy. We investigated two levels of STZ- induced diabetes: long-term mild diabetes (blood glucose level: 120-200 mg/dL) and short-term severe diabetes (blood glucose level >300 mg/dL). Long-term mild diabetic pregnant and short-term severe diabetic pregnant rats had decreased fast fibers and increased slow fibers, disrupted areas of sarcomere, intermyofibrillar mitochondria and myelin figures in the RA muscle. Both groups enabled us to analyze the specific influence of pregnancy, separately from diabetes. The current study demonstrated that diabetes and pregnancy induced intramuscular transformation and reorganization of RA muscle with a switch of fiber type adjusting their architecture according to intensity and duration of hyperglycemic insult within pregnancy.


Assuntos
Colágeno/ultraestrutura , Diabetes Mellitus Experimental/patologia , Fibras Musculares Esqueléticas/ultraestrutura , Gravidez em Diabéticas/patologia , Reto do Abdome/ultraestrutura , Animais , Feminino , Imuno-Histoquímica , Gravidez , Ratos , Ratos Wistar , Índice de Gravidade de Doença
7.
Braz. j. med. biol. res ; 51(4): e7035, 2018. graf
Artigo em Inglês | LILACS | ID: biblio-889054

RESUMO

The urethral muscle of diabetic pregnant rats is affected by long-term mild diabetes and short-term severe diabetes, which plays a crucial role in the pathogenesis of pelvic floor disorders. We hypothesized that muscles outside the pelvis are subject to similar changes. The current study aimed at analyzing the effects of long-term mild and short-term severe diabetes on the structure and ultrastructure of fiber muscles and collagen in rats' rectus abdominis (RA) muscle. Therefore, the RA muscle of virgin, pregnant, long-term mild diabetic, short-term severe diabetic, long-term mild diabetic pregnant and short-term severe diabetic pregnant 3-month-old Wistar rats were collected. The structure was analyzed by picrosirius red staining, immunohistochemistry for fast and slow muscle fibers and transmission electron microscopy. We investigated two levels of STZ- induced diabetes: long-term mild diabetes (blood glucose level: 120-200 mg/dL) and short-term severe diabetes (blood glucose level >300 mg/dL). Long-term mild diabetic pregnant and short-term severe diabetic pregnant rats had decreased fast fibers and increased slow fibers, disrupted areas of sarcomere, intermyofibrillar mitochondria and myelin figures in the RA muscle. Both groups enabled us to analyze the specific influence of pregnancy, separately from diabetes. The current study demonstrated that diabetes and pregnancy induced intramuscular transformation and reorganization of RA muscle with a switch of fiber type adjusting their architecture according to intensity and duration of hyperglycemic insult within pregnancy.


Assuntos
Animais , Feminino , Gravidez , Ratos , Gravidez em Diabéticas/patologia , Colágeno/ultraestrutura , Reto do Abdome/ultraestrutura , Fibras Musculares Esqueléticas/ultraestrutura , Diabetes Mellitus Experimental/patologia , Índice de Gravidade de Doença , Imuno-Histoquímica , Ratos Wistar
8.
Epidemiol Infect ; 143(10): 2241-4, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-26050717

RESUMO

Dobrava-Belgrade virus (DOBV) is the most pathogenic hantavirus in Europe with a case-fatality rate of up to 12%. To detect changes in risk for humans, the prevalence of antibodies to DOBV has been monitored in a population of Apodemus flavicollis in the province of Trento (northern Italy) since 2000, and a sudden increase was observed in 2010. In the 13-year period of this study, 2077 animals were live-trapped and mean hantavirus seroprevalence was 2·7% (s.e. = 0·3%), ranging from 0% (in 2000, 2002 and 2003) to 12·5% (in 2012). Climatic (temperature and precipitation) and host (rodent population density, rodent weight and sex, and larval tick burden) variables were analysed using Generalized Linear Models and multi-model inference to select the best model. Climatic changes (mean annual precipitation and maximum temperature) and individual body mass had a positive effect on hantavirus seroprevalence. Other possible drivers affecting the observed pattern need to be studied further.


Assuntos
Anticorpos Antivirais/sangue , Infecções por Hantavirus/veterinária , Murinae , Orthohantavírus/imunologia , Doenças dos Roedores/epidemiologia , Doenças dos Roedores/virologia , Animais , Peso Corporal , Clima , Feminino , Infecções por Hantavirus/epidemiologia , Itália/epidemiologia , Masculino , Estudos Soroepidemiológicos
9.
J Diabetes Res ; 2013: 473575, 2013.
Artigo em Inglês | MEDLINE | ID: mdl-23878822

RESUMO

The presence of diabetes in pregnancy leads to hormonal and metabolic changes making inappropriate intrauterine environment, favoring the onset of maternal and fetal complications. Human studies that explore mechanisms responsible for changes caused by diabetes are limited not only for ethical reasons but also by the many uncontrollable variables. Thus, there is a need to develop appropriate experimental models. The diabetes induced in laboratory animals can be performed by different methods depending on dose, route of administration, and the strain and age of animal used. Many of these studies are carried out in neonatal period or during pregnancy, but the results presented are controversial. So this paper, addresses the review about the different models of mild diabetes induction using streptozotocin in pregnant rats and their repercussions on the maternal and fetal organisms to propose an adequate model for each approached issue.


Assuntos
Diabetes Mellitus Experimental/fisiopatologia , Diabetes Gestacional/fisiopatologia , Modelos Animais de Doenças , Gravidez em Diabéticas/fisiopatologia , Animais , Diabetes Mellitus Experimental/metabolismo , Diabetes Gestacional/metabolismo , Feminino , Gravidez , Gravidez em Diabéticas/metabolismo
10.
Br J Cancer ; 106(4): 658-65, 2012 Feb 14.
Artigo em Inglês | MEDLINE | ID: mdl-22240782

RESUMO

BACKGROUND: The FAST is a 2 × 2 factorial trial addressing two questions: (1) the role of replacing cisplatin (P) with a non-platinum agent, vinorelbine (N), and (2) the role of adding a third agent, ifosfamide (I), in a doublet based on gemcitabine (G). METHODS: A total of 433 stage IIIB-IV non-small cell lung cancer (NSCLC) patients were randomised to one of four arms: gemcitabine-cisplatin (GP), gemcitabine-vinorelbine, gemcitabine-ifosfamide-cisplatin or gemcitabine-ifosfamide-vinorelbine. Two comparisons were performed: N- vs P-containing regimens and I-triplets vs non-I doublets. RESULTS: For N- vs P-containing regimens, adjusted overall survival was 9.7 vs 11.3 months (P=0.044), progression-free survival was 4.9 vs 6.4 months (P=0.020) and response rate was 24% vs 31% (P=0.124), respectively. No statistically significant difference was observed between doublets and triplets. Grade 3-4 haematological toxicity was significantly more frequent in P-containing therapy; grade 3-4 leucopenia was significantly more common in triplets. Concerning non-haematological toxicity, grade 3-4 nausea-vomiting was significantly increased in P-containing regimens. CONCLUSIONS: This trial provides evidence of a slight survival superiority of GP-containing regimens over platinum-free N-containing chemotherapy. This trial also confirms that the addition of a third chemotherapy agent (I) to a standard G-based doublet does not improve treatment outcome.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Neoplasias Pulmonares/tratamento farmacológico , Adulto , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Carcinoma Pulmonar de Células não Pequenas/mortalidade , Carcinoma Pulmonar de Células não Pequenas/patologia , Cisplatino/administração & dosagem , Desoxicitidina/administração & dosagem , Desoxicitidina/análogos & derivados , Intervalo Livre de Doença , Feminino , Humanos , Ifosfamida/administração & dosagem , Neoplasias Pulmonares/mortalidade , Neoplasias Pulmonares/patologia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Vimblastina/administração & dosagem , Vimblastina/análogos & derivados , Vinorelbina , Gencitabina
11.
Med Phys ; 39(6Part11): 3731, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-28517164

RESUMO

PURPOSE: To evaluate the dose response of EBT2 films in regions of low dose using the decomposition of the image's color channels (RGB, Red, Green and Blue). METHODS: Doses ranging from 1 Gy to 60 Gy were used to calibrate the dose response of Gafchromic ® EBT2 films irradiated in 6MV photons beams. Segments of film with dimensions of 8.5 cm × 8.5 cm were used. Another segment of film with dimensions 8.5 cm × 20.25 cm was also irradiated with a maximum dose of 4Gy to determine the percentage depth dose (PDD). The films were digitized by a LaserJet M1132 MFP - HP ® scanner in standard resolution of 150dpi and analyzed by a routine created in MatLab to convert the image to gray levels as well as assess the desired color components from the image. RESULTS: The green component presented the higher sensitivity (17.8 a.u./Gy) when the separated color channels and the shades of gray analysis are compared. The red component presented the highest signal to noise ratio in the low dose range (63% at 1Gy). The blue component presented low sensitivity (0.66 a.u./Gy) in the entire dose range. A linear fitting (r=0.998) was used to the green and gray components until a dose of 4 Gy. The red component presented a non-linear behavior in the entire dose range. The useful dose range found was from 1 Gy to 15 Gy. The maximum differences between the reference PDD, measured with ionization chamber in a water phantom, and the PDDs determined with film were 6%, 9% and 14% for the green, gray and red components, respectively. CONCLUSIONS: This work results show that the use of radiochromic films on planning verification procedures in low dose ranges can be benefit from the analysis of the image's separated color components.

12.
Breast ; 19(5): 333-8, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-20185313

RESUMO

To evaluate the cardiotoxicity, general toxicity, and activity of non-pegylated liposomal doxorubicin, in combination with docetaxel and trastuzumab, as first-line therapy in metastatic breast cancer. Thirty-one patients with metastatic human epidermal growth factor receptor 2-overexpressing breast cancer, who had not previously received chemotherapy for metastatic disease, received non-pegylated liposomal doxorubicin (50 mg/m(2)), docetaxel (75 mg/m(2)) and trastuzumab (2 mg/kg/week) for up to eight cycles, followed by trastuzumab alone for up to 52 weeks. Cardiotoxicity was defined as a decrease in left ventricular ejection fraction (LVEF) to below 45%, or a decrease in LVEF of at least 20% from baseline. Mean LVEF was maintained at baseline level also in the subset of patients who had received anthracycline previously. Cardiotoxicity developed in three patients during the treatment cycles, and in two further patients after the end of the study. The most common adverse events were haematological toxicity, alopecia, asthenia and fever. The best overall response rate was 65.5%. Median time to progression was 13.0 months. The combination of non-pegylated liposomal doxorubicin, docetaxel and trastuzumab combines acceptable cardiac and general toxicity and promising activity as first-line therapy in metastatic breast cancer.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Doxorrubicina/efeitos adversos , Coração/efeitos dos fármacos , Adulto , Idoso , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais Humanizados , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/patologia , Cardiotoxinas , Progressão da Doença , Docetaxel , Doxorrubicina/administração & dosagem , Feminino , Coração/fisiopatologia , Humanos , Estimativa de Kaplan-Meier , Lipossomos , Pessoa de Meia-Idade , Metástase Neoplásica , Volume Sistólico/efeitos dos fármacos , Taxoides/administração & dosagem , Taxoides/efeitos adversos , Trastuzumab , Função Ventricular Esquerda/efeitos dos fármacos
13.
Minerva Gastroenterol Dietol ; 54(4): 347-53, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19047975

RESUMO

AIM: Human epidermal growth factor receptor (HER2) protooncogene, overexpressed/ amplified in preneoplastic lesions and in adenocarcinoma (ADC) of the esophagus, can be considered a target for treatment of esophageal dysplasia/ADC. The aim of this study was to evaluate the therapeutic role of the anti-HER2 monoclonal antibody, trastuzumab, in the management of ADC originating from HER2-positive Barrett's esophagus (BE). METHODS: Two patients with high-grade dysplasia and ADC of the esophagus after esophageal mucosectomy and no metastatic disease were studied. Patients were not eligible for radical surgery or chemo-radiotherapy because of age and comorbidities. HER2 status was assessed by immunohistochemistry and fluorescence in situ hybridization. Additional immunohistochemical analyses were performed. The whole panel was analysed at baseline, after treatment and at follow-up. RESULTS: At baseline, the two patients showed HER-2 overexpression/amplification in all areas of dysplasia and ADC but not in BE. Six months after treatment no significant differences in terms of endoscopical and histological patterns of the disease were found. HER-2, EGFR, TOPOII-alpha and anti-ssDNA analysis demonstrated a down-regulation of these markers and increased apoptosis. CONCLUSION: This study demonstrates that this treatment is feasible. No clear evidence of dysplasia regression was observed. However, HER2 and TopoII-alpha downregulation and induction of apoptosis occurring 6 months after treatment encourages further investigation.


Assuntos
Adenocarcinoma/complicações , Adenocarcinoma/tratamento farmacológico , Anticorpos Monoclonais/uso terapêutico , Antineoplásicos/uso terapêutico , Esôfago de Barrett/complicações , Neoplasias Esofágicas/complicações , Neoplasias Esofágicas/tratamento farmacológico , Adenocarcinoma/química , Adenocarcinoma/patologia , Idoso , Idoso de 80 Anos ou mais , Anticorpos Monoclonais Humanizados , Neoplasias Esofágicas/química , Neoplasias Esofágicas/patologia , Humanos , Imuno-Histoquímica , Masculino , Receptor ErbB-2/análise , Trastuzumab
14.
Clin Neurophysiol ; 119(2): 315-20, 2008 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-18068429

RESUMO

OBJECTIVE: The aim of this study was to examine whether the mu rhythm is also seen in the EEG of alert, undrugged and freely moving rats. The mu rhythm is a salient neocortical synchrony with dominant frequency in the 8-13 Hz band, initially recorded over the parietal and frontal areas of humans and subsequently investigated in monkeys and cats using the term sensorimotor rhythm. In the rat, these oscillations have been described only at single-unit level in the trigeminal system or in the cerebellar hemispheres. METHODS: In order to identify this rhythm, according to the "functional topography" approach, we examined the shape, spectral content, spatial distribution in power spectra, and functional reactivity. Rats were implanted with multiple electrodes along the antero-posterior axes. Monopolar recordings and simultaneous continuous 24-h video were taken in natural dark-light cycles for 6 consecutive days. Brain mappings based on quantitative spectral analysis were made. RESULTS: Spontaneous well-defined 7-12 Hz EEG oscillations were found during immobile wakefulness and REM sleep. Comparable features of these patterns indicated that they are largely analogous to the mu rhythm. CONCLUSIONS: The conservation of mu rhythm in the EEG across mammalian species with different cortical extension suggests that it is functionally important. SIGNIFICANCE: Given the great interest aroused by the properties of the mirror neurons, reflected by the mu rhythm, the detailed characterization of this rhythm in rats during natural life may prove useful in prospective evolutionary studies.


Assuntos
Ritmo alfa , Mapeamento Encefálico , Sono REM/fisiologia , Vigília/fisiologia , Animais , Comportamento Animal , Polissonografia/métodos , Ratos , Ratos Sprague-Dawley , Análise Espectral
15.
Arch Ital Biol ; 144(1): 33-43, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16425616

RESUMO

In chronically-implanted, drug-free, behaving aged Fischer rats, intracerebroventricularly (i.c.v.) and intraperitoneally (i.p.) acetyl-L-carnitine (ALCAR) injections powerfully enhanced motor behavior and head movements aimed at attention and exploratory activity. This effect was dose-dependent and associated with the abolition or substantial reduction of the incidence and duration of the spontaneous EEG generalized hypersynchronous patterns termed High Voltage Spindle (HVS), with an increase in EEG monitored theta activity. The results suggest that ALCAR may stimulate the motivational system and disrupt the hypersynchronous processes by inhibiting the GABAergic thalamic reticular neurons and/or activating the brain stem cholinergic reticular system (pedunculo pontine tegmental, PPT and laterodorsal tegmental, LDT nuclei).


Assuntos
Acetilcarnitina/farmacologia , Envelhecimento/fisiologia , Envelhecimento/psicologia , Comportamento Animal/efeitos dos fármacos , Nootrópicos/farmacologia , Acetilcarnitina/administração & dosagem , Animais , Nível de Alerta/efeitos dos fármacos , Atenção/efeitos dos fármacos , Relação Dose-Resposta a Droga , Implantes de Medicamento , Eletroencefalografia/efeitos dos fármacos , Eletrofisiologia , Comportamento Exploratório/efeitos dos fármacos , Movimentos da Cabeça/efeitos dos fármacos , Injeções Intraperitoneais , Injeções Intraventriculares , Masculino , Atividade Motora/efeitos dos fármacos , Nootrópicos/administração & dosagem , Ratos , Ratos Endogâmicos F344
16.
Bioinformatics ; 20(17): 2985-96, 2004 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-15180934

RESUMO

MOTIVATION: During the Bavarian newborn screening programme all newborns have been tested for about 20 inherited metabolic disorders. Owing to the amount and complexity of the generated experimental data, machine learning techniques provide a promising approach to investigate novel patterns in high-dimensional metabolic data which form the source for constructing classification rules with high discriminatory power. RESULTS: Six machine learning techniques have been investigated for their classification accuracy focusing on two metabolic disorders, phenylketo nuria (PKU) and medium-chain acyl-CoA dehydrogenase deficiency (MCADD). Logistic regression analysis led to superior classification rules (sensitivity >96.8%, specificity >99.98%) compared to all investigated algorithms. Including novel constellations of metabolites into the models, the positive predictive value could be strongly increased (PKU 71.9% versus 16.2%, MCADD 88.4% versus 54.6% compared to the established diagnostic markers). Our results clearly prove that the mined data confirm the known and indicate some novel metabolic patterns which may contribute to a better understanding of newborn metabolism.


Assuntos
Inteligência Artificial , Biomarcadores/sangue , Diagnóstico por Computador/métodos , Erros Inatos do Metabolismo/classificação , Erros Inatos do Metabolismo/diagnóstico , Triagem Neonatal/métodos , Algoritmos , Alemanha/epidemiologia , Humanos , Recém-Nascido , Erros Inatos do Metabolismo/sangue , Erros Inatos do Metabolismo/epidemiologia , Reconhecimento Automatizado de Padrão/métodos , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
17.
Arch Ital Biol ; 142(1): 59-67, 2004 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-15143624

RESUMO

The K-complex (KC) is an electrographic rhythmic pattern present in human and cat sleep EEG. In long-term multisite videoEEG recordings in behaving Sprague-Dawley (SD) rats, well-defined spontaneous KCs were observed during sleep. Sprague-Dawley rats were implanted with multiple electrodes bilaterally along the antero-posterior axes at the locations F1, F2, F7, F8, T3, T4, P3, P4, all against a ground reference placed in the midline above the cerebellum. Multiple, closely spaced cortical electrodes allowed two-dimensional surface brain mapping of the power spectra distribution. Two silver wires were also inserted into nuchal muscles to record EMG activity. Each rat was monopolarly recorded from 0900 h to 1500 h in a natural dark-light rodents, we examined the patterns of appearance in various conditions, the progression through a full sleep-waking cycle, the shape, density, spectral components, and spatial distribution in power spectra. The rat KC appears to share similar features with the human and cat KC.


Assuntos
Relógios Biológicos/fisiologia , Córtex Cerebral/fisiologia , Eletroencefalografia/efeitos dos fármacos , Sono/fisiologia , Vigília/fisiologia , Potenciais de Ação/efeitos dos fármacos , Potenciais de Ação/fisiologia , Anestésicos/farmacologia , Animais , Comportamento Animal/efeitos dos fármacos , Comportamento Animal/fisiologia , Relógios Biológicos/efeitos dos fármacos , Mapeamento Encefálico , Córtex Cerebral/efeitos dos fármacos , Periodicidade , Ratos , Ratos Sprague-Dawley , Sono/efeitos dos fármacos , Vigília/efeitos dos fármacos
18.
Water Sci Technol ; 47(2): 189-96, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12636079

RESUMO

The worsening environmental situation of the Brantas River, East Java, is addressed by a comprehensive basin management strategy which relies on accurate water quantity and quality data retrieved from a newly installed online monitoring network. Integrated into a Hydrological Information System, the continuously measured indicative parameters allow early warning, control and polluter identification. Additionally, long-term analyses have been initiated for improving modelling applications like flood forecasting, water resource management and pollutant propagation. Preliminary results illustrate the efficiency of the installed system.


Assuntos
Monitoramento Ambiental/normas , Poluentes da Água/análise , Abastecimento de Água/normas , Automação , Conservação dos Recursos Naturais , Bases de Dados Factuais , Monitoramento Ambiental/métodos , Indonésia , Controle de Qualidade , Sensibilidade e Especificidade
19.
G Ital Med Lav Ergon ; 25 Suppl(3): 196-7, 2003.
Artigo em Italiano | MEDLINE | ID: mdl-14979147

RESUMO

The accidents have been esteemed that are verified in four years in a group of 824 employees. The study has underlined a meaningful percentage (30.1%) of road accidents. This suggests the opportunity of contemplate preventive actions: corrected maintenance of the ambulance, control of the conditions of environmental comfort, organization of the job, individualization of conditions that reduces the attention and the concentration, as the use of alcohol and of other substances.


Assuntos
Acidentes de Trabalho/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Ambulâncias , Humanos
20.
Clin Neurophysiol ; 113(7): 1152-64, 2002 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-12088712

RESUMO

OBJECTIVES: The aim of this study was to investigate the effects of bilateral chemical lesion of the rostral pole of the thalamic reticular nucleus on EEG activities in freely moving rats applying quantitative analysis and brain mapping of power spectra distribution. METHODS: Ketamine-sedated Sprague-Dawley rats were implanted to monitor behavioral states with frontoparietal electrodes in a first series of experiments and with multiple electrodes along the antero-posterior axis (F1, F2, F7, F8, T3, T4, P3, P4) in a second series. Monopolar and bipolar recordings were obtained in animals stereotaxically injected with ibotenic acid into both rostral poles of the thalamic reticular nucleus. Long-term video-EEG recordings and brain mapping based on quantitative spectral analysis were made. RESULTS: Two forms of dysrhythmia gradually emerged in the neocortical EEG at 12-24h post-injection: potentiation of theta waves and spontaneous high-voltage spindles (HVS) at 4.5-8Hz frequency. Brain mapping during these dysrhythmia shows highest power posteriorly (parietotemporal) for theta and mesiofrontally for HVS. CONCLUSIONS: Given the lack of inhibitory intrinsic interneurons in the rat thalamus, bilateral destruction of a small part of the solely GABAergic population may promote cortical dysrhythmia (probably by dis-inhibition). The topographic differences in power might indicate different involved structures.


Assuntos
Comportamento Animal/fisiologia , Córtex Cerebral/fisiologia , Núcleos Talâmicos/fisiologia , Tálamo/fisiologia , Anestésicos Dissociativos/farmacologia , Animais , Mapeamento Encefálico , Eletrodos Implantados , Eletroencefalografia , Eletromiografia , Agonistas de Aminoácidos Excitatórios/toxicidade , Lateralidade Funcional/fisiologia , Ácido Ibotênico/toxicidade , Ketamina/farmacologia , Ratos , Ratos Endogâmicos F344 , Ratos Sprague-Dawley , Ritmo Teta/efeitos dos fármacos
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