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1.
Ann Ig ; 31(6): 595-613, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31616904

RESUMO

Physical inactivity represents the fourth leading risk factor with the highest epidemiological impact on population health worldwide, as estimated by the epidemiological measures used in global surveillance systems as the Global Burden of Disease Study. Scientific research has provided compelling evidence to establish and clarify the causal relationships and to devise effective intervention strategies, including the development of both national and international recommendations and the planning of whole-of-system and integrated actions. Over the last few years, new paradigms have been identified, such as the distinction between physical inactivity and sedentary behaviour, the different methods to integrate enough levels of physical activity in daily life, and the relevance of sleep in normal lifestyle activities. The experience in programs planning and in their assessments has led to the definition of a whole-of-system and global approach for the promotion of an active lifestyle, specifically the Global Action Plan on Physical Activity 2018 - 2030 by the World Health Organization, with the definition of overlapping areas with further objectives of public health as established by the 2030 Agenda for Sustainable Development. Thus, the action plan aims to ensure access to inclusive and equitable opportunities for people to be physically active in their daily life (with reference to more socially disadvantaged groups, such as women, people with disabilities, people of low socioeconomic status) and to improve planetary health.


Assuntos
Exercício Físico/fisiologia , Saúde Global , Promoção da Saúde/métodos , Humanos , Estilo de Vida , Fatores de Risco , Comportamento Sedentário , Sono/fisiologia , Populações Vulneráveis
2.
Vet Pathol ; 54(1): 147-154, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27337982

RESUMO

Splenitis is uncommonly reported in dogs. Herein, the authors describe its prevalence, clinical findings and outcomes, histologic patterns, and causes. Splenic samples of dogs diagnosed with splenitis between 2005 and 2013 were collected and stained with hematoxylin and eosin, Gram, green-Gram, Giemsa, periodic acid-Schiff, and Ziehl-Neelsen. Samples were processed for polymerase chain reaction (PCR) to detect bacteria, fungi, and protozoa ( Leishmania infantum, Hepatozoon canis). Thirty-three of 660 splenic samples (5%) had splenitis. Clinical findings and outcomes were available in 19 dogs (58%); 49% had weakness, 33% had fever, and 84% survived. The most frequent inflammatory patterns included purulent splenitis (27%), pyogranulomatous splenitis (24%), and neutrophilic perisplenitis (15%). One dog had a putative diagnosis of primary splenitis; in 8 dogs, microorganisms were identified histologically or by PCR in the spleen without obvious comorbidities. Twenty-four dogs (73%) had concurrent diseases; a permissive role in the development of splenitis was suspected in 21 of these cases. Histologic examination identified the cause of splenitis in 10 dogs. Bacteria were identified by PCR in 23 cases, but the bacteria were confirmed histologically in only 6 of these. Leishmania was detected with PCR in 6 dogs. Leishmania was identified in 1 dog and H. canis in another histologically, but both were PCR negative. Fungi were identified in 8 spleens by PCR and in 1 by histology. This study suggests that splenitis is uncommon in dogs and is frequently associated with systemic diseases. Prognosis is favorable in most cases. Identification of bacteria, fungi, and protozoa in the spleens of affected dogs with PCR should be interpreted cautiously, because the findings are not confirmed histologically in many cases.


Assuntos
Doenças do Cão/patologia , Esplenopatias/veterinária , Animais , Biópsia/veterinária , Doenças do Cão/diagnóstico , Doenças do Cão/etiologia , Cães , Masculino , Reação em Cadeia da Polimerase/veterinária , Baço/microbiologia , Baço/parasitologia , Baço/patologia , Esplenopatias/diagnóstico , Esplenopatias/etiologia , Esplenopatias/patologia
3.
Vet Pathol ; 53(1): 145-52, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26319779

RESUMO

Pancreatitis has been described in cats with diabetes mellitus, although the number of studies currently available is very limited. In addition, ketoacidosis has been hypothesized to be associated with pancreatitis in diabetic cats. The aims of the present study were to investigate whether diabetic cats have pancreatitis and to determine if pancreatitis is more frequent with ketoacidosis. Samples of pancreas were collected postmortem from 37 diabetic cats, including 15 with ketoacidosis, and 20 control cats matched for age, sex, breed, and body weight. Sections were stained with hematoxylin and eosin, double-labeled for insulin/CD3, insulin/CD20, insulin/myeloperoxidase, insulin/PCNA, and glucagon/Ki67, and single-labeled for Iba1. A previously proposed semiquantitative score was used to characterize pancreatitis, along with counts of inflammatory cells. Scores of pancreatitis and the number of neutrophils, macrophages, and lymphocytes in the exocrine pancreas did not differ between diabetic and control cats or between diabetic cats with and without ketoacidosis. Of note, PCNA-positive acinar cells were increased (P = .002) in diabetic cats, particularly near islets (P < .001). Ki67-positive acinar cells were increased only near islets (P = .038). Ketoacidosis was not linked to proliferation. The results suggest that histopathologic evidence of pancreatitis may not be more frequent in diabetic cats and that ketoacidosis may not be associated with it at the time of death. Augmented PCNA-positive acinar cells might indicate increased proliferation due to chronic pancreatitis. The reason behind the prevalent proliferation of acinar cells surrounding pancreatic islets deserves further investigation.


Assuntos
Doenças do Gato/patologia , Diabetes Mellitus/veterinária , Cetose/veterinária , Pâncreas Exócrino/patologia , Pancreatite/veterinária , Células Acinares/patologia , Animais , Doenças do Gato/metabolismo , Gatos , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patologia , Feminino , Glucagon/metabolismo , Insulina/metabolismo , Cetose/metabolismo , Cetose/patologia , Masculino , Pâncreas/metabolismo , Pâncreas/patologia , Pâncreas Exócrino/metabolismo , Pancreatite/metabolismo , Pancreatite/patologia
4.
Vet Pathol ; 53(1): 136-44, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26113611

RESUMO

Pancreatic amyloidosis and loss of α and ß cells have been shown to occur in cats with diabetes mellitus, although the number of studies currently available is very limited. Furthermore, it is not known whether pancreatic islet inflammation is a common feature. The aims of the present study were to characterize islet lesions and to investigate whether diabetic cats have inflammation of the pancreatic islets. Samples of pancreas were collected postmortem from 37 diabetic and 20 control cats matched for age, sex, breed, and body weight. Histologic sections were stained with hematoxylin and eosin and Congo red; double labeled for insulin/CD3, insulin/CD20, insulin/myeloperoxidase, insulin/proliferating cell nuclear antigen, and glucagon/Ki67; and single labeled for amylin and Iba1. Mean insulin-positive cross-sectional area was approximately 65% lower in diabetic than control cats (P = .009), while that of amylin and glucagon was similar. Surprisingly, amyloid deposition was similar between groups (P = .408). Proliferation of insulin- and glucagon-positive cells and the number of neutrophils, macrophages, and T (CD3) and B (CD20) lymphocytes in the islets did not differ. The presence of T and B lymphocytes combined tended to be more frequent in diabetic cats (n = 8 of 37; 21.6%) than control cats (n = 1 of 20; 5.0%). The results confirm previous observations that loss of ß cells but not α cells occurs in diabetic cats. Islet amyloidosis was present in diabetic cats but was not greater than in controls. A subset of diabetic cats had lymphocytic infiltration of the islets, which might be associated with ß-cell loss.


Assuntos
Amiloidose/veterinária , Doenças do Gato/patologia , Diabetes Mellitus/veterinária , Insulina/metabolismo , Ilhotas Pancreáticas/patologia , Amiloidose/metabolismo , Amiloidose/patologia , Animais , Doenças do Gato/metabolismo , Gatos , Diabetes Mellitus/metabolismo , Diabetes Mellitus/patologia , Feminino , Glucagon/metabolismo , Polipeptídeo Amiloide das Ilhotas Pancreáticas/metabolismo , Ilhotas Pancreáticas/metabolismo , Masculino , Pâncreas/metabolismo , Pâncreas/patologia
5.
Vet Pathol ; 51(6): 1143-50, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24565829

RESUMO

In humans, diabetes mellitus (DM) is an important cause of renal damage, with glomerular lesions being predominant. In cats, although diabetes is a common endocrinopathy, it is yet unknown whether it leads to renal damage. The aim of the study was to compare renal histologic features and parameters of renal function in diabetic cats against a control population matched for age, gender, breed, and body weight. Thirty-two diabetic and 20 control cats were included. Kidney sections from paraffin-embedded kidney samples were stained and examined with optical microscopy to identify glomerular, tubulointerstitial, and vascular lesions and to assess their frequency and severity. Serum creatinine and urea concentrations were also compared. Glomerular lesions were observed in 29 cats overall, with mesangial matrix increase being more common (19 cats). Tubulointerstitial lesions were observed in 42 cats, including lymphocytic infiltration (29), fibrosis (22), or tubular necrosis (21). Vascular lesions were observed in 5 cases. The frequency and severity of histologic lesions did not differ between diabetic and control cats; however, among diabetics, those that survived longer after diagnosis had more glomerular and vascular lesions. Serum creatinine and urea concentrations were similar between groups; in diabetic cats median creatinine was 109 µmol/l (range, 51-1200) and urea was 12 mmol/l (range, 4-63), and in controls creatinine was 126 µmol/l (range, 50-875) and urea 11 mmol/l (range, 3-80). The results suggest that DM in cats does not lead to microscopically detectable kidney lesions or clinically relevant renal dysfunction. The authors hypothesize that the short life expectancy of diabetic cats may be the main reason for the difference from human diabetics.


Assuntos
Doenças do Gato/patologia , Diabetes Mellitus/veterinária , Nefropatias/veterinária , Rim/patologia , Animais , Estudos de Casos e Controles , Gatos , Creatinina/sangue , Diabetes Mellitus/patologia , Feminino , Mesângio Glomerular/patologia , Nefropatias/patologia , Glomérulos Renais/patologia , Masculino , Estudos Retrospectivos , Ureia/sangue
6.
Sci Rep ; 14(1): 341, 2024 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-38172270

RESUMO

Although clinical examination still represents the gold standard for the differential diagnosis of prolonged disorders of consciousness (pDoC), the introduction of innovative markers is essential for diagnosis and prognosis, due to the problem of covert cognition. We evaluated the brain-derived neurotrophic factor protein (BDNF) and the soluble cell adhesion molecules proteins (CAMs) in a cohort of prolonged disorders of consciousness patients to identify a possible application in the clinical context. Furthermore, peripheral blood determinations were correlated with imaging parameters such as white matter hyperintensities (WMH), cranial standardized uptake value (cSUV), electroencephalography (EEG) data and clinical setting. Our results, although preliminary, identify BDNF as a possible blood marker for the diagnosis of pDoC (p value 0.001), the soluble CAMs proteins CD44, Vcam-1, E-selectin (p value < 0.01) and Icam-3 (p value < 0.05) showed a higher peripheral blood value in pDoC compared with control. Finally, soluble Ncam protein could find useful applications in the clinical evolution of the pDoC, showing high levels in the MCS and EMCS subgroups (p value < 0. 001) compared to VS/UWS.


Assuntos
Fator Neurotrófico Derivado do Encéfalo , Transtornos da Consciência , Humanos , Projetos Piloto , Transtornos da Consciência/diagnóstico , Estado de Consciência , Molécula 1 de Adesão de Célula Vascular , Proteínas Sanguíneas
7.
Folia Morphol (Warsz) ; 82(1): 119-126, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-34966995

RESUMO

BACKGROUND: In our study we used immunohistochemical technique to demonstrate the presence of the cytokines tumour necrosis factor alpha (TNF-α), interleukin 1beta (IL-1ß), transforming growth factor beta1 (TGF-ß1) and intercellular adhesion molecule-1 (ICAM-1) in porcine coronaries even in physiological conditions. MATERIALS AND METHODS: Inflammatory cytokines are polypeptide mediators which act as a communication signal between immune system cells and other types of cellsin different organs and tissues, both in human and pig coronary circulation. RESULTS: Our results show that pro-inflammatory cytokines TNF-α, IL-1ß, TGF-ß1 and ICAM-1 are also present in the medium tunica of the coronary arteries under physiological conditions. These results may be compared with those found in coronary atherosclerosis, where the increase in TNF-α has a dramatic effect on the function of the left ventricle, and the high value of IL-1 correlates directly with the extent of myocardial necrosis. In our study we observe the damage and activation of endothelial cells; this induces endothelial dysfunction by accumulation and oxidation of low density lipoproteins (LDL). The formation of oxidized LDL could play a central role in the amplification of the inflammatory response causing an increased expression of pro-inflammatory cytokines which promotes leukocyte recruitment in the intimal layer. These leukocytes, after the adhesion to the endothelium, penetrate the intimate tunic. CONCLUSIONS: Therefore inflammatory processes promote the onset and evolution of atheroma and the development of thrombotic complications.


Assuntos
Fator de Crescimento Transformador beta1 , Fator de Necrose Tumoral alfa , Humanos , Suínos , Animais , Fator de Necrose Tumoral alfa/metabolismo , Fator de Crescimento Transformador beta1/metabolismo , Fator de Crescimento Transformador beta1/farmacologia , Molécula 1 de Adesão Intercelular/metabolismo , Molécula 1 de Adesão Intercelular/farmacologia , Interleucina-1beta/metabolismo , Interleucina-1beta/farmacologia , Células Endoteliais/metabolismo , Vasos Coronários , Citocinas
8.
Sci Rep ; 12(1): 18446, 2022 11 02.
Artigo em Inglês | MEDLINE | ID: mdl-36323711

RESUMO

Behavioral assessments during the clinical evaluation in prolonged disorders of consciousness patients could be not sufficient for a correct diagnosis and prognostication. To this aim, we used an innovative approach, involving the ultra-sensitive determination of biological markers, correlating them with imaging parameters to investigate the prolonged disorders of consciousness (pDoC).We assessed the serum concentration of neurofilament light chain(NF-L) and glial fibrillary acidic protein (GFAP) in pDoC (n = 16), and healthy controls (HC, n = 6) as well as several clinical imaging parameters such as Fractional Anisotropy (FA), Whole Brain SUV, and White Matter Hyperintensities volumes (WMH) using PET-MRI acquisition. As for differential diagnosis task, only the imaging WMH volume was able to discriminate between vegetative state/unresponsive wakefulness syndrome (VS/UWS), and minimally conscious state (MCS) patients (p-value < 0.01), while all selected markers (both imaging and in vitro) were able to differentiate between pDoC patients and HC. At subject level, serum NF-L concentrations significantly differ according to clinical progression and consciousness recovery (p-value < 0.01), highlighting a potential play for the longitudinal management of these patients.


Assuntos
Estado de Consciência , Filamentos Intermediários , Humanos , Biomarcadores , Proteína Glial Fibrilar Ácida , Estado Vegetativo Persistente/diagnóstico por imagem
9.
Acta Neurol Scand ; 122(3): 175-81, 2010 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-20003087

RESUMO

OBJECTIVE: To determine if the circulating nitrotyrosine level significantly correlates with parameters measuring cognitive abilities. MATERIALS AND METHODS: One-hundred and twelve community-living subjects (ranging in age from 27 to 98 years) were evaluated for cognitive abilities [Mini Mental State Examination (MMSE) score] and circulating free nitrotyrosine plasma level, as well as for several variables that might influence cognitive abilities (age, education) and nitrotyrosine level (body mass index, haematological parameters, cardiovascular and inflammatory indices). RESULTS: In the sub-group of cognitively impaired subjects (score at MMSE < 23.9), but not in that of cognitively not impaired subjects, a significant inverse correlation exists between nitrotyrosine level and MMSE score (r = -0.378; P < 0.02). CONCLUSIONS: The finding, if confirmed by longitudinal studies, could play a role in the management of the subjects with Mild Cognitive Impairment, the clinical condition considered as a transitional state between the changes of cognitive ability in normal aging and dementia.


Assuntos
Transtornos Cognitivos/sangue , Tirosina/análogos & derivados , Adulto , Idoso , Idoso de 80 Anos ou mais , Contagem de Células Sanguíneas/métodos , Peso Corporal/fisiologia , Transtornos Cognitivos/fisiopatologia , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Hemoglobinas/metabolismo , Humanos , Masculino , Entrevista Psiquiátrica Padronizada , Pessoa de Meia-Idade , Testes Neuropsicológicos , Características de Residência , Fatores Sexuais , Tirosina/sangue
10.
Clin Nephrol ; 72(4): 247-51, 2009 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19825329

RESUMO

OBJECTIVE: In Type 2 diabetes, it is not clear if renal size is constantly related to the glomerular filtration rate. In addition, it is not known if kidney volume (KV) is associated with an increased urinary albumin and IgG excretion. METHODS: The relationship between kidney volume, creatinine clearance (CrCl), urinary albumin and IgG excretion in 95 Type 2 diabetic patients with different stages of nephropathy (1 - 4 Stage sec NKDF-QD) was elevated and compared to 85 non-diabetic subjects with similar degree of kidney function. RESULTS: In Type 2 diabetic patients the KV/CrCl ratio was increased, in comparison with the control subjects, from about 15% in Stage 1 to 53% in Stage 4. In T2D subjects, significant correlations were found between KV and urinary albumin excretion (r = 0.665, p < 0.05), and between KV and urinary IgG excretion (r = 0.800, p < 0.001). CONCLUSION: The present study finds that Type 2 diabetic subjects, are characterized by an increased ratio between KV/CrCl, throughout the different progressive stages of nephropathy. In Type 2 diabetes relationships between KV and urinary albumin and between KV and IgG excretion also were found to be significant, suggesting a role for the impaired size selectivity of proteinuria as a possible determinant of KV.


Assuntos
Diabetes Mellitus Tipo 2/fisiopatologia , Nefropatias Diabéticas/fisiopatologia , Rim/fisiopatologia , Idoso , Albuminúria/fisiopatologia , Biomarcadores/urina , Estudos de Casos e Controles , Creatinina/urina , Diabetes Mellitus Tipo 2/urina , Nefropatias Diabéticas/urina , Progressão da Doença , Feminino , Humanos , Imunoglobulina G/urina , Testes de Função Renal , Masculino , Pessoa de Meia-Idade
11.
Transl Med UniSa ; 19: 66-81, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31360670

RESUMO

Seventy four Reference Sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) have been recognised by the European Commission in 2016 for their commitment to excellence in investing and scaling up innovative solutions for active and healthy ageing. The Reference Site Collaborative Network (RSCN) brings together the EIP on AHA Reference Sites awarded by the European Commission, and Candidate Reference Sites into a single forum. The overarching goals are to promote cooperation, share and transfer good practice and solutions in the development and scaling up of health and care strategies, policies and service delivery models, while at the same time supporting the action groups in their work. The RSCN aspires to be recognized by the EU Commission as the principal forum and authority representing all EIP on AHA Reference Sites. The RSCN will contribute to achieve the goals of the EIP on AHA by improving health and care outcomes for citizens across Europe, and the development of sustainable economic growth and the creation of jobs.

12.
Int J Androl ; 31(3): 337-45, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-17573845

RESUMO

In this work we report a relatively simple and fast method for analysing oxygen consumption and therefore mitochondrial functionality, in individual human ejaculates. This oxygraphic method requires a low number of cells, is highly reproducible and linearly correlates with sperm concentration. Our results have shown that oxygen uptake by mitochondria of demembranated sperm cells from normozoospermic subjects is significantly stimulated by a large set of respiratory substrates and ADP. The respiratory control ratio (RCR) values indicate a good coupling between respiration and phosphorylation by sperm mitochondria and thus a well preserved integrity of the mitochondria themselves. Interestingly, whereas the rates of oxygen uptake, as expected, changed with different sperm concentrations, the RCR values remained constant, thus demonstrating a linear response of the assay. In asthenozoospermic subjects, however, a significant decrease in the sperm respiratory efficiency was found. The results obtained suggest that this method, besides its potential clinical application, could be useful for a deeper understanding of the biochemical properties of sperm mitochondria and their role in ATP production in human spermatozoa.


Assuntos
Bioensaio/métodos , Metabolismo Energético , Mitocôndrias/metabolismo , Consumo de Oxigênio , Oxigênio/metabolismo , Espermatozoides/metabolismo , Difosfato de Adenosina/metabolismo , Trifosfato de Adenosina/metabolismo , Animais , Astenozoospermia/metabolismo , Respiração Celular , Humanos , Soluções Hipotônicas , Masculino , Mitocôndrias/ultraestrutura , Pressão Osmótica , Fosforilação Oxidativa , Ratos , Ratos Wistar , Reprodutibilidade dos Testes , Espermatozoides/ultraestrutura , Fatores de Tempo
13.
J Clin Invest ; 99(3): 433-8, 1997 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-9022076

RESUMO

This study aimed at evaluating whether increased availability of the natural precursor of nitric oxide, L-arginine, could influence systemic hemodynamic and rheologic parameters in humans and whether the effects of L-arginine are mediated by endogenous insulin. 10 healthy young subjects participated in the following studies: study I, infusion of L-arginine (1 g/min for 30 min); study II, infusion of L-arginine plus octreotide (25 microg as i.v. bolus + 0.5 microg/min) to block endogenous insulin and glucagon secretion, plus replacement of basal insulin and glucagon; study III, infusion of L-arginine plus octreotide plus basal glucagon plus an insulin infusion designed to mimic the insulin response of study I. L-Arginine infusion significantly reduced systolic (11+/-3, mean+/-SE) and diastolic (8+/-2 mmHg, P < 0.001) blood pressure, platelet aggregation (20+/-4%), and blood viscosity (1.6+/-0.2 centipois, P < 0.01), and increased leg blood flow (97+/-16 ml/min), heart rate, and plasma catecholamine levels (P < 0.01). In study II, plasma insulin levels remained suppressed at baseline; in this condition, the vascular responses to L-arginine were significantly reduced, except for plasma catecholamines which did not change significantly. In study III, the plasma insulin response to L-arginine was reestablished; this was associated with hemodynamic and rheologic changes following L-arginine not significantly different from those recorded in study I. These findings show that systemic infusion of L-arginine in healthy subjects induces vasodilation and inhibits platelet aggregation and blood viscosity. These effects are mediated, in part, by endogenous released insulin.


Assuntos
Arginina/farmacologia , Hemodinâmica/efeitos dos fármacos , Insulina/metabolismo , Óxido Nítrico/metabolismo , Adulto , Pressão Sanguínea/efeitos dos fármacos , Viscosidade Sanguínea/efeitos dos fármacos , Catecolaminas/análise , Feminino , Fármacos Gastrointestinais/farmacologia , Glucagon/metabolismo , Frequência Cardíaca/efeitos dos fármacos , Hormônios/farmacologia , Humanos , Hipoglicemiantes/farmacologia , Insulina/farmacologia , Perna (Membro)/irrigação sanguínea , Masculino , Octreotida/farmacologia , Plasma/química , Agregação Plaquetária/efeitos dos fármacos , Reologia/efeitos dos fármacos , Vasodilatação/efeitos dos fármacos
14.
J Endocrinol Invest ; 30(1): 3-8, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-17318015

RESUMO

UNLABELLED: Thyroid dysfunction and the presence of thyroid antibodies increase the risk of infertility and miscarriage. The aim of the present study was to assess if patients with autoimmune thyroid disease undergoing assisted reproduction technologies (ART) are afflicted by poor pregnancy and/or delivery rate and if the outcome is conditioned by pre-ART thyroid status. The study was retrospective (from January 2000 to January 2005) and was carried out at the Division of Physiopathology of Human Reproduction. Women who underwent ART were tested for TSH, free T4 (FT4), thyroid peroxidase antibodies (TPOAb) before and during pregnancy. A total of 416 euthyroid women were selected; 42 (10.1%) were TPOAb (+). Women >35 yr were excluded. The endpoints were pregnancy and delivery rates. RESULTS: no differences in pregnancy and delivery rates were observed between women with and without antibodies. In TPOAb (+), women who failed to become pregnant or miscarried displayed higher TSH values before ART (2.8 mIU/l) compared to the ones who delivered (1.6 mIU/l; p=0.032) and compared to TPOAb (-) (1.1 mIU/l; p=0.018). CONCLUSIONS: in euthyroid women undergoing ART the pregnancy and delivery rates are not affected by the presence of TPOAb. In TPOAb (+) high-normal TSH values are associated with increased risk of unsuccessful pregnancy or subsequent miscarriage. Further studies are required to ascertain possible benefits of levo-T4 (L-T4) in such patients.


Assuntos
Doenças Autoimunes/fisiopatologia , Autoimunidade/fisiologia , Complicações na Gravidez , Técnicas de Reprodução Assistida , Doenças da Glândula Tireoide/fisiopatologia , Glândula Tireoide/fisiologia , Adulto , Autoanticorpos/sangue , Autoantígenos/imunologia , Doenças Autoimunes/sangue , Doenças Autoimunes/complicações , Feminino , Humanos , Iodeto Peroxidase/imunologia , Proteínas de Ligação ao Ferro/imunologia , Gravidez , Resultado da Gravidez , Taxa de Gravidez , Estudos Retrospectivos , Doenças da Glândula Tireoide/sangue , Doenças da Glândula Tireoide/complicações
15.
Eur J Surg Oncol ; 42(8): 1206-14, 2016 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27265040

RESUMO

BACKGROUND: Gastric gastrointestinal stromal tumors (GISTs) represent a subgroup of GISTs with a better prognosis than those located in other areas. In this retrospective study we performed a molecular characterization of a large series of patients with gastric GISTs in relation to clinical-pathological characteristics and prognosis. METHODS: DNA was extracted from paraffin-embedded sections from 221 gastric GIST patients submitted to surgery. Exons 9, 11, 13 and 17 of KIT, exons 12 and 18 of PDGFRA and exons 11 and 15 of BRAF were analyzed by direct sequencing. Cox regression analysis adjusted for clinical-pathological factors was performed to evaluate KIT and PDGFRA mutations in relation to the composite endpoint of relapse or death. RESULTS: KIT and PDGFRA mutations were observed in 119 (53.8%) and 56 (25.3%) patients, respectively, whereas 46 (20.8%) patients had wild type (wt) disease. Univariable analyses showed that a high Miettinen risk category and the presence of ulceration and KIT deletions were associated with increased risk of relapse or death (p < 0.001; p = 0.0389 and p = 0.002, respectively). After adjusting for Miettinen risk score, KIT deletions remained an independent prognostic factor (HRadj = 2.65, 95% CI [1.15-6.13], p = 0.023). Moreover, KIT deletions in exon 11 codons 557, 558 or 559 were associated with a higher risk of relapse or death than wt tumors (HRadj = 3.29 95% CI [1.64-6.64], p = 0.001). CONCLUSIONS: KIT deletions in exon 11, especially those involving codons 557, 558 or 559, were correlated with a more aggressive gastric GIST phenotype and increased risk of relapse or death.


Assuntos
Tumores do Estroma Gastrointestinal/genética , Mutação , Recidiva Local de Neoplasia/genética , Proteínas Proto-Oncogênicas B-raf/genética , Proteínas Proto-Oncogênicas c-kit/genética , Receptor alfa de Fator de Crescimento Derivado de Plaquetas/genética , Neoplasias Gástricas/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Éxons/genética , Feminino , Tumores do Estroma Gastrointestinal/mortalidade , Tumores do Estroma Gastrointestinal/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Neoplasias Gástricas/mortalidade , Neoplasias Gástricas/patologia , Carga Tumoral , Adulto Jovem
16.
Int J Immunopathol Pharmacol ; 18(1): 155-64, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-15698520

RESUMO

The treatment with infliximab is employed successfully in Crohn's disease (CD) but predictors of efficacy are lacking. Activation of the transcription factor NF-kB has been demonstrated in CD and its inhibition is one of the mechanisms by which anti-inflammatory agents exert their effects. We evaluated the production of TNFalpha by peripheral blood mononuclear cells (PBMC) and the levels of NF-kappaB family molecules in the intestinal mucosa during infliximab therapy in 12 patients. TNFalpha was assayed on supernatants of PBMC culture stimulated with PHA or LPS. Immunohistochemistry was also done on intestinal biopsies. In six patients, Western blot analysis of the NF-kappaB subunit Rel-A, and its inhibitors IkappaBalpha and IkappaBgamma was performed on intestinal biopsies and PBMC. The TNFalpha production by LPS stimulated PBMC showed mild changes, while it was increased by PHA-stimulated PBMC after treatment. The number of inflammatory cells in the intestinal mucosa was reduced (p<0.002) by the treatment. In five out of six cases we detected an increase of the IkappaBalpha and IkappaBgamma)inhibitor levels in intestinal biopsies after treatment. An increase of IkappaB inhibitors levels could be one of the mechanisms by which infliximab decreases NF-kappaB activity and exerts its anti-inflammatory effects.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Doença de Crohn/tratamento farmacológico , Doença de Crohn/metabolismo , Fármacos Gastrointestinais/uso terapêutico , Proteínas I-kappa B/metabolismo , Mucosa Intestinal/metabolismo , NF-kappa B/antagonistas & inibidores , Fragmentos de Peptídeos/metabolismo , Fatores de Transcrição/metabolismo , Adulto , Idoso , Western Blotting , Feminino , Humanos , Imuno-Histoquímica , Infliximab , Masculino , Pessoa de Meia-Idade , Monócitos/imunologia , Inibidor de NF-kappaB alfa , Fator de Necrose Tumoral alfa/metabolismo
17.
Leukemia ; 13(4): 514-7, 1999 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-10214855

RESUMO

The feasibility and safety of outpatient management of acute promyelocytic leukemia (APL) during the aplastic phase after intensive consolidation chemotherapy, the incidence and types of complications requiring readmission to hospital, and the number of hospital days spared by this policy have been prospectively evaluated. After chemotherapy administration, patients were evaluated on an ambulatory basis. In the event of any complication they referred to the Emergency Unit (EU) of our Department dedicated to outpatients with hematologic diseases. Forty patients with APL observed over a 4 year period were eligible for intensive chemotherapy. After the achievement of complete remission they received a total of 104 consolidation courses and in 98 instances they were followed on an ambulatory basis. There were 41 cases (42%) of rehospitalization for fever (40 cases) or severe anemia (one case). Only one patient died due to a brain hemorrhage. Streptococcus viridans was the organism most frequently isolated from blood. Empiric once-a-day antibacterial therapy with ceftriaxone and amikacin was effective in 87% of the cases and made possible early discharge in 28% of the cases to continue the antibiotic therapy on an outpatient setting. Patients were managed out of the hospital for 76% of the post-consolidation neutropenia period. Thanks to the availability of an EU specifically dedicated to outpatients with hematologic diseases, out-hospital management of APL patients after consolidation therapy appeared to be safe, well accepted, potentially cost-saving, and contributed to saving the risk of developing severe nosocomial infections.


Assuntos
Assistência Ambulatorial , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Leucemia Promielocítica Aguda/tratamento farmacológico , Adulto , Idoso , Amicacina/uso terapêutico , Anemia/etiologia , Protocolos de Quimioterapia Combinada Antineoplásica/administração & dosagem , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Infecções Bacterianas/tratamento farmacológico , Infecções Bacterianas/epidemiologia , Infecções Bacterianas/etiologia , Ceftriaxona/uso terapêutico , Hemorragia Cerebral/etiologia , Infecção Hospitalar/tratamento farmacológico , Infecção Hospitalar/epidemiologia , Infecção Hospitalar/etiologia , Infecção Hospitalar/microbiologia , Quimioterapia Combinada/uso terapêutico , Serviço Hospitalar de Emergência/organização & administração , Serviço Hospitalar de Emergência/estatística & dados numéricos , Feminino , Febre/epidemiologia , Febre/etiologia , Hospitalização/estatística & dados numéricos , Humanos , Idarubicina/administração & dosagem , Idarubicina/efeitos adversos , Incidência , Tempo de Internação/estatística & dados numéricos , Leucemia Promielocítica Aguda/complicações , Leucemia Promielocítica Aguda/mortalidade , Masculino , Pessoa de Meia-Idade , Neutropenia/etiologia , Indução de Remissão , Tretinoína/administração & dosagem , Tretinoína/efeitos adversos
18.
Diabetes Care ; 21(4): 631-6, 1998 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9571355

RESUMO

OBJECTIVE: To compare the effects of the ACE inhibitor perindopril and the beta-blocker carvedilol on blood pressure and endothelial functions in NIDDM patients with hypertension. RESEARCH DESIGN AND METHODS: We conducted a double-blind randomized trial in 26 patients with NIDDM and mild hypertension. A 4-week run-in placebo period preceded the active 12-week treatment with perindopril (4-8 mg daily) or carvedilol (25-50 mg daily). Endothelial functions were assessed by evaluating the hemodynamic (mean blood pressure, leg blood flow) and rheological (platelet aggregation, blood viscosity, and blood filterability) responses to an intravenous bolus of 3 g L-arginine, the natural precursor of nitric oxide. RESULTS: Both perindopril and carvedilol significantly reduced mean blood pressure (P < 0.001) and increased leg blood flow (P < 0.05) to the same extent; blood filterability remained unchanged in both perindopril- and carvedilol-treated groups. Carvedilol reduced platelet aggregation and blood viscosity significantly (P < 0.05) but perindopril did not. Before treatment, the hemodynamic and rheologic responses to L-arginine were significantly lower in patients (P < 0.05-0.01) than in 20 nondiabetic nonhypertensive control subjects. After 12 weeks of treatment, both drugs normalized the hemodynamic responses to L-arginine. Platelet aggregation response to L-arginine was ameliorated by carvedilol and remained unchanged in the perindopril group. CONCLUSIONS: At the doses used, both drugs effectively reduce blood pressure and normalize the hemodynamic responses to L-arginine. The implications of the ameliorated endothelial function for the poor cardiovascular outlook of the NIDDM hypertensive patient need further assessment.


Assuntos
Antagonistas Adrenérgicos beta/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Carbazóis/uso terapêutico , Diabetes Mellitus Tipo 2/fisiopatologia , Angiopatias Diabéticas/tratamento farmacológico , Endotélio Vascular/efeitos dos fármacos , Hemodinâmica/efeitos dos fármacos , Hipertensão/tratamento farmacológico , Indóis/uso terapêutico , Perna (Membro)/irrigação sanguínea , Propanolaminas/uso terapêutico , Anti-Hipertensivos/uso terapêutico , Arginina , Pressão Sanguínea/efeitos dos fármacos , Viscosidade Sanguínea/efeitos dos fármacos , Carvedilol , Angiopatias Diabéticas/fisiopatologia , Método Duplo-Cego , Endotélio Vascular/fisiologia , Endotélio Vascular/fisiopatologia , Feminino , Frequência Cardíaca/efeitos dos fármacos , Hemodinâmica/fisiologia , Humanos , Hipertensão/fisiopatologia , Masculino , Pessoa de Meia-Idade , Perindopril , Agregação Plaquetária/efeitos dos fármacos , Valores de Referência , Fluxo Sanguíneo Regional/efeitos dos fármacos , Reologia/efeitos dos fármacos , Resistência Vascular/efeitos dos fármacos
19.
Vet J ; 204(3): 333-7, 2015 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-25951986

RESUMO

Campylobacteriosis is among the most common bacterial causes of human gastroenteritis worldwide and pet ownership has been identified as a risk factor for Campylobacter infection in humans. Since canine and feline prevalence data are scarce in Italy, the present study was carried out to assess the prevalence, species distribution and risk factors for Campylobacter infection in dogs and cats under different husbandry conditions. Rectal swabs were collected from 171 dogs (household pets, n = 100; shelter-housed dogs, n = 50; dogs from breeding kennels, n = 21) and 102 cats (household pets, n = 52; shelter-housed cats, n = 21; free-roaming cats n = 29) in Northern Italy. Campylobacter was isolated from 17% (n = 29) of dogs and 14.7% (n = 15) of cats. C. jejuni was the most common isolate in both species (Campylobacter spp.-positive dogs, 55.2%; Campylobacter spp.-positive cats, 53.3%), followed by C. upsaliensis (Campylobacter spp.-positive dogs, 27.6%; Campylobacter spp.-positive cats, 40%). Other Campylobacter species were rarely detected, but included C. hyointestinalis subsp. hyointestinalis, C. lari and C. coli in dogs and C. coli and C. helveticus in cats. Among considered variables (sex, age, origin, diarrhoea, season of sampling), origin was identified as a risk factor for dogs, with shelter-housed dogs at higher risk than household dogs (odds ratio, 2.84; 95% CI 1.17, 6.92; P = 0.021). The results of this study, particularly the high prevalence of C. jejuni in Campylobacter-positive animals, demonstrated that household and stray dogs and cats in Northern Italy might pose a zoonotic risk for humans. Moreover, biosecurity measures should be improved in dog shelters.


Assuntos
Infecções por Campylobacter/veterinária , Campylobacter/isolamento & purificação , Doenças do Gato/microbiologia , Doenças do Cão/microbiologia , Propriedade , Animais , Infecções por Campylobacter/epidemiologia , Infecções por Campylobacter/microbiologia , Doenças do Gato/epidemiologia , Gatos , Doenças do Cão/epidemiologia , Cães , Feminino , Itália/epidemiologia , Masculino , Razão de Chances , Estações do Ano
20.
J Clin Endocrinol Metab ; 79(3): 826-30, 1994 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-8077368

RESUMO

The purpose of the present study was to determine if opioid agonism (beta-endorphin) and antagonism (Naloxone) exert rheological and cardiovascular effects in normal humans and in patients with essential hypertension. Eight hypertensive patients were matched for age, sex, and body habitus (body mass index, waist to hip ratio) with eight normotensive healthy subjects. In all subjects, heart rate and blood pressure (continuous automatic recording), blood and plasma viscosity, fibrinogen, hematocrit, and platelet aggregation to ADP were evaluated during an infusion of human synthetic beta-endorphin (0.5 mg/h). On a different day and in randomized order, the subjects were submitted to another beta-endorphin infusion preceded by an i.v. naloxone bolus (5 mg in 5 min). beta-Endorphin and naloxone failed to significantly alter heart rate or blood pressure in both normotensive and hypertensive subjects. In hypertensive patients, beta-endorphin significantly increased blood viscosity and ADP-induced platelet aggregation, but only the former effect was naloxone-sensitive. In normotensive subjects, beta-endorphin caused a transient but significant decrease of platelet aggregation that was reversed by naloxone. These data suggest that beta-endorphin may play some role in the inhibitory control of platelet aggregation in normal subjects. An altered responsiveness of some rheological determinants to beta-endorphin seems to be present in human hypertension.


Assuntos
Sistema Cardiovascular/efeitos dos fármacos , Hipertensão/fisiopatologia , Naloxona/farmacologia , beta-Endorfina/farmacologia , Difosfato de Adenosina/farmacologia , Adulto , Pressão Sanguínea/efeitos dos fármacos , Viscosidade Sanguínea/efeitos dos fármacos , Sistema Cardiovascular/fisiopatologia , Feminino , Fibrinogênio/metabolismo , Frequência Cardíaca/efeitos dos fármacos , Hematócrito , Humanos , Masculino , Pessoa de Meia-Idade , Agregação Plaquetária/efeitos dos fármacos , Reologia , beta-Endorfina/fisiologia
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