Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 264
Filtrar
1.
Climacteric ; 25(2): 118-127, 2022 04.
Artigo em Inglês | MEDLINE | ID: mdl-34036861

RESUMO

The objective of this systematic review was to evaluate the influence of the use of phytoestrogens on variations in endometrial thickness in postmenopausal women. Randomized controlled trials were searched in the following electronic databases until March 2020: MEDLINE, Embase, Cochrane Library, Web of Science and LILACS. We used the terms 'phytoestrogens' and 'endometrium' or 'endometrial hyperplasia' to search for relevant trials. The data were analyzed using RevMan 5.3 software. A total of 10 studies involving 1476 patients were included. The difference in endometrial thickness was evaluated in 10 studies, with a total of 805 participants in the phytoestrogen group and 761 in the control group. Such a difference was not significant between groups after 3 months (standardized mean difference [SMD] 0.00, 95% confidence interval [CI] - 0.37 to 0.37; I2 = 63%), 6 months (SMD -0.30, 95% CI -0.79 to 0.19; I2 = 70%), 12 months (SMD -0.02, 95% CI 0.22 to -0.18; I2 = 0%) and 24 months (SMD -0.09, 95% CI -0.25, 0.08; I2 = 0%) of use. Our meta-analysis shows no changes in endometrial thickness in women using phytoestrogens. Evidence is still uncertain owing to the presence of heterogeneity among the studies currently available, whose reported outcomes cover a period between 3 and 6 months.


Assuntos
Hiperplasia Endometrial , Fitoestrógenos , Endométrio/diagnóstico por imagem , Feminino , Humanos , Fitoestrógenos/farmacologia , Fitoestrógenos/uso terapêutico
2.
J Endocrinol Invest ; 44(10): 2213-2218, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-33586024

RESUMO

PURPOSE: The question whether the new cystic fibrosis transmembrane conductance regulator (CFTR) modulator drugs aimed at restoring CFTR protein function might improve glucose metabolism is gaining attention, but data on the effect of lumacaftor/ivacaftor treatment (LUMA/IVA) on glucose tolerance are limited. We evaluated the variation in glucose metabolism and insulin secretion in CF patients homozygous for Phe508del CFTR mutation after one-year treatment with LUMA/IVA in comparison to patients with the same genotype who did not receive such treatment. METHODS: We performed a retrospective case-control study on 13 patients with a confirmed diagnosis of CF, homozygous for the Phe508del CFTR mutation, who received LUMA/IVA for one year (cases) and 13 patients with identical genotype who did not receive this treatment (controls). At the beginning and conclusion of the follow-up, all subjects received a modified 3 h OGTT, sampling at baseline, and at 30 min intervals for plasma glucose, serum insulin, and c-peptide concentrations to evaluate glucose tolerance, and quantify by modeling beta-cell insulin secretion responsiveness to glucose, insulin clearance and insulin sensitivity. RESULTS: LUMA/IVA did not produce differences in glucose tolerance, insulin secretory parameters, clearance and sensitivity with respect to matched controls over one-year follow-up. CONCLUSION: We found no evidence of improvements in glucose tolerance mechanisms in patients with CF after one-year treatment with LUMA/IVA.


Assuntos
Aminofenóis/uso terapêutico , Aminopiridinas/uso terapêutico , Benzodioxóis/uso terapêutico , Glicemia/análise , Fibrose Cística/tratamento farmacológico , Secreção de Insulina , Quinolonas/uso terapêutico , Adulto , Estudos de Casos e Controles , Agonistas dos Canais de Cloreto/uso terapêutico , Fibrose Cística/genética , Fibrose Cística/metabolismo , Fibrose Cística/patologia , Regulador de Condutância Transmembrana em Fibrose Cística/genética , Feminino , Seguimentos , Homozigoto , Humanos , Masculino , Mutação , Prognóstico , Estudos Retrospectivos , Adulto Jovem
3.
J Endocrinol Invest ; 44(3): 587-597, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32656666

RESUMO

PURPOSE: Reliable cut-offs for basal (bCT) and calcium stimulated calcitonin (casCT) are needed for an early and accurate diagnosis of medullary thyroid cancer (MTC). PATIENTS AND METHODS: Fifty-four new patients with nodular goiter were enrolled and analysed together with those previously published by our group for a total of 135 cases. bCT and casCT were measured by a highly sensitive method and the results compared with histological findings. In a subgroup of patients, cardiac rhythm was recorded before and during the calcium test. RESULTS: In both females (F) and males (M), there was a significant correlation between tumor size and bCT levels (P < 0.001). The receiver operating characteristic plot analyses showed that, for bCT, the new cut-off points able to separate non-MTC from MTC patients were > 30 (F) and > 34 pg/mL (M), whereas the best casCT thresholds were > 79 (F) and > 466 pg/mL (M). bCT was shown to harbour a high accuracy, though some cases were diagnosed only upon stimulation test. Importantly, combining bCT, below or above the cut-offs, with casCT above the cut-offs, all the MTC cases were correctly identified. A reversible sinus bradycardia was observed in 9% of cases during the test. CONCLUSIONS: Refined cut-offs for bCT and casCT in patients with nodular goiter are reported. Sensitive bCT was shown to have a high accuracy, but the combination with casCT data was needed to identify all MTC cases. The reliability and safety of calcium test strongly favour the routine use of CT determination in nodular thyroid disease.


Assuntos
Biomarcadores Tumorais/sangue , Calcitonina/sangue , Cálcio/farmacologia , Carcinoma Neuroendócrino/diagnóstico , Bócio Nodular/fisiopatologia , Neoplasias da Glândula Tireoide/diagnóstico , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma Neuroendócrino/sangue , Carcinoma Neuroendócrino/epidemiologia , Diagnóstico Diferencial , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Neoplasias da Glândula Tireoide/sangue , Neoplasias da Glândula Tireoide/epidemiologia
4.
J Endocrinol Invest ; 43(6): 703-716, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31853887

RESUMO

BACKGROUND: The diagnosis of indeterminate lesions of the thyroid is a challenge in cytopathology practice. Indeed, up to 30% of cases lack the morphological features needed to provide definitive classification. Molecular tests have been developed to assist in the diagnosis of these indeterminate cases. The first studies dealing with the preoperative molecular evaluation of FNA samples focused on the analysis of BRAFV600E or on the combined evaluation of two or three genetic alterations. The sensitivity of molecular testing was then improved through the introduction of gene panels, which became available for clinical use in the late 2000s. Two different categories of molecular tests have been developed, the 'rule-out' methods, which aim to reduce the avoidable treatment of benign nodules, and the 'rule-in' tests that have the purpose to optimize surgical management. The genetic evaluation of indeterminate thyroid nodules is predicted to improve patient care, particularly if molecular tests are used appropriately and with the awareness of their advantages and weaknesses. The main disadvantage of these tests is the cost, which makes them rarely used in Europe. To overcome this limitation, customized panels have been set up, which are able to detect the most frequent genetic alterations of thyroid cancer. CONCLUSIONS: In the present review, the most recent available versions of commercial molecular tests and of custom, non-commercial panels are described. Their characteristics and accuracy in the differential diagnosis of indeterminate nodules, namely Bethesda classes III (Atypical follicular lesion of undetermined significance, AUS/FLUS) and IV (Suspicious for follicular neoplasm, FN/SFN) are fully analyzed and discussed.


Assuntos
Técnicas de Diagnóstico Molecular/classificação , Técnicas de Diagnóstico Molecular/métodos , Nódulo da Glândula Tireoide/classificação , Nódulo da Glândula Tireoide/diagnóstico , Técnicas Citológicas/classificação , Técnicas Citológicas/métodos , Diagnóstico Diferencial , Humanos , Nódulo da Glândula Tireoide/genética
5.
Int J Med Microbiol ; 307(6): 353-362, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-28754426

RESUMO

Multidrug-resistant (MDR) Pseudomonas aeruginosa is an important issue for physicians who take care of patients with cystic fibrosis (CF). Here, we review the latest research on how P. aeruginosa infection causes lung function to decline and how several factors contribute to the emergence of antibiotic resistance in P. aeruginosa strains and influence the course of the infection course. However, many aspects of the practical management of patients with CF infected with MDR P. aeruginosa are still to be established. Less is known about the exact role of susceptibility testing in clinical strategies for dealing with resistant infections, and there is an urgent need to find a tool to assist in choosing the best therapeutic strategy for MDR P. aeruginosa infection. One current perception is that the selection of antibiotic therapy according to antibiogram results is an important component of the decision-making process, but other patient factors, such as previous infection history and antibiotic courses, also need to be evaluated. On the basis of the known issues and the best current data on respiratory infections caused by MDR P. aeruginosa, this review provides practical suggestions to optimize the diagnostic and therapeutic management of patients with CF who are infected with these pathogens.


Assuntos
Fibrose Cística/tratamento farmacológico , Fibrose Cística/microbiologia , Farmacorresistência Bacteriana Múltipla/genética , Infecções por Pseudomonas/tratamento farmacológico , Infecções por Pseudomonas/microbiologia , Pseudomonas aeruginosa/efeitos dos fármacos , Antibacterianos/farmacologia , Antibacterianos/uso terapêutico , Estudos de Coortes , Fibrose Cística/diagnóstico , Quimioterapia Combinada , Humanos , Testes de Sensibilidade Microbiana , Infecções por Pseudomonas/diagnóstico , Pseudomonas aeruginosa/genética , Pseudomonas aeruginosa/patogenicidade , Ensaios Clínicos Controlados Aleatórios como Assunto
6.
Ann Surg Oncol ; 24(13): 3872-3879, 2017 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-29043525

RESUMO

BACKGROUND: This study was designed to assess patterns of recurrence and long-term outcomes of patients undergoing surgery for localized retroperitoneal sarcoma (RPS) after neoadjuvant high dose long-infusion ifosfamide (HLI) and radiotherapy (RT). METHODS: Patients received three cycles of HLI (14 g/m2). RT was started in combination with II cycle up to a total dose of 50.4 Gy. Surgery was scheduled 4-6 weeks after the end of RT. The primary endpoint was relapse-free survival (RFS) after surgery. Secondary endpoints were overall survival (OS), crude cumulative incidence of local recurrence (CCI-LR), and distant metastases (CCI-DM). For patients who relapsed, progression-free survival (PFS) and post-relapse OS were estimated. The trial was registered with ITASARC_*II_2004_003. RESULTS: Between 2003 and 2010, 83 patients were recruited. At a median follow-up of 91.7 months, 42 (56%) of 75 operated patients developed LR (n = 27) or DM (n = 10) or both LR and DM (n = 5) relapse. Seven-year RFS was 46.6% [95% confidence interval (CI) 29.6-52.4]. Thirty-two patients died. Seven-year OS rate was 63.2% (95% CI 42.7-66.0). The corresponding CCI of LR and DM were 37.4% [standard error (SE) 5.5%] and 20.0% (SE 12.6%), respectively. The only factor significantly associated with LR was FNCLCC grading, whereas histological subtype resulted associated with DM. At recurrence, 24 patients (57%) underwent surgery. Two-year post-relapse PFS and OS rates for patients developing LR or DM were 14.8, 41.0, 27.3, and 63.6%, respectively. CONCLUSIONS: LR after neoadjuvant CT-RT for RPS were predominantly infield. While almost one half of relapsed patients underwent further surgery, prognosis was poor.


Assuntos
Quimiorradioterapia , Ifosfamida/uso terapêutico , Terapia Neoadjuvante , Recidiva Local de Neoplasia/patologia , Neoplasias Retroperitoneais/patologia , Sarcoma/patologia , Adulto , Idoso , Antineoplásicos Alquilantes/uso terapêutico , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/terapia , Prognóstico , Neoplasias Retroperitoneais/terapia , Sarcoma/terapia , Taxa de Sobrevida
7.
Genet Mol Res ; 16(2)2017 May 31.
Artigo em Inglês | MEDLINE | ID: mdl-28613382

RESUMO

Jatropha curcas L. is a highly promising oilseed for sustainable production of biofuels and bio-kerosene due to its high oil content and excellent quality. However, it is a perennial and incipiently domesticated species with none stable cultivar created until now despite genetic breeding programs in progress in several countries. Knowledge of the genetic structure and diversity of the species is a necessary step for breeding programs. The molecular marker can be used as a tool for speed up the process. This study was carried out to assess genetic diversity of a germplasm bank represented by J. curcas accessions from different provenance beside interspecific hybrid and backcrosses generated by IAC breeding programs using inter-simple sequence repeat markers. The molecular study revealed 271 bands of which 98.9% were polymorphic with an average of 22.7 polymorphic bands per primer. Genetic diversity of the germplasm evaluated was slightly higher than other germplasm around the world and ranged from 0.55 to 0.86 with an average of 0.59 (Jaccard index). Cluster analysis (UPGMA) revealed no clear grouping as to the geographical origin of accessions, consistent with genetic structure analysis using the Structure software. For diversity analysis between groups, accessions were divided into eight groups by origin. Nei's genetic distance between groups was 0.14. The results showed the importance of Mexican accessions, congeneric wild species, and interspecific hybrids for conservation and development of new genotypes in breeding programs.


Assuntos
Jatropha/genética , Repetições de Microssatélites , Polimorfismo Genético , Melhoramento Vegetal , Banco de Sementes
8.
Analyst ; 141(3): 731-9, 2016 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-26646435

RESUMO

This article reviews a very recent field of noninvasive analysis of turbid media using micro-scale Spatially Offset Raman Spectroscopy - micro-SORS. The technique combines conventional SORS with microscopy concepts and represents a new imaging modality in Raman microscopy. Micro-SORS facilitates analytical capability for investigating non-destructively the chemical composition of subsurface, micrometer-scale-thick diffusely scattering layers at depths more than an order of magnitude larger than those accessible with the depth resolving power of conventional confocal Raman microscopy. Potential application areas include nondestructive subsurface analysis of painted layers in cultural heritage, characterization of stratified polymer systems, analysis of layered biological samples or forensic analysis. The article discusses the basic principles of the technique, its variants and outlines emerging applications in this rapidly evolving field.


Assuntos
Análise Espectral Raman/métodos , Método de Monte Carlo , Pintura/análise , Papel , Espalhamento de Radiação , Sementes/química , Triticum
9.
J Biol Regul Homeost Agents ; 30(1): 111-22, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27049081

RESUMO

The potential of adipose-derived mesenchymal stromal (stem) cells (ADSCs) to differentiate into either osteoblasts or chondrocytes is controversial. In this study we investigated the multicapacity potential of ADSCs to differentiate towards adipocyte, osteoblast, and chondrocyte lineages when cells are seeded onto plastic in comparison with incubation with conditioned media (CM) obtained from differentiated cell types.ADSCs, obtained from liposuctions, were characterized for mesenchymal and hematopoietic markers by cytofluorimetry. Their differentiation capacity towards adipocytes, osteoblasts, and chondrocytes was investigated by histochemistry methods (Oil-Red-O staining, Safranin O and Alizarin Red staining, respectively). Dental pulp stem cells (DPSCs) and dedifferentiated auricle derived-chondrocytes were differentiated towards osteoblastic and chondrocytic lineages respectively, and the CM obtained from these cultures was used to induce differentiation of ADSCs. ADSCs were positive for mesenchymal markers (CD29, CD105, CD73, CD44), but not for hematopoietic lineage markers (CD14, CD34, CD45) and this behavior was conserved from the isolation up to the fifth passage. While ADSCs were readily differentiated in adipocytes, they were not towards chondrocytes and osteoblastic lineages, a behavior different from that of bone marrow-derived MSCs that differentiated into the three lineages at two weeks post-induction. Only ADSCs treated with CM from cultured chondrocytes and DPSCs, produced glycosaminoglycans and mineralized matrix. These results indicate that ADSCs need growth/morphogenic factor supplementation from the tissue environment to be appropriately differentiated to mesodermic lineages.


Assuntos
Tecido Adiposo/citologia , Diferenciação Celular/efeitos dos fármacos , Linhagem da Célula/efeitos dos fármacos , Condrócitos/citologia , Meios de Cultivo Condicionados/farmacologia , Polpa Dentária/citologia , Cartilagem da Orelha/citologia , Células-Tronco Mesenquimais/citologia , Osteoblastos/citologia , Adipogenia/efeitos dos fármacos , Adolescente , Adulto , Idoso , Células da Medula Óssea/citologia , Células da Medula Óssea/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Separação Celular , Forma Celular/efeitos dos fármacos , Condrócitos/efeitos dos fármacos , Condrócitos/metabolismo , Condrogênese/efeitos dos fármacos , Humanos , Células-Tronco Mesenquimais/efeitos dos fármacos , Células-Tronco Mesenquimais/metabolismo , Pessoa de Meia-Idade , Osteoblastos/efeitos dos fármacos , Osteoblastos/metabolismo , Osteogênese/efeitos dos fármacos , Adulto Jovem
10.
Br J Surg ; 102(9): 1079-87, 2015 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-26041724

RESUMO

BACKGROUND: More than 60 per cent of patients treated surgically for primary retroperitoneal sarcoma survive for at least 5 years. Extended surgical resection has been proposed for primary disease, but long-term morbidity data are lacking. A cross-sectional study was conducted to assess the long-term morbidity of patients undergoing surgery for retroperitoneal sarcoma. METHODS: Patients operated on between January 2002 and December 2011 were eligible for the study. Long-term morbidity was evaluated based on a semistructured clinical interview. Lower limb function was assessed by means of the Lower Extremity Functional Scale (LEFS), a self-report questionnaire with a total score ranging from 0 (low functioning) to 80 (high functioning). Pain was investigated by means of the Brief Pain Inventory--Short Form, with pain intensity scores reported on a scale from 0 (no pain) to 10 (worst pain). RESULTS: Some 243 patients underwent surgery, and 101 of 160 patients who were alive at the time of the investigation responded to the study invitation letter. Finally, 95 patients were enrolled in the study. Sensory impairment of the limbs was reported in 72 patients (76 per cent). The median LEFS score was 60 (i.q.r. 43-73). Mean scores for the pain intensity items varied from 1.23 to 2.68. In multivariable analysis, there was no difference in median levels of creatinine at survey between patients who did or did not undergo nephrectomy (difference between median values 13 (95 per cent c.i. -4 to 30) µmol/l; P = 0.170). CONCLUSION: Severe chronic pain and lower limb motor impairment after multivisceral resection for retroperitoneal sarcomas are rare. Long-term renal function is not significantly impaired when nephrectomy is performed.


Assuntos
Complicações Pós-Operatórias/epidemiologia , Neoplasias Retroperitoneais/cirurgia , Sarcoma/cirurgia , Adulto , Dor Crônica/diagnóstico , Dor Crônica/epidemiologia , Dor Crônica/etiologia , Estudos Transversais , Avaliação da Deficiência , Feminino , Seguimentos , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Medição da Dor , Dor Pós-Operatória/diagnóstico , Dor Pós-Operatória/epidemiologia , Complicações Pós-Operatórias/diagnóstico , Estudos Retrospectivos , Inquéritos e Questionários
11.
Analyst ; 140(24): 8127-33, 2015 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-26526114

RESUMO

We compare several basic embodiments of a recently proposed and demonstrated micrometer-scale Spatially Offset Raman Spectroscopy (micro-SORS). Micro-SORS is a recently introduced analytical method for noninvasive characterisation of the chemical composition of subsurface, micrometre-scale-thick diffusely scattering layers at depths beyond the reach of conventional confocal Raman microscopy. The technique is applicable, for example, in nondestructive subsurface analysis of highly scattering stratified matrices such as painted layers in cultural heritage or in noninvasive analysis of stratified polymer systems or biological samples. Using Monte Carlo simulations, we analysed two defocusing variants of micro-SORS and a variant involving a full separation of illumination and collection zones on the sample surface. Both the penetration depth into the sample and relative enhancement of sublayer Raman signals were studied as a function of layer thickness and type of technique and their parameters. The model predicts that the most effective method by far is the variant with fully spatially separated illumination and collection zones. On the other hand, the defocusing micro-SORS, where both the laser and Raman collection zones are defocussed and overlapped, yielded the lowest performance although its key benefit lies in its simplicity as the concept can be practiced on existing conventional Raman microscopes without any modifications. A basic experimental verification of the theoretical findings contrasting two extreme modalities, the fully separated micro-SORS variant with the defocusing one, is also presented.


Assuntos
Análise Espectral Raman , Microscopia Confocal , Método de Monte Carlo
12.
Br J Cancer ; 111(7): 1350-62, 2014 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-25101565

RESUMO

BACKGROUND: Host immunity is emerging as a key player in the prognosis and response to treatment of cancer patients. However, the impact of the immune system and its modulation by therapies are unknown in rare soft tissue sarcomas such as solitary fibrous tumours (SFTs), whose management in the advanced forms includes anti-angiogenic therapy. Here, we studied the in situ and systemic immune status of advanced SFT patients and the effects of sunitinib malate (SM) in association with the clinical efficacy. METHODS: Immune contexture of SFTs was assessed by immunohistochemistry in lesions from untreated or SM-treated patients. Frequency of circulating myeloid-derived suppressor cells (MDSCs), regulatory T cells (Tregs) and T-cell functions was assessed ex vivo in SFT patients prior and during anti-angiogenic therapy. Patients with long-term tumour control were included to correlate immune profiles and clinical responses. RESULTS: Anti-angiogenic naïve SFT lesions were heavily infiltrated by CD163(+)CD14(+)CD68(-) and CD163(+)CD14(-)CD68(-) myeloid cells but devoid of T cells. Conversely, post-SM tumours acquired a new subset of CD68(+)CD14(+) myeloid cells and displayed traits of an on-going adaptive immunity, strongly enriched in activated CD8(+) and CD4(+) T cells. These changes at the tumour site paralleled the alleviation of systemic immunosuppression and the drop in the frequency of circulating monocytic MDSCs (mMDSCs) and granulocytic MDSCs (gMDSCs). Rebound in the number of mMDSCs, but not of gMDSCs occurred at disease progression, and a reduced percentages of mMDSCs, comparable to those found in healthy donors (HDs), endured only in the SM-responsive patients. CONCLUSIONS: The immune contexture of SFT patients is heavily involved in anti-angiogenic therapy and it could be exploited to achieve more durable disease control through immune-based combination strategies.


Assuntos
Imunidade Adaptativa/efeitos dos fármacos , Inibidores da Angiogênese/farmacologia , Indóis/farmacologia , Células Progenitoras Mieloides/imunologia , Pirróis/farmacologia , Tumores Fibrosos Solitários/imunologia , Adulto , Idoso , Inibidores da Angiogênese/uso terapêutico , Intervalo Livre de Doença , Feminino , Humanos , Terapia de Imunossupressão , Indóis/uso terapêutico , Linfócitos/efeitos dos fármacos , Linfócitos/imunologia , Masculino , Pessoa de Meia-Idade , Células Progenitoras Mieloides/efeitos dos fármacos , Pirróis/uso terapêutico , Tumores Fibrosos Solitários/sangue , Tumores Fibrosos Solitários/tratamento farmacológico , Sunitinibe , Resultado do Tratamento , Microambiente Tumoral/efeitos dos fármacos , Microambiente Tumoral/imunologia
13.
Ann Oncol ; 25(3): 578-583, 2014 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-24325833

RESUMO

Desmoid-type fibromatosis (DF) is a rare locally aggressive monoclonal proliferation of myofibroblasts lacking metastatic capacity. It may be observed in nearly every part of the body. Considering the variable clinical presentations, anatomic locations, and biologic behaviors, an individualized treatment approach is required. The pathogenesis of DF is not completely understood even if a high prevalence (∼85%) of CTNNB1 mutations discovered in sporadic DF underlies the importance of the Wnt/ß-catenin pathway. No established and evidence-based approach for the treatment of this neoplasm is available as of today. Considering the unpredictable behavior and the heterogeneity of this disease, we propose a treatment algorithm approved by the French and the Italian Sarcoma Group, based on a front-line wait and see approach and subsequent therapy in the case of progression. A careful counseling at a referral center is mandatory and should be offered to all patients affected by sporadic DF from the time of their diagnosis.


Assuntos
Fibromatose Agressiva/radioterapia , Fibromatose Agressiva/cirurgia , Conduta Expectante , beta Catenina/genética , Fibromatose Agressiva/genética , França , Humanos , Itália , Recidiva Local de Neoplasia/radioterapia , Via de Sinalização Wnt/genética
14.
Psychol Med ; 44(14): 3069-82, 2014 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-25065766

RESUMO

BACKGROUND: Bipolar disorder (BD) is associated with adverse childhood experiences (ACE), which worsen the lifetime course of illness, and with signs of widespread disruption of white matter (WM) integrity in adult life. ACE are associated with changes in WM microstructure in healthy humans. METHOD: We tested the effects of ACE on diffusion-tensor imaging (DTI) measures of WM integrity in 80 in-patients affected by a major depressive episode in the course of BD. We used whole-brain tract-based spatial statistics in the WM skeleton with threshold-free cluster enhancement of DTI measures of WM microstructure: axial, radial and mean diffusivity, and fractional anisotropy. RESULTS: ACE hastened the onset of illness. We observed an inverse correlation between the severity of ACE and DTI measures of axial diffusivity in several WM fibre tracts contributing to the functional integrity of the brain and including the corona radiata, thalamic radiations, corpus callosum, cingulum bundle, superior longitudinal fasciculus, inferior fronto-occipital fasciculus and uncinate fasciculus. CONCLUSIONS: Axial diffusivity reflects the integrity of axons and myelin sheaths, and correlates with functional connectivity and with higher-order abilities such as reasoning and experience of emotions. In patients with BD axial diffusivity is increased by lithium treatment. ACE might contribute to BD pathophysiology by hampering structural connectivity in critical cortico-limbic networks.


Assuntos
Transtorno Bipolar/patologia , Imagem de Tensor de Difusão/métodos , Relações Familiares , Substância Branca/patologia , Adulto , Criança , Transtorno Depressivo Maior/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
Nanotechnology ; 25(33): 335706, 2014 Aug 22.
Artigo em Inglês | MEDLINE | ID: mdl-25074670

RESUMO

One of the major drawbacks that limits the clinical application of nanoparticles is the lack of preliminary investigations related to their biocompatibility, biodegradability and biodistribution. In this work, biodegradable PEGylated polymer nanoparticles (NPs) have been synthesized by using macromonomers based on poly(ε-caprolaconte) oligomers. More in detail, NPs have been produced by adopting a surfactant-free semibatch emulsion polymerization process using PEG chains as a stabilizing agent. The NPs were also labeled with rhodamine B covalently bound to the NPs to quantitatively study their biodistribution in vivo. NPs were investigated in both in vitro and in vivo preclinical systems to study their biodistribution in mice bearing B16/F10 melanoma, as well as their biocompatibility and biodegradability. The NP concentration was evaluated in different tissues at several times after intravenous injection. The disappearance of the NPs from the plasma was biphasic, with distribution and elimination half-lives of 30 min and 15 h, respectively. NPs were retained in tumors and in filter organs for a long time, were still detectable after 7 d and maintained a steady concentration in the tumor for 120 h. 48 h after injection, 70 ± 15% of the inoculated NPs were excreted in the feces. The favorable tumor uptake, fast excretion and absence of cytotoxicity foster the further development of produced NPs as drug delivery carriers.


Assuntos
Sistemas de Liberação de Medicamentos , Nanopartículas/química , Polietilenoglicóis/química , Polietilenoglicóis/farmacocinética , Animais , Linhagem Celular Tumoral , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Feminino , Melanoma Experimental , Camundongos , Camundongos Endogâmicos C57BL , Tamanho da Partícula , Polímeros , Rodaminas/química , Rodaminas/farmacocinética , Distribuição Tecidual
16.
Emerg Med J ; 31(11): 877-81, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23935157

RESUMO

BACKGROUND: Syncope is a common clinical problem that accounts for 1-3% of all emergency department (ED) visits. Its prognosis is extremely variable with a 1-year mortality that may reach 30%. There are no available data about the accuracy of nursing triage in identifying high-risk syncope. The aim of our study was to evaluate the predictive accuracy of nursing triage in identifying high-risk syncope. METHODS: We conducted a retrospective study on 678 consecutive patients who presented with syncope at four EDs. For each patient, nursing triage, comorbidities, clinical features and adverse events that occurred both in the ED and at 10-day follow-up were assessed. Adverse events included death, readmission to ED, need for major therapeutic procedures, cardiopulmonary resuscitation, intensive care unit admittance, acute antiarrhythmic therapy and major causes of syncope identified during the ED evaluation. Predictive accuracy of nursing triage was evaluated. RESULTS: We observed a total of 55 (8.1%) adverse events. Eight of them (9.4%) occurred among the 85 patients who were identified as high priority by nursing triage. Sensitivity (Sn) and specificity (Sp) of urgent nursing triage in identifying adverse outcomes in the ED (19 patients) were 21% (95% CI 3% to 39%) and 88% (95% CI 85% to 90%), while the positive likelihood ratio (LR+) and negative likelihood ratio (LR-) were 1.7 and 0.9, respectively. Sn and Sp for 10-day adverse events were 15% (95% CI 5% to 24%) and 88% (95% CI 85% to 90%), respectively, with a LR+ of 1.18 and a LR- of 0.98. CONCLUSIONS: Nursing triage was characterised by a low predictive accuracy in identifying high-risk individuals.


Assuntos
Enfermagem em Emergência , Serviço Hospitalar de Emergência , Medição de Risco , Síncope/complicações , Síncope/diagnóstico , Triagem , Adulto , Comorbidade , Eletrocardiografia , Humanos , Itália , Valor Preditivo dos Testes , Prognóstico , Estudos Retrospectivos , Sensibilidade e Especificidade , Síncope/enfermagem
17.
Sci Rep ; 14(1): 9108, 2024 Apr 20.
Artigo em Inglês | MEDLINE | ID: mdl-38643281

RESUMO

Understanding the effects of consolidating inorganic mineral treatments on carbonate stones of cultural heritage, and on the nature and distribution of newly formed products within the matrix, poses a significant challenge in Heritage Science and Conservation Science. Existing analytical methods often fail to deliver spatial and compositional insights into the newly formed crystalline phases with the appropriate high lateral resolution. In this study, we explore the capabilities and limitations of synchrotron radiation (SR) micro-X-ray powder diffraction (µXRPD) mapping combined with micro-X-ray fluorescence (µXRF) to give insight into compounds formed following the application of ammonium oxalate (AmOx) and diammonium phosphate-based (DAP) solutions on porous carbonate stone. Ultimately, the integration of µXRPD mapping and µXRF analysis proved itself a powerful asset in providing precise qualitative and quantitative data on the newly formed phases, in the case of both calcium oxalates (CaOxs) and calcium phosphates (CaPs), and their complex stratigraphic distribution, thus opening a new route for applications to a more comprehensive study of inorganic treatments applied to carbonate substrates.

18.
Sci Total Environ ; 914: 170026, 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38218486

RESUMO

Estuarine coastal water and sediments collected from multiple locations within the middle Río de la Plata (RDLP) estuary were analyzed in order to identify the presence of microplastics (MPs, <5 mm) and mesoplastics (MePs, 5-25 mm) in one of the most significant estuaries in the Southwestern Atlantic. The present study represents one of the first researches to survey MPs and MePs contamination in key stations at RDLP estuary. Average concentrations of 14.17 ± 5.50 MPs/L and 10.00 MePs/L were detected in water samples, while 547.83 ± 620.06 MPs/kg (dry weight) and 74.23 ± 47.29 MePs/kg d.w. were recorded in sediments. The greatest abundances were observed in the more anthropized areas, near urban settlements. Fibers were the most conspicuous plastic items in water and sediments, followed by fragments. On the other hand, surface sediments, and 50 cm and 100 cm-depth sediments also presented MPs and MePs indicating they could serve as a stratigraphic indicator for recently formed sediments. The main polymer type identified were acrylic fibers, followed by polypropylene (PP) and polyethylene terephthalate (PET). Besides, SEM-EDX detected the presence of Si, Fe, Ti, Al and Cl onto the plastics' surface. These elements may serve as additives to enhance the plastics' properties, such as in the case of Ti, or they could originate from the environment, like biogenic Si or Fe, and Al possibly as a component of the suspended particles or sediments adhered to the micro or meso plastics. Finally, the results of the present study showed that MPs and MePs are commonly found in waters and also tend to be trapped in sediments of the RDLP estuary supporting the assertion that these areas play a substantial role in influencing the transport, dispersion, and buildup of MPs in estuarine regions.

19.
Sci Total Environ ; 913: 169677, 2024 Feb 25.
Artigo em Inglês | MEDLINE | ID: mdl-38163594

RESUMO

Microplastics (MPs) and antifouling paint particles (APPs) are important components of marine microdebris (MDs), which constitute a potential environmental risk. This study analyzed baseline contamination levels of MDs and mesodebris (MesDs) in intertidal sediments at different depths, exploring the geomorphological influence in three Argentine coastal environments: Bahía Blanca Estuary (BBE), Los Pocitos (LP) and Puerto Madryn (PM). The MDs and MesDs samples were characterized by µ-FTIR, SEM/EDX and XRD. The abundance of MPs and APPs in sediments, range between 19.78 and 1087.19 and between 0 and 172.93 items/kg d.w., respectively. Despite variations in population and industrial developments in these areas, MPs abundance shows no significant differences in low and high intertidal zones. However, mean MPs concentrations were higher in the surface layer (0-5 cm) compared to the deeper sediments (5-10 cm), indicating recent MPs deposition. Chemical characterization evidenced the presence of cellulose (CE) and denser polymers as acrylonitrile butadiene styrene (ABS) and polyacrylics (PAN), APPs, metallic and black MDs. Surface degradation and heavy metals (Zn, Cr, and Ba) were also detected in APPs and other MDs, either as additives or adhered to their surfaces. Changes in crystallinity were also observed on the MesDs due to weathering. The calculated polymer hazard index (PHI) and the presence of hazardous polymers such as ABS and PAN indicated an increased risk of MPs pollution on the BBE and PM coasts. The pollution load index (PLI) values (from 4.63 to 5.34) suggested unpolluted to moderately polluted levels. These findings offer insights into potential risks associated with MDs in Argentine intertidal sediments, underscoring the critical need to comprehend the geomorphology and the influence of coastal dynamics. This is crucial for effectively addressing challenges linked to MDs pollution guiding the development of robust management and mitigation strategies.

20.
Sci Total Environ ; 923: 171390, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38438044

RESUMO

Marine microdebris (MDs, <5 mm) and mesodebris (MesDs, 5-25 mm), consist of various components, including microplastics (MPs), antifouling or anticorrosive paint particles (APPs), and metallic particles (Mmps), among others. The accumulation of these anthropogenic particles in macroalgae could have significant implications within coastal ecosystems because of the role of macroalgae as primary producers and their subsequent transfer within the trophic chain. Therefore, the objectives of this study were to determine the abundance of MDs and MesDs pollution in different species of macroalgae (P. morrowii, C. rubrum, Ulva spp., and B. minima) and in surface waters from the Southwest Atlantic coast of Argentina to evaluate the ecological damage. MDs and MesDs were chemically characterized using µ-FTIR and SEM/EDX to identify, and assess their environmental impact based on their composition and degree of pollution by MPs, calculating the Polymer Hazard Index (PHI). The prevalence of MDs was higher in foliose species, followed by filamentous and tubular ones, ranging from 0 to 1.22 items/g w.w. for MPs and 0 to 0.85 items/g w.w. for APPs. It was found that macroalgae accumulate a higher proportion of high-density polymers like PAN and PES, as well as APPs based on alkyd, PMMA, and PE resins, whereas a predominance of CE was observed in surrounding waters. Potentially toxic elements, such as Cr, Cu, and Ti, were detected in APPs and MPs, along with the presence of epiplastic communities on the surface of APPs. According to PHI, the presence of high hazard score polymers, such as PAN and PA, increased the overall risk of MP pollution in macroalgae compared to surrounding waters. This study provided a baseline for MDs and MesDs abundance in macroalgae as well as understanding the environmental impact of this debris and their bioaccumulation in the primary link of the coastal trophic chain.


Assuntos
Alga Marinha , Poluentes Químicos da Água , Plásticos , Monitoramento Ambiental , Ecossistema , Argentina , Poluentes Químicos da Água/análise , Microplásticos
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA