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1.
Prog Urol ; 32(8-9): 558-566, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-35589469

RESUMO

PURPOSE: Image-based morphometric scoring systems such as the RENAL and PADUA scores are useful to evaluate the complexity of partial nephrectomy for renal cell carcinoma (RCC). The main aim of this study was to develop a new imaging software to enable an automatic detection and a 3D visualization of RCC from CT angiography (CTA) and to address the feasibility to use it to evaluate the features of the RENAL and the PADUA scores. METHODS: A training dataset of 210 patients CTA-scans manually segmented was used to train a deep learning algorithm to develop the automatic detection and 3D-visualization of RCC. A trained operator blindly assessed the RENAL and PADUA scores on a testing dataset of 41 CTA from patients with RCC using a commercialized semi-automatic software (ground truth) and the new automatic software. Concordance between the two methods was evaluated. RESULTS: The median PADUA score was 9 (7-11) and the renal score was 8 (5.5-9). The automatic software enabled to automatically detect the tumoral kidney and provided a 3D-visualization in all cases, with a computational time less than 20 seconds. Concordances for staging the anatomical features of the RENAL scores were respectively: 87.8% for radius, 85.4% for exophytic rate, 82.9% for location to the polar lines and 92.7% for the antero-posterior location. For the PADUA scores, concordances were 90.2% for tumor size, 85.4% for exophytic rate, 87.8% for polar location and 100% for renal rim. CONCLUSION: By enabling an automatic 3D-visualization of tumoral kidney, this software could help to calculate morphometric scores, save time and improve reproducibility for clinicians.


Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Carcinoma de Células Renais/diagnóstico por imagem , Carcinoma de Células Renais/cirurgia , Estudos de Viabilidade , Humanos , Rim/diagnóstico por imagem , Rim/patologia , Rim/cirurgia , Neoplasias Renais/diagnóstico por imagem , Neoplasias Renais/cirurgia , Nefrectomia/métodos , Projetos Piloto , Reprodutibilidade dos Testes , Estudos Retrospectivos , Software
2.
Global Biogeochem Cycles ; 35(4): e2020GB006759, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-35860208

RESUMO

Stratified oceanic systems are characterized by the presence of a so-called Deep Chlorophyll a Maximum (DCM) not detectable by ocean color satellites. A DCM can either be a phytoplankton (carbon) biomass maximum (Deep Biomass Maximum, DBM), or the consequence of photoacclimation processes (Deep photoAcclimation Maximum, DAM) resulting in the increase of chlorophyll a per phytoplankton carbon. Even though these DCM (further qualified as either DBMs or DAMs) have long been studied, no global-scale assessment has yet been undertaken and large knowledge gaps still remain in relation to the environmental drivers responsible for their formation and maintenance. In order to investigate their spatial and temporal variability in the open ocean, we use a global data set acquired by more than 500 Biogeochemical-Argo floats given that DCMs can be detected from the comparative vertical distribution of chlorophyll a concentrations and particulate backscattering coefficients. Our findings show that the seasonal dynamics of the DCMs are clearly region-dependent. High-latitude environments are characterized by a low occurrence of intense DBMs, restricted to summer. Meanwhile, oligotrophic regions host permanent DAMs, occasionally replaced by DBMs in summer, while subequatorial waters are characterized by permanent DBMs benefiting from favorable conditions in terms of both light and nutrients. Overall, the appearance and depth of DCMs are primarily driven by light attenuation in the upper layer. Our present assessment of DCM occurrence and of environmental conditions prevailing in their development lay the basis for a better understanding and quantification of their role in carbon budgets (primary production and export).

3.
Phys Rev Lett ; 120(10): 105001, 2018 Mar 09.
Artigo em Inglês | MEDLINE | ID: mdl-29570337

RESUMO

The first direct experimental measurements of the scattering of a millimeter-wave beam by plasma blobs in a simple magnetized torus are reported. The wavelength of the beam is comparable to the characteristic size of the blob. In situ Langmuir probe measurements show that fluctuations of the electron density induce correlated fluctuations of the transmitted power. A first-principles full-wave model, using conditionally sampled 2D electron density profiles, predicts fluctuations of the millimeter-wave power that are in agreement with experiments.

4.
J Hazard Mater ; 470: 134164, 2024 May 15.
Artigo em Inglês | MEDLINE | ID: mdl-38583200

RESUMO

Strawberry, a globally popular crop whose fruit are known for their taste and health benefits, were used to evaluate the effects of polyethylene microplastics (PE-MPs) on plant physiology and fruit quality. Plants were grown in 2-L pots with natural soil mixed with PE-MPs at two concentrations (0.2% and 0.02%; w/w) and sizes (⌀ 35 and 125 µm). Plant physiological responses, root histochemical and anatomical analyses as well as fruit biometric and quality features were conducted. Plants subjected to ⌀ 35 µm/0.2% PE-MPs exhibited the most severe effects in terms of CO2 assimilation due to stomatal limitations, along with the highest level of oxidative stress in roots. Though no differences were observed in plant biomass, the impact on fruit quality traits was severe in ⌀ 35 µm/0.2% MPs treatment resulting in a drop in fruit weight (-42%), soluble solid (-10%) and anthocyanin contents (-25%). The smallest sized PE-MPs, adsorbed on the root surface, impaired plant water status by damaging the radical apparatus, which finally resulted in alteration of plant physiology and fruit quality. Further research is required to determine if these alterations also occur with other MPs and to understand more deeply the MPs influence on fruit physio-chemistry.


Assuntos
Fragaria , Frutas , Microplásticos , Raízes de Plantas , Polietileno , Fragaria/efeitos dos fármacos , Raízes de Plantas/efeitos dos fármacos , Raízes de Plantas/crescimento & desenvolvimento , Raízes de Plantas/metabolismo , Frutas/efeitos dos fármacos , Polietileno/toxicidade , Microplásticos/toxicidade , Poluentes do Solo/toxicidade , Antocianinas/análise , Estresse Oxidativo/efeitos dos fármacos
5.
ESMO Open ; 9(8): 103658, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39096894

RESUMO

BACKGROUND: Interstitial lung disease (ILD) encompasses a heterogeneous group of disorders sharing pathophysiological inflammatory mechanisms, leading to parenchymal distortions. The prevalence of ILD with new cancer drugs is underreported: the identification of potential determinants is priority. MATERIALS AND METHODS: ILDE is a retrospective study aimed at describing the clinical course and potential determinants of ILD in patients receiving experimental treatments. RESULTS: We identified 226 eligible patients, of whom 5.3% (n = 12) had ILD. In five patients, the diagnosis was radiological, while seven patients had initial cough, dyspnea, fatigue or fever. ILD was graded as grade 1 (G1) in four, G2 in five and G3 in three patients. The first occurrence of ILD resolved completely in 50% of patients (n = 6/12). No patient had fatal ILD. Eight patients (66.7%) resumed the treatment after the first episode of ILD, while four patients (33.3%) had to discontinue the therapy. Five out of six patients had resolved the first ILD episode and then resumed treatment, experiencing a second ILD episode (n = 5/6; 83.3%). The second ILD event was G1 in three patients and G2 in two patients, resulting in three patients who eventually discontinued the treatment (n = 3/5; 60%). Correlation analysis showed a higher risk of ILD in older patients (P = 0.051), those who had received previous chest radiation therapy (P = 0.047) or those receiving antibody-drug conjugates (P = 0.006). In a survival analysis adjusted for immortal time bias, ILD was not independently prognostic (hazard ratio 0.50, 95% confidence interval 0.23-1.09, P = 0.082). CONCLUSIONS: In ILDE, patients experiencing ILD had generally good outcomes, and many could resume the cancer treatments. Implementing best practices to prompt diagnosis and management of ILD is critical to treat a potentially severe adverse effect of new drugs, while not affecting patients' outcomes. Research efforts to identify risk factors is warranted, to implement risk-based monitoring schedules and develop ad hoc strategies to improve the cure rates of ILD.


Assuntos
Doenças Pulmonares Intersticiais , Humanos , Feminino , Masculino , Estudos Retrospectivos , Idoso , Pessoa de Meia-Idade , Antineoplásicos/uso terapêutico , Antineoplásicos/efeitos adversos , Idoso de 80 Anos ou mais , Neoplasias/complicações , Neoplasias/tratamento farmacológico
6.
ESMO Open ; 9(9): 103685, 2024 Aug 29.
Artigo em Inglês | MEDLINE | ID: mdl-39214046

RESUMO

BACKGROUND: Among patients with advanced high-grade ovarian carcinoma (aHGOC) treated with poly (ADP-ribose) polymerase (PARP) inhibitors (PARPis), the presence of a germline BRCA pathogenic variant (gBRCA-PV) may increase the risk of bone marrow mutagenesis resulting in postcytotoxic therapy myelodysplastic neoplasms (MDS-pCT) or acute myeloid leukemia (AML-pCT), as it is expressed in heterozygosity also by hematopoietic progenitors. We aimed to investigate the occurrence of post-PARPi MDSs/AMLs-pCTs according to gBRCA-PV status. PATIENTS AND METHODS: We conducted a retrospective single-center study to evaluate MDS/AML-pCT in patients with aHGOC and a known gBRCA-PV status receiving at least 8 weeks of maintenance PARPi, in any line of therapy, from February 2017 to December 2022. The endpoint was the proportion of patients who experienced MDSs-pCT and AMLs-pCT during and after treatment with PARPi, in gBRCA-PV carriers and non-carriers. RESULTS: A total of 166 patients were included: 95 (57%) had a gBRCA-PV and 72% received PARPi for recurrent disease. The number of lines of chemotherapies before and after PARPi, median overall survival, and median follow-up were comparable between gBRCA-PV carriers and non-carriers. After a median follow-up of 40.0 (95% confidence interval: 35.7-44.3) months, 10 (6%) patients were diagnosed with an MDS-pCT and 4 (2%) with an AML-pCT. A higher proportion of MDSs/AMLs-pCT (10% versus 2%; P = 0.16) and, in particular, of MDSs-pCT (9% versus 1%; P = 0.04) was observed among gBRCA-PV carriers. CONCLUSIONS: The presence of a gBRCA-PV is associated with a higher risk of MDS-pCT and possibly of myeloid neoplasms after PARPi in patients with aHGOC who received PARPi, especially in the setting of recurrent disease.

7.
ESMO Open ; 9(8): 103662, 2024 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-39111110

RESUMO

BACKGROUND: Carcinoma of unknown primary (CUP) with a gastrointestinal profile is categorized by the European Society of Medical Oncology (ESMO) guidelines into favorable and unfavorable subsets. Favorable CUPs benefit from site-specific chemotherapy (CT), while the optimal treatment for unfavorable CUPs is still undefined. MATERIALS AND METHODS: We conducted a single-center retrospective study to describe outcomes of patients with CUP with a gastrointestinal profile referred to our center from January 2000 to August 2023. Favorable CUPs were defined as CK7-/CK20+/CDX2+ by immunohistochemistry, according to the ESMO definition; all other cases were considered unfavorable. The main endpoint was the progression-free survival (PFS) of first-line CT for advanced disease in all patients and in the unfavorable group. RESULTS: A total of 56 patients were included, of whom 46 (82%) had unfavorable CUPs. After a median follow-up of 43.9 months, the median overall survival (mOS) was 11.8 months [95% confidence interval (CI) 8.3-15.3 months]. At univariate analysis, the presence of peritoneal metastases and residual tumor after primary surgery were associated with a shorter OS. The median PFS (mPFS) was 6.1 months (95% CI 3.6-8.7 months). In the unfavorable CUP subgroup, the mOS was 12.6 months (95% CI 8.7-16.5 months), the mPFS was 6.1 months (95% CI 3.5-8.9 months) and none of the CT regimens used showed to portend better PFS. The most relevant altered genes included: KRAS (9/29; 31%), BRAF (1/26; 4%), NRAS (1/25; 4%), TP53 (9/23; 39%). CONCLUSIONS: CUPs with a gastrointestinal profile are characterized by poor prognosis and the absence of biomarker for treatment personalization. No CT regimen was superior in terms of PFS in patients with unfavorable CUPs.


Assuntos
Neoplasias Primárias Desconhecidas , Humanos , Estudos Retrospectivos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Adulto , Idoso de 80 Anos ou mais , Prognóstico , Neoplasias Gastrointestinais/patologia
8.
Eur Rev Med Pharmacol Sci ; 17(20): 2831-6, 2013 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-24174369

RESUMO

Anti tumor necrosis factor antibodies are used to treat both psoriasis and inflammatory bowel disease. Several paradoxical cases of psoriatic skin lesions induced by tumor necrosis factor antagonist therapy have been described in IBD patients in the recent years. Ustekinumab, a fully human anti-interleukin-12/-23 monoclonal antibody, is the first drug of a new class of biologic therapy approved for the treatment of moderate to severe plaque psoriasis. Data on the efficacy of ustekinumab in patients with moderate-to-severe Crohn's disease, especially in patients previously treated with infliximab, have been recently published. We report about the effectiveness of ustekinumab in the treatment of both severe scalp psoriasis lesions with alopecia and active Crohn's disease.


Assuntos
Alopecia/induzido quimicamente , Anticorpos Monoclonais Humanizados/uso terapêutico , Anticorpos Monoclonais/efeitos adversos , Doença de Crohn/tratamento farmacológico , Psoríase/induzido quimicamente , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Adulto , Alopecia/tratamento farmacológico , Feminino , Humanos , Infliximab , Psoríase/tratamento farmacológico , Ustekinumab
9.
Reumatismo ; 65(2): 75-8, 2013 May 27.
Artigo em Inglês | MEDLINE | ID: mdl-23877411

RESUMO

Inflammatory bowel disease (IBD) is commonly associated with peripheral inflammatory arthritis, and it has been estimated that as many as 12% of IBD patients report these manifestations. However, rheumatoid arthritis (RA) is rarely associated with ulcerative colitis (UC). Among all the biological agents available, nine have been currently approved for the treatment of RA. Conversely, only Infliximab and recently Adalimumab have been approved for UC. In particular, the efficacy of Adalimumab in UC has been demonstrated by both recent randomized controlled trials and real-life studies. Moreover, Adalimumab is a well-established treatment for RA. Herein, we describe a patient with RA and UC treated successfully with ADA.


Assuntos
Anti-Inflamatórios/uso terapêutico , Anticorpos Monoclonais Humanizados/uso terapêutico , Antirreumáticos/uso terapêutico , Artrite Reumatoide/complicações , Artrite Reumatoide/tratamento farmacológico , Colite Ulcerativa/complicações , Colite Ulcerativa/tratamento farmacológico , Adalimumab , Artrite Reumatoide/sangue , Feminino , Humanos , Pessoa de Meia-Idade , Indução de Remissão
10.
Sci Total Environ ; 865: 161200, 2023 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-36581265

RESUMO

Streetlamp illumination disturbs the natural physiological processes and circadian rhythms of living organisms, including photosynthesizing "citizens". The light-emitting diode (LED) technology has replaced high-pressure sodium lamps. Therefore, the effects of LED streetlamps on urban trees need to be elucidated as these new lamps have a different light spectrum (with a peak in the blue and red regions of the spectrum, i.e., highly efficient wavebands for photosynthesis) compared to older technologies. To address the above-mentioned issue, two widely utilised tree species in the urban environment, including Platanus × acerifolia (P) and Tilia platyphyllos (T), were grown with or without the effect of LED streetlamps using two realistic illumination intensities (300 and 700 µmol m-2 s-1). Gas exchanges and biochemical features (starch, soluble sugar, and chlorophyll content) of illuminated vs non-illuminated trees were compared during the whole vegetative season. Our results showed that both tree species were strongly influenced by LED streetlamps at physiological and biochemical levels. Specifically, the mature leaves of P and T streetlamp-illuminated trees had a lower CO2 assimilation rate at dawn and had higher chlorophyll content, with lower starch content than controls. Our results showed that the differences between the effects of the two selected light intensities on the physiochemical attributes of P and T trees were not statistically significant, suggesting the absence of a dose-dependent effect. The most significant difference between T and P trees concerning the LED-triggered species-specific effect was that the delay in winter dormancy occurred only in P individuals. This study provided insights into the extent of LED streetlamp disturbance on trees. Our findings might raise awareness of the necessity to provide less impacting solutions to improve the wellness of trees in the urban environment.


Assuntos
Clorofila , Árvores , Humanos , Árvores/fisiologia , Clorofila/análise , Fotossíntese/fisiologia , Luz , Folhas de Planta/química
11.
Expert Rev Endocrinol Metab ; 18(5): 387-398, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37743651

RESUMO

INTRODUCTION: In the treatment scenario of PanNETs-targeted therapies are desired but limited, as rarity and heterogeneity on PanNETs pose limitations to their development. AREAS COVERED: We performed a literature review searching for promising druggable biomarkers and potential treatments to be implemented in the next future. We focused on treatments which have already reached clinical experimentation, although in early phases. Six targets were identified, namely Hsp90, HIFa, HDACs, CDKs, uPAR, and DDR. Even though biological rational is strong, so far reported efficacy outcomes are quite disappointing. The reason of that should be searched in the patients' heterogeneity, lack of biomarker selection, poor knowledge of interfering mechanisms as well as difficulties in patients accrual. Moreover, different ways to assess treatment efficacy should be considered, other than response rate, in light of the more indolent nature of NETs. EXPERT OPINION: Development of targeted treatments in PanNETs is still an uncovered area, far behind other more frequent cancers. Rarity of NETs led to accrual of unselected populations, possibly jeopardizing the drug efficacy. Better patients' selection, both in terms of topography, grading and biomarkers is crucial and will help understanding which role targeted therapies can really play in these tumors.


Assuntos
Tumores Neuroendócrinos , Neoplasias Pancreáticas , Humanos , Neoplasias Pancreáticas/tratamento farmacológico , Neoplasias Pancreáticas/patologia , Tumores Neuroendócrinos/tratamento farmacológico , Tumores Neuroendócrinos/patologia , Resultado do Tratamento , Biomarcadores Tumorais , Seleção de Pacientes
12.
Neurol Sci ; 33 Suppl 1: S203-5, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22644204

RESUMO

Alcoholic drinks (AD) have been known as migraine triggers in about one-third of migraine patients in retrospective studies. We have reviewed the studies concerning the role of AD in triggering the various types of primary headaches published after the International Headache Society classification of 1988. There are many studies showing that AD are triggers of migraine without aura (MO), migraine with aura (MA), cluster headache (CH) and tension-type headache (TH). About one-third of MO and half of CH patients reported AD as trigger factors. Some studies show that AD are triggers in MA and TH in a similar percentage to that found in MO, but there are also discordant findings. There are sparse reports that AD are also triggers of less frequent types of primary headache such as familial hemiplegic migraine, hemicrania continua and paroxysmal hemicrania. The mechanism of alcohol-provoking headache is debated and should be compatible with the principal pathogenetic theories of primary headaches. If AD are capable of triggering practically all primary headaches, they should act at a common pathogenetic level. Vasodilatation is unlikely to be compatible as common mechanism. An action at cortical or more likely at subcortical level is plausible.


Assuntos
Bebidas Alcoólicas/efeitos adversos , Comportamento Alimentar/fisiologia , Transtornos da Cefaleia Primários/etiologia , Transtornos da Cefaleia Primários/fisiopatologia , Animais , Humanos , Nociceptores/fisiologia , Estudos Retrospectivos , Serotonina/fisiologia , Canais de Cátion TRPV/fisiologia
13.
Eur Rev Med Pharmacol Sci ; 16(7): 890-901, 2012 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-22953637

RESUMO

Inflammatory bowel disease, Crohn's disease and ulcerative colitis, are immune-mediated disorders of unknown etiology that primarily affect the gastrointestinal tract. In addition, other organ systems can be involved such as joint/bones, skin, eyes, hepatobiliary tract, lungs and kidney. Overall, they represent extraintestinal manifestations of inflammatory bowel disease and may present before, in conjunction or after the onset of bowel disease. Extraintestinal manifestations are observed in 20-40% of patients and frequently have a negative impact on quality of patients' life. Some extraintestinal manifestations such as arthritis, erytema nodosum, pyoderma gangrenosum, iritis, uveitis have a pathogenic tumor necrosis factor alpha-dependent mechanism common with Crohn's disease and ulcerative colitis. Early recognition and treatment of extraintestinal manifestations can minimize potential severe complications. In this review we provide an overview on the prevalence and clinical aspects of the more commonly reported extraintestinal manifestations of Crohn's disease and ulcerative colitis and the role of tumor necrosis factor alpha inhibitors in their treatment.


Assuntos
Anti-Inflamatórios/uso terapêutico , Oftalmopatias/tratamento farmacológico , Fármacos Gastrointestinais/uso terapêutico , Doenças Inflamatórias Intestinais/tratamento farmacológico , Artropatias/tratamento farmacológico , Dermatopatias/tratamento farmacológico , Fator de Necrose Tumoral alfa/antagonistas & inibidores , Animais , Oftalmopatias/epidemiologia , Oftalmopatias/imunologia , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Doenças Inflamatórias Intestinais/imunologia , Artropatias/epidemiologia , Artropatias/imunologia , Prevalência , Dermatopatias/epidemiologia , Dermatopatias/imunologia , Resultado do Tratamento
14.
Radiol Med ; 117(4): 558-74, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22095418

RESUMO

PURPOSE: This study was performed to assess the feasibility and possible advantages of bowel sonography after fluid filling of intestinal loops compared with conventional sonography. MATERIALS AND METHODS: Forty-five consecutive patients with known or suspected coeliac disease (35 females, ten males; age range 11-65 years) prospectively underwent sonography before and after ingestion of 750 ml of an aqueous solution of polyethylene glycol. Results before and after fluid distension were compared to assess whether luminal filling improved small-bowel visualisation. RESULTS: Luminal filling improved visualisation of intestinal features (luminal diameter, mucosal folds, parietal layers) in 77.6% of cases (marked, moderate or mild improvement in 2, 16 and 17 patients; 4.4%, 35.5% and 37.7%), respectively, and showed no change or worsening in 20% and 2.2% nine and one patient), respectively. Baseline examination showed abnormal features in 13/25 celiac patients (dilated fluid-filled loops, increased peristalsis, transient intussusception, mesenteric lymph nodes, intraperitoneal fluid). Reexamination after luminal filling showed additional abnormalities in six of the previous 13 and in three further coeliac patients. There were no false positive signs due to fluid administration. CONCLUSIONS: Luminal filling can improve visualisation of bowel walls and fold pattern and may be helpful in selected cases.


Assuntos
Doença Celíaca/diagnóstico por imagem , Intestino Delgado/diagnóstico por imagem , Polietilenoglicóis/administração & dosagem , Administração Oral , Adolescente , Adulto , Idoso , Criança , Meios de Contraste/administração & dosagem , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Estatísticas não Paramétricas , Ultrassonografia
15.
Eur Rev Med Pharmacol Sci ; 25(18): 5826-5835, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34604974

RESUMO

OBJECTIVE: The management of Inflammatory Bowel Disease (IBD) has changed significantly in recent years, mainly due to the introduction of biologic medications, however, other factors may also have a role. The aim of this study was to evaluate the evolution of IBD admissions, including trends, modality of admission and rates of surgical intervention, in a tertiary care center. PATIENTS AND METHODS: Hospitalization of patients with a diagnosis of Crohn's disease (CD) or ulcerative colitis (UC) were identified between 2000 and 2013, using ICD-9-CM codes for IBD, from our hospital database. The following parameters were evaluated for each admission: type of admission (ordinary vs. day care service), mode of admission (elective vs. emergency care, for ordinary admissions only), admission code, surgical procedures and complication rates. Comparison between pre- and post-biologic therapy introduction years was also performed. RESULTS: Between 2000 and 2013 a total of 8834 IBD-related admissions were recorded. Hospitalizations increased linearly reaching a peak in 2006, with a downward trend in the following years. The downward trend was especially marked for patients younger than 40 years. No significant differences in hospitalization trends between CD and UC were recorded. Disease flare represented the cause of hospitalization in approximately 50% of cases. Overall, 10.8% of patients underwent surgery with no difference between the two conditions. Complications occurred in 28.7% of admissions. CONCLUSIONS: Hospitalizations for IBD patients have decreased in recent years, especially in younger patients. However, a significant proportion of patients are still admitted to complete diagnostic workup, indicating the need to better implement outpatient services. A clear reduction in surgery occurrence over time could not be observed in our study.


Assuntos
Colite Ulcerativa/epidemiologia , Colite Ulcerativa/terapia , Doença de Crohn/epidemiologia , Doença de Crohn/terapia , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Admissão do Paciente/estatística & dados numéricos , Admissão do Paciente/tendências , Centros de Atenção Terciária/estatística & dados numéricos , Adulto , Fatores Etários , Bases de Dados Factuais , Procedimentos Cirúrgicos do Sistema Digestório/estatística & dados numéricos , Feminino , Humanos , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Tempo
16.
Cephalalgia ; 30(5): 576-81, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-19732070

RESUMO

Studies performed in selected populations have shown a poor utilization of triptans for migraine. Our study was aimed at establishing patterns of triptans utilization in a large community using the pharmaceutical prescriptions database of two consecutive years in a regional Health Authority in Italy. About 0.5% of the population observed received triptans prescriptions in a year, but > 50% of the cases received only one prescription. On the other hand, 46% of triptan users did not receive a triptan prescription in the following year (past users): in 80% of cases, patients received only 1-2 triptan packages. The evaluation of the discontinued triptan type has shown percentages varying between 30 and 70%. The percentage of triptan users who received a triptan prescription for the first time in the successive year of study (new users) was 52%. These findings together highlight a high turnover in triptans utilization. Less than 15% of subjects received more than one triptan product in the 2 years. In conclusion, we observed a low percentage of triptan users and a low rate of utilization, associated with a high percentage of discontinuation and new utilization (high turnover), without any substantial increase in triptans utilization during the years. All these data probably do not support optimal satisfaction with triptan therapy.


Assuntos
Transtornos de Enxaqueca/tratamento farmacológico , Cooperação do Paciente/estatística & dados numéricos , Triptaminas/uso terapêutico , Adolescente , Adulto , Idoso , Uso de Medicamentos , Humanos , Itália , Pessoa de Meia-Idade , Adulto Jovem
17.
Eur Rev Med Pharmacol Sci ; 14(4): 342-6, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20496545

RESUMO

BACKGROUND: Several new biological drugs have been introduced in the last decade or are under investigation for the treatment of IBD. They include anti TNFalpha agents, anti adhesion molecules, anti IL-12/23, anti IL-6R and others. Their role in IBD therapy will be discussed in regard of the association of chronic inflammation and cancer in the gut. The risk of colorectal cancer is increased in ulcerative colitis (UC) and, to some extent, in Crohn's disease (CD). This association is well known from many years. However, the mechanisms linking chronic inflammation and carcinogenesis are beginning to be elucidated only recently. RESULTS AND CONCLUSIONS: Experimental data indicate that several cytokines could play a role in promoting tumour development. In this perspective, the anti cytokine agents could be not only powerful tools in treating inflammation but also efficacious in preventing the onset of inflammation associated colorectal cancer.


Assuntos
Anticorpos Monoclonais/uso terapêutico , Antineoplásicos/uso terapêutico , Doenças Inflamatórias Intestinais/terapia , Adalimumab , Anticorpos Monoclonais/efeitos adversos , Anticorpos Monoclonais Humanizados , Antineoplásicos/efeitos adversos , Certolizumab Pegol , Neoplasias Gastrointestinais/etiologia , Humanos , Fragmentos Fab das Imunoglobulinas/efeitos adversos , Fragmentos Fab das Imunoglobulinas/uso terapêutico , Doenças Inflamatórias Intestinais/complicações , Doenças Inflamatórias Intestinais/patologia , Infliximab , Polietilenoglicóis/efeitos adversos , Polietilenoglicóis/uso terapêutico , Fator de Necrose Tumoral alfa/antagonistas & inibidores
18.
J Neurol Sci ; 272(1-2): 106-9, 2008 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-18603265

RESUMO

We sequenced all genes of mitochondrial tRNAs of a patient with chronic progressive external ophthalmoplegia with 5% ragged red fibres and 15% COX-negative fibres but without macrorearrangements of mitochondrial DNA (mtDNA). Direct sequencing showed a novel heteroplasmic G>A substitution in position 12316 of tRNA(Leu(CUN)) gene. This change destroys a highly conserved G-C base coupling in tRNA TpsiC branch. By RFLP analysis we could demonstrate different degrees of heteroplasmy in different patient's tissues. This alteration, absent in a population of 110 patients with different encephalomyopathies, can be considered pathogenic: it is the tenth tRNA(Leu(CUN)) pathogenic mutation described up to date.


Assuntos
DNA Mitocondrial/genética , Mutação , Oftalmoplegia Externa Progressiva Crônica/genética , RNA de Transferência de Leucina/genética , Análise Mutacional de DNA , Feminino , Humanos , Pessoa de Meia-Idade , Músculo Esquelético/patologia , Oftalmoplegia Externa Progressiva Crônica/patologia
19.
Tree Physiol ; 28(6): 873-83, 2008 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-18381268

RESUMO

We studied the interactive effects of water stress and solar irradiance on physiological and biochemical traits in Ligustrum vulgare L., with special emphasis on antioxidant enzymes and flavonoids. Water relations, photosynthetic performance, plant growth, activities of antioxidant enzymes and of phenylalanine-ammonia-lyase, and concentrations of nonstructural carbohydrates and phenylpropanoids were measured in plants growing in 12% (shade) or 100% (sun) sunlight and supplied with 100 or 40% of daily evapotranspiration-demand over a 4-week period. The mild water stress treatment caused leaf water potential and relative water content to decline on average by -0.22 MPa and 4.5%, respectively. In response to the water stress treatment, photosynthetic rates decreased more in sun plants than in shade plants, likely because of declines in photosystem II photochemistry, apparent maximum rate of carboxylation and apparent maximum electron transport rate coupled with significant reductions in stomatal conductance. Antioxidant enzymatic activities, which were much greater in sun leaves than in shade leaves under well-watered conditions, increased (particularly the enzymatic activities associated with hydrogen peroxide removal) in response to water stress only in shade leaves. Antioxidant phenylpropanoids, particularly quercetin and luteolin derivatives, markedly increased in response to full sunlight irrespective of water treatment; however, antioxidant phenylpropanoid concentrations increased in response to water stress only in shade leaves. We suggest that: (1) assimilated carbon in sun plants was used largely to support an effective antioxidant system capable of countering water-stress-induced oxidative damage--an example of cross tolerance; and (2) in shade plants, carbon was also diverted from growth to counter oxidative damage driven by the mild water-stress treatment. Both findings are consistent with the nearly exclusive distribution of L. vulgare in well-watered, partially shaded Mediterranean areas.


Assuntos
Ligustrum/fisiologia , Luz Solar , Carboidratos/fisiologia , Clorofila/metabolismo , Flavonoides/metabolismo , Gases/metabolismo , Glucose/metabolismo , Itália , Ligustrum/crescimento & desenvolvimento , Ligustrum/efeitos da radiação , Fenóis/metabolismo , Complexo de Proteína do Fotossistema II/metabolismo , Polifenóis , Abastecimento de Água
20.
Food Chem ; 110(2): 361-7, 2008 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-26049227

RESUMO

The influence was evaluated of four rootstocks (Ishtara, Mr. S 2/5, GF 677 and Barrier 1) and of harvesting time (early, middle, late) on the quality characteristics and nutritional value (vitamin C, phenols, carotenoids, total antioxidant capacity) of 'Flavorcrest' peach. The better rootstocks were Mr. S 2/5 (low-vigour) and Barrier 1 (high-vigour). In particular, Flavorcrest fruit on Mr. S 2/5 and on Barrier 1 rootstocks had higher antioxidant capacities and also higher phytochemical content, although fruits on Mr. S 2/5 were less firm. Flesh firmness was best for fruits at mid-harvest (H2, 7 July 2006), whereas phytochemical contents were best at late harvest (H3, 13 July 2006), when, for all rootstocks, the best nutritional characteristics were also recorded. Total antioxidant capacity and phytochemical content were determined for the peel and flesh. The results show that removal of peel from peach results in a significant loss of total antioxidant capacity.

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