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1.
Dermatol Ther ; : e13958, 2020 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-32621642

RESUMO

Bullous pemphigoid (BP) patients are predominantly above 70 years of age, with limited tolerance to the side effects of the immunosuppressive drugs. Advancements in our understanding of the pathophysiology of BP have led to the development of molecules which target specific pathways involved in induction and perpetuation of disease. Patients with BP Disease Area Index above 60 and less than 100 were split into two groups-one with high and the other with normal levels of IgE. The tested parameters included eosinophils' count, total IgE serum level, and interleukins (IL) 16, 17A, and 23 counts in the peripheral blood and skin bulla serum, before any therapeutic intervention. Thirty individuals fulfilled the criteria for enrollment. Patients with high IgE blood serum levels had significantly higher levels of IL17A and normal IL23 levels in blood and bulla serum. Patients with normal serum IgE levels had slightly higher IL23 levels in blood and bulla serum. The eosinophil count was positively related to IL17 blood serum level and negatively related to IL23. IL16 did not differ in the two groups. BP patients may represent a group of patients benefiting most substantially from the introduction of nonimmunosuppressive therapeutics into the treatment regimens for their disease. Clinical criteria and immune biomarkers are needed for making the best therapeutic choice.

2.
Ann Hepatol ; 16(4): 584-590, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28611262

RESUMO

BACKGROUND: The clinical impact of relative adrenal insufficiency (AI) on patients with stable decompensated cirrhosis (DeCi) has not been yet elucidated. AIM: Explore the association between AI and outcome [death or liver transplantation (LT)] in patients with DeCi. MATERIAL AND METHODS: Patients with DeCi presenting no active complication have been included. Clinical and laboratory data, including serum levels of corticosteroid-binding globulin (CBG), interleukin (IL)-1b, IL-6 and tumor necrosis factor (TNFα) were recorded in each participant. Salivary cortisol (SC) and serum total cortisol (STC) were assessed at (T0) and 1 h (T60) after intravenous injection of 250 µg corticotropin. RESULTS: 113 consecutive patients were totally tested. Median SC was 3.9 ng/mL and 15.5 ng/mL and median STC was 10.7 µg/dL and 22.7 µg/dL at T0 and T60 respectively. The patients with AI [group 1, n = 34 (30%)] had significantly lower systolic blood pressure (106 ± 12 vs. 113 ± 13 mmHg, p = 0.05), serum sodium (133 ± 7 vs. 137 ± 12 mEq/ L, p = 0.04), HDL (29.9 ± 14 vs. 38.6 ± 18 mg/dL, p = 0.034) and albumin (2.7 ± 0.5 vs. 3.1 ± 0.5 g/dL, p = 0.002), but higher direct bilirubin (median: 1.6 vs. 0.8 mg/dL, p = 0.029) compared to those without AI [group 2, n = 79 (70%)]. Moreover, group 1 patients presented more frequently past history of spontaneous bacterial peritonitis (SBP) [10/34 (29.4%) vs. 6/79 (7.5%), p = 0.002]. AI was significantly associated with death [HR = 2.65, 95% C.I.: 1.55 - 4.52, p = 0.003 over a follow up period of 12 (6-48) months.] Conclusions. The presence of AI in patients with stable DeCi predispose to obvious clinical implications since it is associated with circulatory dysfunction, previous history of SBP and worse survival.


Assuntos
Insuficiência Adrenal/epidemiologia , Cirrose Hepática/cirurgia , Transplante de Fígado , Insuficiência Adrenal/diagnóstico , Insuficiência Adrenal/mortalidade , Adulto , Idoso , Biomarcadores/sangue , Distribuição de Qui-Quadrado , Feminino , Grécia/epidemiologia , Humanos , Hidrocortisona/sangue , Interleucina-1beta/sangue , Interleucina-6/sangue , Estimativa de Kaplan-Meier , Cirrose Hepática/diagnóstico , Cirrose Hepática/mortalidade , Transplante de Fígado/efeitos adversos , Transplante de Fígado/mortalidade , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Razão de Chances , Prevalência , Modelos de Riscos Proporcionais , Fatores de Risco , Saliva/metabolismo , Fatores de Tempo , Transcortina/análise , Resultado do Tratamento , Fator de Necrose Tumoral alfa/sangue
4.
BMC Res Notes ; 6: 370, 2013 Sep 12.
Artigo em Inglês | MEDLINE | ID: mdl-24028157

RESUMO

BACKGROUND: Acute adrenal insufficiency is a potentially lethal condition rarely caused by bilateral adrenal haemorrhage due to heparin use. Most of the times, it is difficult to establish the diagnosis, as symptoms are not specific. Few cases have been reported in the literature. CASE PRESENTATION: A 52-year-old Caucasian woman presented with abdominal pain, vomiting and weakness nine days after arthroplasty and heparin use. Hyperkalemia, low cortisol and high adrenocorticotropic hormone levels were found, indicating adrenal insufficiency. Magnetic resonance imaging of the upper abdomen was compatible with preceding adrenal haemorrhage. Hydrocortisone and fludrocortisone were administered. Review of the literature revealed 36 cases of postoperative adrenal haemorrhage which are presented briefly. CONCLUSION: Postoperative acute adrenal insufficiency due to haemorrhage is a rare condition. If patients are treated based on clinical suspicion, they have good chances to survive. Hydrocortisone is given permanently in the majority of the patients.


Assuntos
Insuficiência Adrenal/patologia , Artroplastia/efeitos adversos , Fibrinolíticos/efeitos adversos , Hemorragia/patologia , Heparina/efeitos adversos , Insuficiência Adrenal/tratamento farmacológico , Insuficiência Adrenal/etiologia , Feminino , Fludrocortisona/uso terapêutico , Hemorragia/tratamento farmacológico , Hemorragia/etiologia , Humanos , Hidrocortisona/uso terapêutico , Pessoa de Meia-Idade
5.
Vector Borne Zoonotic Dis ; 13(10): 719-22, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-23919603

RESUMO

To estimate the prevalence of West Nile virus (WNV) immunoglobulin G (IgG) antibodies in residents of northern Greece before the large outbreak of 2010, stored serum samples collected during 2003-2004 from 626 apparently healthy residents of northern Greece were tested. A seroprevalence of 0.62% was detected, with no statistically significant differences among the various prefectures, gender, and age groups, suggesting that the lineage 2 WNV strain that caused the outbreaks for 3 consecutive years was introduced recently. Data from the present study can be used as a threshold in future comparisons with respective data after the outbreaks to estimate and assess the public health impact, as well as for WNV evolutionary studies.


Assuntos
Anticorpos Antivirais/sangue , Surtos de Doenças , Imunoglobulina G/sangue , Febre do Nilo Ocidental/epidemiologia , Vírus do Nilo Ocidental/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Grécia/epidemiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Saúde Pública , Estudos Retrospectivos , Estudos Soroepidemiológicos , Febre do Nilo Ocidental/virologia , Vírus do Nilo Ocidental/isolamento & purificação , Adulto Jovem
6.
Sleep Breath ; 15(4): 861-6, 2011 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-21267664

RESUMO

OBJECTIVE: Several studies suggest that obstructive sleep apnea syndrome (OSAS) is associated with oxidative stress. However, there are also contrary observations and the role of antioxidant mechanisms has not been fully explored. PATIENTS AND METHODS: The present study evaluated serum total antioxidant status (TAS) in 32 OSAS patients without comorbidities, before and after a diagnostic sleep study and at a second sleep study after continuous positive airway pressure (CPAP) application. RESULTS: Lower TAS values were found in the morning, immediately after the first sleep study, compared with those before sleep (1.68 ± 0.11 vs. 1.61 ± 0.10 mmol/l, p < 0.01); this was evident in patients with less severe syndrome [apnea-hypopnea index (AHI) <30; 1.73 ± 0.08 vs. 1.65 ± 0.09 mmol/l, p = 0.01] but not in severe syndrome (AHI ≥30; 1.64 ± 0.12 vs. 1.58 ± 0.10 mmol/l, p = 0.07). After CPAP application, a statistically significant decrease in TAS values was observed in patients with less severe syndrome (1.72 ± 0.05 vs. 1.63 ± 0.04 mmol/l, p = 0.003). On the contrary, no statistically significant changes in TAS were observed in patients with severe syndrome. CONCLUSIONS: The present study supports a reduction in antioxidant capacity during sleep in otherwise healthy patients with OSAS. This reduction was evident in less severe syndrome. However, a single night of CPAP application seems to ameliorate this antioxidant disturbance only in less severe syndrome.


Assuntos
Antioxidantes/metabolismo , Estresse Oxidativo/fisiologia , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologia , Adulto , Pressão Positiva Contínua nas Vias Aéreas , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Valores de Referência , Apneia Obstrutiva do Sono/terapia
7.
Exp Appl Acarol ; 45(3-4): 195-8, 2008 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-18563592

RESUMO

The tick species infesting grazing animals in the countryside of 11 prefectures in Northern Greece were investigated during April-July and September-December of consecutive years 2003-2006. A total of 3,249 (1,952 males, 1,297 females) adult ticks were collected from goats, sheep, cattle and dogs. Ticks were identified as Ixodes ricinus (44.57%), Ixodes gibbosus (4.09%), Rhipicephalus bursa (19.14%), Rhipicephalus sanguineus, Rhipicephalus turanicus (5.79%), Hyalomma marginatum marginatum (12.40%), Dermacentor marginatus (0.31%) and Boophilus annulatus (4.43%). Rhipicephalus spp. and Hyalomma spp. were abundant in all prefectures, Ixodes spp. were present in 9/11 prefectures, Boophilus spp. in 4/11, while Dermacentor spp. were found only in one. Results of this study give an insight into the ecology of ticks and their potential of tick-borne diseases in the country.


Assuntos
Animais Domésticos/parasitologia , Vetores Aracnídeos/classificação , Carrapatos/classificação , Animais , Bovinos/parasitologia , Cães/parasitologia , Feminino , Cabras/parasitologia , Grécia , Masculino , Ovinos/parasitologia
8.
Vector Borne Zoonotic Dis ; 8(3): 351-4, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18471057

RESUMO

Tick-borne encephalitis virus (TBEV) and Louping ill virus (LIV) are viruses in the Mammalian tick-borne virus group/genus Flavivirus, causing central nervous system disease. Greek goat encephalitis virus (GGEV), which was isolated from the brain of a newborn goat with neurological symptoms, is currently classified in the TBEV group. The vector of GGEV has not yet been specifically identified but is considered likely to be Ixodes ricinus. A total of 3,144 Ixodidae ticks collected during 2003-2006 from goats and sheep in rural areas of Northern Greece were tested by reverse transcription-polymerase chain reaction (RT-PCR) for the presence of TBEV-specific RNA. Two pools of I. ricinus ticks were shown to be RNA-positive. Sequence analysis showed that the virus was GGEV. The RNA-positive ticks were detected in regions where high prevalence of TBE antibodies in humans was present. Prevalence in ticks varied according to year, season, and geographic region. TBEV is not endemic in Greece, and most probably the seroprevalence of TBE antibodies in humans is due to cross-reactivity to GGEV.


Assuntos
Vírus da Encefalite Transmitidos por Carrapatos/genética , Encefalite Transmitida por Carrapatos/veterinária , Doenças das Cabras/epidemiologia , Animais , Vetores Aracnídeos/classificação , Vetores Aracnídeos/virologia , Encefalite Transmitida por Carrapatos/epidemiologia , Encefalite Transmitida por Carrapatos/virologia , Feminino , Doenças das Cabras/sangue , Doenças das Cabras/virologia , Cabras , Grécia/epidemiologia , Masculino , Carrapatos/classificação , Carrapatos/virologia , Proteínas Virais Reguladoras e Acessórias/sangue
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