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1.
Parasitol Res ; 119(12): 4211-4218, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33140165

RESUMO

Cryptosporidiosis is recognized as being a significant cause of gastrointestinal illness due to its wide range of vertebrate hosts, including humans. Infection with Cryptosporidium spp. is especially common in young domestic ruminants (calves, lambs and goat kids) and has been associated with economic losses worldwide. In contrast to cattle, to date, detailed studies on Cryptosporidium infections in sheep from Europe are still limited; thus, their importance as reservoirs of Cryptosporidium species with implications on animal and public health still needs to be clarified. This study evaluates the prevalence and zoonotic potential of Cryptosporidium spp. in sheep farms in Italy. A total of 915 individual faecal samples divided into three different animal categories were collected from 61 sheep farms. Each sample was examined by microscopy of faecal smears stained by modified Ziehl-Neelsen and by biomolecular techniques. Cryptosporidium oocysts were detected in 10.1% of the animals examined and in 34.4% of the farms. The prevalence of Cryptosporidium spp. was significantly higher (χ2 = 51.854; P < 0.001) in diarrhoeic samples than in pasty or normal faeces. Genotype analyses showed the presence of two Cryptosporidium species: C. parvum and C. ubiquitum. Subtyping analysis of C. parvum isolates revealed the presence of subtypes IIa15G2R1 and IIdA20G1 and of subtype XIIa for C. ubiquitum. These findings have public health implications since both Cryptosporidium species identified are considered zoonotic, and C. parvum is the second-most common Cryptosporidium species infecting humans. Our data reveal that lambs, especially those excreting diarrhoeic faeces, may be important reservoirs of Cryptosporidium. We also highlight the need to establish adequate control and monitoring programmes for the control of this infection in sheep farms primarily through coprological monitoring.


Assuntos
Criptosporidiose/epidemiologia , Cryptosporidium/isolamento & purificação , Fazendas/estatística & dados numéricos , Doenças dos Ovinos/epidemiologia , Doenças dos Ovinos/parasitologia , Animais , Criptosporidiose/parasitologia , Criptosporidiose/patologia , Cryptosporidium/classificação , Cryptosporidium/genética , Fezes/parasitologia , Genótipo , Itália/epidemiologia , Prevalência , Ovinos , Doenças dos Ovinos/patologia
2.
Ann Oncol ; 29(8): 1748-1754, 2018 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-29893790

RESUMO

Background: The activity of palbociclib as a single agent in advanced breast cancer has not been extensively studied, with the only available clinical data limited to heavily pretreated patients. Preclinical data suggests palbociclib may partially reverse endocrine resistance, though this hypothesis has not been evaluated in previous clinical studies. This phase II, open-label, multicenter study examined the activity of palbociclib monotherapy, as well as palbociclib given in combination with the same endocrine therapy (ET) that was received prior to disease progression, in postmenopausal women with moderately pretreated, estrogen receptor-positive, HER2 negative advanced breast cancer. Patients and methods: Eligible women with advanced disease which had progressed on one or two prior ETs were randomized 1 : 1 to receive either palbociclib alone, or palbociclib in combination with the ET as previously received. Primary end point was clinical benefit rate (CBR); secondary end points included progression-free survival (PFS). Results: Between October 2012 and July 2016, a total of 115 patients were randomized. The CBR was 54% [95% confidence interval (CI): 41.5-63.7] for combination therapy, and 60% (95% CI: 47.8-72.9) for monotherapy. Median PFS was 10.8 months (95% CI: 5.6-12.7) for combination therapy, and 6.5 months (95% CI: 5.4-8.5) for monotherapy [hazard ratio (HR) 0.69; 95% CI: 0.4-1.1, exploratory P-value = 0.12]. Exploratory analyses revealed the PFS advantage for combination therapy was seen in the subgroup of patients who received prior ET for >6 months (HR 0.53; 95% CI: 0.3-0.9, exploratory P-value = 0.02), but not in those who received prior ET for ≤6 months. Conclusion: Palbociclib has clinical activity as a single agent in women with moderately pretreated, oestrogen receptor-positive, HER2-negative advanced breast cancer. Palbociclib may have potential to reverse endocrine resistance in patients with a history of previous durable response to ET. Clinical trial information: NCT02549430.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Antagonistas de Estrogênios/uso terapêutico , Piperazinas/uso terapêutico , Piridinas/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/farmacologia , Neoplasias da Mama/mortalidade , Neoplasias da Mama/patologia , Progressão da Doença , Resistencia a Medicamentos Antineoplásicos/efeitos dos fármacos , Antagonistas de Estrogênios/farmacologia , Feminino , Humanos , Pessoa de Meia-Idade , Piperazinas/farmacologia , Intervalo Livre de Progressão , Piridinas/farmacologia , Receptor ErbB-2/metabolismo , Receptores de Estrogênio/antagonistas & inibidores , Receptores de Estrogênio/metabolismo , Análise de Sobrevida
3.
Lupus ; 27(4): 670-675, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28764615

RESUMO

Central nervous system (CNS) tuberculosis (TB) is a rare but catastrophic event in patients with systemic lupus erythematosus (SLE). Here we report a case of cerebral TB in a patient with lupus myocarditis and nephritis, following cyclophosphamide immunosuppression. To our knowledge this is the first reported case of cerebral TB in SLE in a non-endemic country. A 31-year-old female with SLE and a history of regular travel to Kenya presented to our centre with clinical features of acute heart failure. She was diagnosed with severe lupus myocarditis, and a renal biopsy also confirmed lupus nephritis. Prior to admission, she had also had a cough, fever and weight loss and was under investigation for suspected TB infection. She was treated with ivabradine, beta-blockers and diuretics together with methylprednisolone and cyclophosphamide immunosuppression. Subsequent sputum cultures confirmed TB and she was commenced on triple therapy. Despite this, she developed confusion, dizziness, blurred vision and fluctuating consciousness. Magnetic resonance imaging (MRI) and lumbar puncture revealed CNS TB infection resulting in meningitis. This was later complicated by obstructive hydrocephalus due to TB abscesses. A ventriculoperitoneal (VP) shunt was inserted and TB medications were given intravenously (IV) with dexamethasone. Following a prolonged hospital admission, the patient eventually recovered and rituximab treatment was used to control her SLE. TB infection has been associated with SLE flares. It is likely in this case that TB exacerbated a lupus flare and subsequent immunosuppression resulted in mycobacterial dissemination to the CNS. Systemic and CNS features of TB and SLE are difficult to distinguish and their contemporaneous management represents a diagnostic and therapeutic challenge.


Assuntos
Ciclofosfamida/efeitos adversos , Hospedeiro Imunocomprometido , Imunossupressores/efeitos adversos , Lúpus Eritematoso Sistêmico/tratamento farmacológico , Mycobacterium tuberculosis/isolamento & purificação , Tuberculose do Sistema Nervoso Central/microbiologia , Tuberculose Pulmonar/microbiologia , Adulto , Antituberculosos/uso terapêutico , Feminino , Humanos , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/imunologia , Imageamento por Ressonância Magnética , Mycobacterium tuberculosis/efeitos dos fármacos , Escarro/microbiologia , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Tuberculose do Sistema Nervoso Central/diagnóstico , Tuberculose do Sistema Nervoso Central/imunologia , Tuberculose do Sistema Nervoso Central/terapia , Tuberculose Pulmonar/diagnóstico , Tuberculose Pulmonar/tratamento farmacológico , Tuberculose Pulmonar/imunologia , Derivação Ventriculoperitoneal
4.
Parasitol Res ; 117(10): 3081-3090, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30008134

RESUMO

To provide up-to-date information on the occurrence of Cryptosporidium in pre-weaned calves from Sardinia (Italy), the species implicated and their zoonotic potential, 147 faecal samples from 22 cattle herds were microscopically examined for Cryptosporidium oocysts; positive isolates were molecularly characterised. A questionnaire was developed to identify risk factors for Cryptosporidium infection. Overall, the percentage of positive calves and farms was 38.8 and 68.2%, respectively. The SSU rRNA-based PCR identified two Cryptosporidium species, Cryptosporidium parvum (95.8%) and C. bovis (4.2%). Sequence analyses of the glycoprotein (gp60) gene revealed that all C. parvum isolates belonged to the subtype family IIa (IIaA15G2R1 and IIaA16G3R1), with the exception of three isolates that belonged to the subtype family IId (IIdA20G1b and IIdA20). Mixed logistic regression results indicated that calves aged 15-21 days were more likely to be Cryptosporidium-positive. The risk of being positive was also significantly higher in herds from Central Sardinia and in farms using non-slatted flooring. In addition, the application of disinfectants and milk replacers was significantly associated with higher Cryptosporidium prevalence. In contrast, the risk of being positive was significantly reduced in halofuginone-treated calves. Our results reveal that a significant percentage of suckling calves are carriers of zoonotic subtypes of C. parvum. Thus, both healthy and diarrhoeic calves younger than 1 month may represent a risk for the transmission of cryptosporidiosis in humans and animals.


Assuntos
Doenças dos Bovinos/parasitologia , Criptosporidiose/parasitologia , Cryptosporidium/genética , Cryptosporidium/isolamento & purificação , Animais , Bovinos , Doenças dos Bovinos/epidemiologia , Criptosporidiose/epidemiologia , Cryptosporidium/classificação , DNA de Protozoário/genética , Fazendas , Fezes/parasitologia , Feminino , Itália/epidemiologia , Masculino , Oocistos/classificação , Oocistos/genética , Oocistos/isolamento & purificação , Prevalência , RNA Ribossômico/genética , Fatores de Risco , Desmame
5.
Arch Virol ; 162(11): 3481-3486, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28707272

RESUMO

Canine parvovirus type 2 (CPV-2) is responsible of acute hemorrhagic gastroenteritis in young dogs. CPV-2 emerged in 1978 in the USA, but new antigenic types, CPV-2a, 2b and 2c, have completely replaced the original type. In this study, we analyzed 81 animals collected in Sardinia, Italy. The VP2 sequence analysis of 27 positive samples showed that all antigenic CPV-2 types are circulating. CPV-2b seems to be the most widespread variant, followed by CPV-2a. Furthermore, 12 CPV-2b strains displayed further amino acid substitutions and formed a separate cluster in a phylogenetic tree, indicating regional genetic variation.


Assuntos
Doenças do Gato/virologia , Doenças do Cão/virologia , Infecções por Parvoviridae/veterinária , Parvovirus Canino/genética , Animais , Doenças do Gato/epidemiologia , Gatos , Cães , Itália/epidemiologia , Infecções por Parvoviridae/epidemiologia , Infecções por Parvoviridae/virologia , Filogenia
6.
J Appl Microbiol ; 123(2): 372-379, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-28561911

RESUMO

AIMS: To perform a phenotypic and genotypic characterization of 258 Staphylococcus aureus isolates from clinical ovine mastitis and used for the preparation of inactivated autogenous vaccines. METHODS AND RESULTS: The potential for biofilm production was determined by phenotypic test of Congo Red Agar (CRA) and by PCR for the detection of icaA/D genes. Isolates were also screened by PCR for the presence of enterotoxins (sea, seb, sec, sed and see), toxic shock syndrome toxin (tsst), leukotoxins (lukD-E, lukM and lukPV83), haemolysins (hly-ß and hly-γ), autolysin (atlA) genes and encoding microbial surface components recognizing adhesive matrix molecules (MSCRAMMs: clfA, clfB, fnbA, fnbB, bbp, cna, eno, fib, epbs, sdrC, sdrD and SdrE). None of the 258 isolates showed biofilm-forming ability on CRA and harboured icaA/D genes. The most frequent pyrogenic toxin superantigen genes amplified were sec plus tsst-1, which were found strictly in combination with 71·3% of the Staph. aureus isolates tested. None of the isolates harboured the genes encoding sea and see. Of the 258 isolates tested, 159 (61·6%) possessed all lukD-E/lukM/lukPV83 genes, 123 (47·7%) harboured both hly-ß/hly-γ genes, whereas almost all (97·3%) were PCR positive for atlA gene. With respect to adhesion determinants, 179 (69·4%) isolates presented simultaneously four genes (fnbA, fib, clfA and clfB) for fibronectin- and fibrinogen-binding proteins. CONCLUSIONS: In this search, several putative virulence determinants have been identified in ovine Staph. aureus isolates collected in Sardinia. SIGNIFICANCE AND IMPACT OF THE STUDY: Some of the putative virulence determinants could be considered as components of a vaccine because of their role in ovine mastitis pathogenesis.


Assuntos
Proteínas de Bactérias/metabolismo , Biofilmes , Mastite/veterinária , Doenças dos Ovinos/microbiologia , Infecções Estafilocócicas/veterinária , Staphylococcus aureus/fisiologia , Fatores de Virulência/metabolismo , Adesinas Bacterianas/genética , Animais , Proteínas de Bactérias/genética , Toxinas Bacterianas/metabolismo , Enterotoxinas/metabolismo , Feminino , Genótipo , Itália , Mastite/microbiologia , Reação em Cadeia da Polimerase , Ovinos , Infecções Estafilocócicas/microbiologia , Staphylococcus aureus/genética , Staphylococcus aureus/isolamento & purificação , Superantígenos/metabolismo , Fatores de Virulência/genética
7.
J Helminthol ; 91(4): 447-453, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-27329583

RESUMO

Infections by gastrointestinal nematodes negatively affect small ruminant health and at the same time cause substantial economic losses worldwide. Because resistance to conventional anthelmintic compounds is growing, target studies evaluating the effectiveness of alternative ingredients of botanical origin on gastrointestinal nematodes are needed. In this study, we evaluated the in vitro anthelmintic activity of Ruta chalepensis L. extracts on the third-stage larvae of sheep gastrointestinal nematodes. A methanol extract showed the highest anthelmintic activity, with an EC50 = 0.10 ± 0.06 mg/ml after 96 h, while the essential oil had an EC50 = 1.45 ± 1.22 mg/ml after 48 h. Moreover, three secondary metabolites of the essential oil, i.e. 2-decanone, 2-nonanone and 2-undecanone, showed EC50 values of 0.07 ± 0.06, 0.25 ± 0.29 and 0.88 ± 0.73 mg/ml at 24 h, respectively. The present study indicated that the R. chalepensis methanol extract, the essential oil and its metabolites 2-decanone, 2-nonanone and 2-undecanone showed promising anthelmintic activity on gastrointestinal nematodes.


Assuntos
Anti-Helmínticos/farmacologia , Helmintíase/parasitologia , Enteropatias Parasitárias/parasitologia , Nematoides/efeitos dos fármacos , Compostos Fitoquímicos/farmacologia , Extratos Vegetais/farmacologia , Ruta/química , Doenças dos Ovinos/parasitologia , Animais , Anti-Helmínticos/isolamento & purificação , Bioensaio , Larva/efeitos dos fármacos , Nematoides/isolamento & purificação , Testes de Sensibilidade Parasitária , Compostos Fitoquímicos/isolamento & purificação , Extratos Vegetais/isolamento & purificação , Ovinos
8.
J Helminthol ; 90(1): 113-6, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-25120032

RESUMO

An acute outbreak of Taenia hydatigena cysticercosis, causing mortality in 5 of 21 (23.8%) female lambs, is reported. Gross post-mortem examinations and histology showed Cysticercus tenuicollis as the cause of death. Biochemical parameters in infected lambs confirmed severe hepatitis. Praziquantel, given once at 15 mg/kg body weight (bw), was administered and a dramatic improvement in the clinical condition and biochemical parameters was observed up to 30 days following treatment.


Assuntos
Anti-Helmínticos/administração & dosagem , Cisticercose/veterinária , Praziquantel/administração & dosagem , Doenças dos Ovinos/tratamento farmacológico , Taenia/efeitos dos fármacos , Doença Aguda/terapia , Animais , Cisticercose/tratamento farmacológico , Cisticercose/parasitologia , Cysticercus/efeitos dos fármacos , Cysticercus/crescimento & desenvolvimento , Cysticercus/fisiologia , Feminino , Fígado/parasitologia , Ovinos , Doenças dos Ovinos/parasitologia , Taenia/crescimento & desenvolvimento , Taenia/fisiologia
9.
Parasitol Res ; 114(8): 3137-43, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-25968992

RESUMO

The aim of this study was to investigate the epidemiology and transmission of Taenia hydatigena in sheep and dogs from Sardinia and the economic estimation of losses due to this metacestodosis in lambs. A total of 7781 Sarda breed lambs were examined at abattoirs for the detection of Cysticercus tenuicollis or necrotic-haemorrhagic tracks of their migration. Morphological and molecular identification of parasites was carried out. Individual faecal samples from 300 dogs were examined for copromicroscopic investigations and coproELISA assay. An overall prevalence of 14.6% for T. hydatigena cysticercosis was found in the examined lambs. In total, 10,807 parasitary tracks were found, with an abundance of 1.39 and an average intensity of 9.52. The molecular analysis of the isolates showed an overall pairwise nucleotide divergence for the CO1 and ND1 was of 0-3.1 and 0-3.3%, respectively. Low intra- and interspecific variation was recorded for C. tenuicollis isolates used in this study which suggested the absence of differentiation. Microscopic examination of dog faeces showed a total prevalence of 31.3% for endoparasites in the examined samples (94/300). Taeniid eggs were found in 8.3% of the dogs. The results of the monoclonal antibody ATH4 ELISA test showed a prevalence of 11% (33/300) for T. hydatigena coproantigens. The total economic costs related to cysticercosis amounted to almost € 330,000. The prevalence of C. tenuicollis in 14.6% of 30-40-day-old lambs highlights the high parasitic pressure by T. hydatigena in the territory of Sardinia, Italy.


Assuntos
Cisticercose/veterinária , Doenças dos Ovinos/parasitologia , Taenia , Animais , Cisticercose/economia , Cisticercose/epidemiologia , Cisticercose/parasitologia , Doenças do Cão/epidemiologia , Doenças do Cão/parasitologia , Cães , Ensaio de Imunoadsorção Enzimática , Fezes/parasitologia , Itália/epidemiologia , Prevalência , Ovinos , Doenças dos Ovinos/economia , Doenças dos Ovinos/epidemiologia
10.
J Appl Microbiol ; 117(6): 1585-91, 2014 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-25272958

RESUMO

AIMS: To develop an immunomagnetic capture (IMC) to detect viable Mycoplasma agalactiae in routine ovine milk samples. METHODS AND RESULTS: Polyclonal antibodies against two M. agalactiae membrane surface proteins (P80 and P55) were covalently conjugated to magnetic beads (MBs) to form MB-Ab80 and MB-Ab55. Mycoplasma agalactiae cells were captured by a specific antigen-antibody reaction and magnetic separation. Immunomagnetic capture (IMC) was used to isolate and concentrate M. agalactiae in serial decimal dilutions and in artificially contaminated milk to facilitate subsequent detection by PCR. A 375-bp fragment of M. agalactiae was amplified using a pair of M. agalactiae-specific primers in PCR. The limit of detection of IMC-PCR method ranged from 10 to 10(2)  CCU ml(-1) when mycoplasmas were resuspended in PBS and from 10(2) to 10(3)  CCU ml(-1) when mycoplasmas were resuspended in uncontaminated ovine milk. This study also describes the application of IMC-PCR method to test for M. agalactiae in 516 milk samples collected from sheep with suspected contagious agalactia. Its performance was evaluated relative to culture. CONCLUSIONS: This report has demonstrated for the first time, the effective use of rapid and reliable IMC combined with PCR assay for the detection of viable M. agalactiae. SIGNIFICANCE AND IMPACT OF THE STUDY: The method IMC-PCR provides an alternative to conventional microbiological detection, method and it could be applied to quick detection of M. agalactiae in routine sheep milk samples.


Assuntos
Separação Imunomagnética/métodos , Leite/microbiologia , Mycoplasma agalactiae/isolamento & purificação , Reação em Cadeia da Polimerase , Animais , Anticorpos Antibacterianos/sangue , Proteínas de Bactérias/imunologia , Proteínas de Membrana/imunologia , Mycoplasma/isolamento & purificação , Mycoplasma agalactiae/genética , Mycoplasma agalactiae/imunologia , Carneiro Doméstico
11.
Parasitol Res ; 113(4): 1505-9, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24525757

RESUMO

Dog heartworms Angiostrongylus vasorum and Dirofilaria immitis cause severe parasitological diseases; the importance of these parasitosis is growing due to their health impact on animals, the possible zoonotic implications and the recent spreading across several European countries and previously non-endemic areas. The aim of this study is to update the epidemiological scenario of cardiopulmonary nematodes A. vasorum and D. immitis in dogs of Sardinia island and to perform a morphological identification of larvae by the use of the Baermann and Knott techniques respectively and the molecular characterization of the mitochondrial cytochrome c oxidase subunit I (cox1) and the second ribosomal transcribed spacer region (ITS-2) of larvae L1 of A. vasorum. In the present study, 3.4% (5/146) of dogs resulted positive at Baermann technique for A. vasorum while 8.9% (61/684) to D. immitis. If on one side A. vasorum can be considered an emerging parasite in Sardinia, the parasitic pressure and the risk of infection for D. immitis in the island seems to be increased compared with the recent past.


Assuntos
Dirofilariose/epidemiologia , Doenças do Cão/parasitologia , Cardiopatias/veterinária , Infecções por Strongylida/epidemiologia , Angiostrongylus/genética , Animais , Dirofilaria immitis/genética , Doenças do Cão/epidemiologia , Cães , Feminino , Cardiopatias/epidemiologia , Cardiopatias/parasitologia , Itália/epidemiologia , Larva/parasitologia , Masculino , Prevalência , Infecções por Strongylida/veterinária
12.
Ann Oncol ; 24(9): 2224-35, 2013 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-23709175

RESUMO

BACKGROUND: Breast cancer in young women is typically characterised by aggressive disease, and treatment with adjuvant chemotherapy is generally recommended. Chemotherapy has conferred significant improvements in disease-free and overall survival for young women with breast cancer; however, with improved cure rates, long-term adverse effects of cytotoxic treatment, such as premature ovarian failure (POF) and infertility, have become increasingly important. A potential fertility preservation strategy is administration of gonadotropin-releasing hormone agonists (GnRHas) during adjuvant chemotherapy. DESIGN: This review analyses and summarises the current evidence for use of GnRHa in preserving ovarian function in young breast cancer patients. RESULTS: Twelve trials, both non-randomised and randomised, have now been conducted assessing GnRHas in fertility preservation in young breast cancer patients, with conflicting results. Limitations of the current data include the use of poorly sensitive end points for fertility preservation, variable age of enrolled patients and limited pregnancy data. CONCLUSION: The utility of GnRHa as a fertility preservation strategy remains uncertain, and use outside of a clinical trial generally not recommended. Further research into this under-recognised issue is vital.


Assuntos
Neoplasias da Mama/tratamento farmacológico , Preservação da Fertilidade/métodos , Hormônio Liberador de Gonadotropina/agonistas , Infertilidade Feminina/prevenção & controle , Insuficiência Ovariana Primária/prevenção & controle , Neoplasias da Mama/mortalidade , Quimioterapia Adjuvante/efeitos adversos , Ensaios Clínicos como Assunto , Intervalo Livre de Doença , Feminino , Humanos , Infertilidade Feminina/induzido quimicamente , Infertilidade Feminina/tratamento farmacológico , Ovário/efeitos dos fármacos , Ovário/metabolismo , Gravidez , Insuficiência Ovariana Primária/induzido quimicamente , Insuficiência Ovariana Primária/tratamento farmacológico
13.
Eur Rev Med Pharmacol Sci ; 25(1): 423-430, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33506932

RESUMO

OBJECTIVE: Symptomatic uncomplicated diverticular disease of the colon (SUDD) is generally managed by gastroenterologists rather than General Practitioners (GPs). The aim of this study was to assess the efficacy of the treatment of SUDD with rifaximin, a non-absorbable antibiotic, in a primary care setting by GPs. PATIENTS AND METHODS: This retrospective, observational study investigated the use of rifaximin at a dose of 400 mg b.i.d. for 5, 7 or 10 days monthly, up to 3 months. The symptoms were reported by the patients using a visual analogic scale (VAS) of 0-10. RESULTS: 286 SUDD patients were enrolled (44.4% of men, average age 70.92±10.98). Respectively, 15 (5.2%) patients received the treatment for 5 days, 205 (71.7%) for 7 days and 66 (23.1%) for 10 days. After three months, a significant reduction of VAS score was observed in almost all symptoms assessed: 135 (47.2%) patients reported no abdominal pain (p<0.001) and 23 (8.1%) reported no symptom. Adverse events related to the treatment were recorded in 3 (1.04%) patients, all of them mild and not requiring interruption of the treatment. Acute diverticulitis occurred in 9 (3.1%) patients, but only 2 of them [0.7% (n=2)] underwent surgery due to complicated diverticulitis. Analysis within the different treatment groups (5, 7 and 10 days) shows that rifaximin treatment is effective in reducing the severity of symptoms in almost all groups except for the constipation in the 5-day group. CONCLUSIONS: Rifaximin can be effectively used by GPs in real-life for the management of SUDD.


Assuntos
Antibacterianos/uso terapêutico , Colo/efeitos dos fármacos , Doenças Diverticulares/tratamento farmacológico , Clínicos Gerais , Rifaximina/uso terapêutico , Adulto , Idoso , Idoso de 80 Anos ou mais , Colo/patologia , Doenças Diverticulares/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
14.
Lupus ; 19(8): 918-26, 2010 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-20427410

RESUMO

Gamma-aminobutyric acid-A (GABA-A) receptors play a crucial role in regulating neuronal excitability and cognitive functions. Single-photon emission computerized tomography (SPECT) analysis of GABA-A receptors binding by (123)I-labelled Iomazenil ((123)I-IMZ) has been applied in some neuropsychiatric disorders to investigate conditions where GABA-A receptor density can be detected in several pathophysiological conditions. In this study we investigate cerebral GABA-A receptor density in a small series of patients with systemic lupus erythematosus (SLE) and cognitive impairment characterized by recurrent, episodic memory loss. Nine female patients with SLE and cognitive alterations underwent to a clinical neuropsychiatric evaluation including digital video-EEG, brain MRI, (99m)Tc-ECD brain SPECT and (123)I-IMZ brain SPECT. All patients tested showed diffuse or focal GABA-A receptor density reduction. This is, to our knowledge, the first report on GABA-A receptor density abnormalities associated with cognitive defects in SLE patients. We hypothesize that in our series a decrease in GABA-A receptor density might be related to the neurological manifestations. Further studies are needed to clarify this aspect and the possible mechanisms. GABA-A receptor density impairment might be due to the SLE-related cerebral vasculopathy, or to neuronal-reacting auto-antibodies or drugs which could interfere with GABA-A receptors expression/binding. This study may support the concept that cognitive impairment in systemic lupus erythematosus could be the outcome of fine-tuned neurotransmission alterations.


Assuntos
Sistema Nervoso Central/diagnóstico por imagem , Córtex Cerebral/diagnóstico por imagem , Lúpus Eritematoso Sistêmico/patologia , Receptores de GABA-A/metabolismo , Receptores de GABA-A/ultraestrutura , Adulto , Sistema Nervoso Central/metabolismo , Córtex Cerebral/metabolismo , Circulação Cerebrovascular/fisiologia , Transtornos Cognitivos/diagnóstico por imagem , Transtornos Cognitivos/patologia , Eletroencefalografia , Feminino , Flumazenil/análogos & derivados , Flumazenil/química , Flumazenil/metabolismo , Humanos , Radioisótopos do Iodo/química , Radioisótopos do Iodo/metabolismo , Lúpus Eritematoso Sistêmico/metabolismo , Imageamento por Ressonância Magnética , Pessoa de Meia-Idade , Gravidez , Compostos Radiofarmacêuticos/metabolismo , Receptores de GABA-A/genética , Tomografia Computadorizada de Emissão de Fóton Único/métodos
15.
Minerva Med ; 100(6): 437-46, 2009 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-20010479

RESUMO

In recent decades, many research groups have focused on the role of viral infections in the etiopathogenesis of systemic lupus erythematosus (SLE), the so-called "viral hypothesis". The main candidates are herpes viruses such as Epstein-Barr virus (EBV) and cytomegalovirus (CMV), which have a high seroprevalence in the general population. However, a viral causal agent of SLE has not yet been discovered, although many interesting clinical findings on the complex interactions between viruses and SLE have been made. This review analyzes 88 cases of acute viral infections in adult patients with SLE and identifies situations in which viral infections influenced the diagnosis, prognosis or treatment of SLE. We also propose clinical guidelines for the management of these infections in patients with SLE.


Assuntos
Lúpus Eritematoso Sistêmico/virologia , Viroses/complicações , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecções por Citomegalovirus/complicações , Infecções por Citomegalovirus/diagnóstico , Diagnóstico Diferencial , Infecções por Vírus Epstein-Barr/complicações , Infecções por Vírus Epstein-Barr/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Viroses/diagnóstico , Adulto Jovem
16.
Ann Oncol ; 18(12): 1969-75, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17846020

RESUMO

BACKGROUND: Trastuzumab (T) combined with i.v. vinorelbine (i.v.VNR) is an active regimen for patients with advanced breast cancer (ABC). In order to further improve quality of life of patients undergoing treatment for ABC, a new regimen using oral vinorelbine (oVNR) (d1 + d3) plus q3wks T was tested (ToVNR). PATIENTS AND METHODS: Thirty-nine patients with ABC, human epidermal growth factor receptor 2/neu 3+ or FISH positive received 288 treatment cycles with T 6 mg/kg (loading dose, 8 mg/kg) on d1 and oVNR 55 mg/m(2) on d1 + d3, q3wks until disease progression or unacceptable toxicity. RESULTS: Thirty-seven patients and 286 treatment cycles were evaluated (two patients were lost to follow-up). Treatment was very well tolerated. Two patients had complete response (CR), 14 partial response (PR), 17 stable disease (SD) and four disease progression (PD) (overall response rate: 43%). Clinical benefit rate (CR + PR + SD >24 months) was 73%. Median time to progression was 8.9 months (range 2-27) and median duration of response was 10.9 months (range 2-27). CONCLUSIONS: The ToVNR combination is active and very well tolerated. It favorably compares with the combination of T and weekly i.v. administered VNR, allowing a more convenient once every three weeks hospital admission and leaving patients and care providers free from the unpleasant effect of i.v.VNR.


Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Administração Oral , Adulto , Idoso , Anticorpos Monoclonais/administração & dosagem , Anticorpos Monoclonais Humanizados , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Neoplasias da Mama/patologia , Feminino , Humanos , Pessoa de Meia-Idade , Metástase Neoplásica , Trastuzumab , Vimblastina/administração & dosagem , Vimblastina/análogos & derivados , Vinorelbina
17.
Ann Oncol ; 18(12): 1963-8, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17785760

RESUMO

BACKGROUND: Biotin-labeled trastuzumab (BiotHER) can be used to test for HER2 by immunohistochemistry. We previously showed that BiotHER immunoreactivity is highly correlated with HER2 amplification and indicated that it could be associated with better clinical outcome in advanced breast cancer patients receiving trastuzumab. PATIENTS AND METHODS: Tumor specimens and clinical information from 234 patients who received trastuzumab-based treatments were collected from 10 institutions. HER2 amplification and BiotHER immunoreactivity were assessed centrally. The effect of BiotHER positivity on response rate (RR), time to progression and survival were studied by univariate and multivariate analysis in patients presenting HER2-amplified breast cancer. The pathologic reviews of the assays were blinded to patient outcomes. RESULTS: BiotHER was positive in 109/194 (56%) HER2-amplified breast cancers and in one not amplified tumor. RRs were 74% [95% (confidence interval) CI 64%-81%] and 47% (95% CI 36%-58%) in BiotHER-positive and -negative tumors, respectively (P < 0.001). BiotHER immunoreactivity was independently associated with increased probability of tumor response (odds ratio 3.848; 95% CI 1.952-7.582), with reduced risk of disease progression [hazard ratio (HR) 0.438; 95% CI 0.303-0.633] and with reduced risk of death (HR 0.566; 95% CI 0.368-0.870) by multivariate analysis. CONCLUSION: The results support a role for BiotHER testing in better tailoring trastuzumab-based treatments in patients with advanced HER2-amplified breast cancers.


Assuntos
Anticorpos Monoclonais/metabolismo , Anticorpos Monoclonais/uso terapêutico , Antineoplásicos/uso terapêutico , Biotina/metabolismo , Neoplasias da Mama/tratamento farmacológico , Anticorpos Monoclonais Humanizados , Neoplasias da Mama/imunologia , Humanos , Imuno-Histoquímica , Hibridização in Situ Fluorescente , Trastuzumab
18.
Anticancer Res ; 27(4C): 2865-9, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17695462

RESUMO

BACKGROUND: The incidence of brain metastases (BM) is apparently rising in patients with advanced breast cancer (ABC). We performed a case control study to define current features of breast cancer related to central nervous system (CNS) metastases. PATIENTS AND METHODS: From March 1999 to May 2006, we identified 72 patients with symptomatic BM of breast cancer. A comparison group was randomly selected assigning to each case two patients with primary breast cancer and no BM, matched for year of diagnosis, age and tumour stage (pT status and nodal status). RESULTS: Cases had a significantly higher rate of negative estrogen receptors (ERs) (60% in cases vs. 29% in controls), negative progesterone receptors (PgRs) (79% vs. 43%), HER2/neu over expression (44% vs. 13%) and immunostaining for Ki-67 > or =20% (84% vs. 55%), with p-value <0.001 for all four parameters in univariate analyses. On multivariate analysis, HER2/neu over expression and Ki-67 -20% were independent predictive factors of brain relapse (Odds Ratio (OR) 2.55, 95% confidence intervals (CI) 1.10-5.94 and OR 2.97, 95% CI 1.01-8.73, respectively). Endocrine unresponsive tumours (both ER and PgR <10%) showed an increased risk of relapse with BM of borderline significance (OR 1.91, 95% CI 0.87-4.12). CONCLUSION: Patients with ER and PgR negative tumours either with or without HER-2/neu over expression should be considered at higher risk of BM.


Assuntos
Neoplasias Encefálicas/secundário , Neoplasias da Mama/patologia , Adulto , Neoplasias Encefálicas/metabolismo , Neoplasias Encefálicas/patologia , Neoplasias da Mama/metabolismo , Estudos de Casos e Controles , Processos de Crescimento Celular/fisiologia , Humanos , Metástase Linfática , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Receptores de Estrogênio/biossíntese , Receptores de Progesterona/biossíntese
19.
J Trace Elem Med Biol ; 40: 54-60, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-28159222

RESUMO

In 1953, during the building restoration of San Michele church (Bono, Sardinia, 16th-19th Century), a high number of disarticulated skeletons were recovered. From a group of 412 hip bones, two of these, affected by several pathological lesions, were analysed. The two coxal bones can be referred to the same individual, an adult man. A multi-analytical study, started with the purpose of investigating the bone pathology, was extended to characterize the mineral components of a large representative set of bones from the same ossuary, all attributed to adult men who lived in the region four-two centuries ago. A quantitative ICP-AES analysis for Ca, Fe, Mg, Mn, Na, Pb and Zn was executed, and a chemometric investigation on the results was performed. This approach gave evidence of the effects of diagenesis, allowed some hypothesis of the incidence of the known dietary habits on bone composition, and completely differentiated the pathological bones from those of a normal population on the basis of the mineral composition. Moreover, porosity, crystallinity and FT-IR analysis were conducted on both non- and pathological sample.


Assuntos
Osso e Ossos/química , Minerais/análise , Adulto , Osso e Ossos/patologia , Humanos , Masculino , Espectroscopia de Infravermelho com Transformada de Fourier
20.
Transbound Emerg Dis ; 64(4): 1280-1286, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27174805

RESUMO

African swine fever virus (ASFV) is the aetiological agent of a highly lethal haemorrhagic disease affecting pigs that inflicts significant economic damage on the swine industry. ASF is present in many African countries, in several eastern and central European countries and in Sardinia (Italy). Sequence analyses of variable genomic regions have been extensively used for molecular epidemiological studies of ASFV isolates. Previous sequencing data of genes that codify for viral protein p54, p72 and the central variable region (CVR) within the B602L gene revealed that Sardinian isolates show a very low level of variability. To achieve a finer level of discrimination among such closely related viruses, in this study, we have chosen three different genome regions to investigate the within-genotype relationships and to provide a more accurate assessment of the origin of outbreaks. The analysis of p30 and I73R/I329L sequences obtained from ASFV collected in Sardinia over a 13-years period confirms a remarkable genetic stability in these regions. The sequence comparison of the protein encoded by the EP402R gene (CD2v), carried out on various strains from 1978 to 2014, revealed a temporal subdivision of Sardinian viruses into two subgroups: one group includes the historical isolates from 1978 to 1990, and the second one is comprised of the viruses collected from 1990 until 2014. These data, together with those obtained from CVR within the B602L gene analysis, demonstrated that the viruses circulating in Sardinia belong to p72 genotype I, but have undergone genetic variations in two different regions of the genome since 1990. We proposed the cytoplasmic region of CD2v protein as a new genetic marker that could be use to analyse ASFVs from different locations to track virus spread. Our study reaffirms the need to analyse other genome regions in order to improve the molecular characterization of ASFV.


Assuntos
Vírus da Febre Suína Africana/genética , Variação Genética , Proteínas Virais/genética , Sequência de Aminoácidos , Animais , Marcadores Genéticos/genética , Genótipo , Itália , Fosfoproteínas/química , Fosfoproteínas/genética , Sus scrofa/virologia , Proteínas Virais/química
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