Colchicine reduces the activation of NLRP3 inflammasome in COVID-19 patients.

OBJECTIVE: To evaluate whether colchicine treatment was associated with the inhibition of NLRP3 inflammasome activation in patients with COVID-19. METHODS: We present a post hoc analysis from a double-blinded placebo-controlled randomized clinical trial (RCT) on the effect of colchicine for the treatment of COVID-19. Serum levels of NOD-like receptor protein 3 (NLRP3) inflammasome products-active caspase-1 (Casp1p20), IL-1ß, and IL-18-were assessed at enrollment and after 48-72 h of treatment in patients receiving standard-of-care (SOC) plus placebo vs. those receiving SOC plus colchicine. The colchicine regimen was 0.5 mg tid for 5 days, followed by 0.5 mg bid for another 5 days. RESULTS: Thirty-six patients received SOC plus colchicine, and thirty-six received SOC plus placebo. Colchicine reduced the need for supplemental oxygen and the length of hospitalization. On Days 2-3, colchicine lowered the serum levels of Casp1p20 and IL-18, but not IL-1ß. CONCLUSION: Treatment with colchicine inhibited the activation of the NLRP3 inflammasome, an event triggering the 'cytokine storm' in COVID-19. TRIAL REGISTRATION NUMBERS: RBR-8jyhxh.

Humeral fractures due to low-energy trauma: an epidemiological survey in patients referred to a large emergency department in Northern Italy.

UNLABELLED: This survey describes the epidemiology of approximately 1800 low-energy humeral fractures seen in a large emergency department in Northern Italy over 7 years (2007-2013), highlighting the differences from previous Italian studies. PURPOSE: The purpose of this study was to determine the incidence of humeral fractures due to low-energy trauma in patients 40 years of age or older referred to a large Emergency Department (Parma, Northern Italy) in a 7-year period (2007-2013). METHODS: All humeral fractures referred to the emergency department of the Academic Hospital of Parma (the main hospital in the province with a catchment area of approximately 345,000) were retrieved from the hospital database using both ICD-9CM codes and text strings. The diagnosis of humeral fracture due to low-energy trauma was confirmed by medical records and X-ray reports, after exclusion of injuries due to a clear-cut high-energy trauma or cancer. RESULTS: The query identified 1843 humeral fractures (1809 first fractures), with a clear predominance in women (78 %). Fractures of the proximal humerus represented the large majority of humeral fractures (more than 85 %), with an incidence progressively increasing with age (more than 60-fold in women and 20-fold in men). Simultaneous fractures (hip in particular) were frequent especially after 85 years of age (1 out of 8 cases). When compared to other Italian studies, the incidence of humeral fractures was significantly lower than that derived from discharge data corrected for hospitalization rate (standardized rate ratio 0.74; p < 0.001), while the pattern of age-related changes was significantly different from that computed by applying the ratio between hip and humeral fractures observed in Malmö, Sweden, to the Italian hip fracture rates. CONCLUSIONS: This study gives an up-to-date description of the epidemiology of low-energy humeral fractures in Italy. Our results partly differ from previous Italian studies based on indirect estimations.

Carcinomatosis peritoneal: resultados quirúrgicos de la cirugía de citorreducción y quimioterapia / Peritoneal carcinomatosis: results of surgical cytoreduction surgery and chemotherapy

Objetivo: Presentar la experiencia preliminar en el tratamiento de la carcinomatosis peritoneal de origen gastrointestinal y ginecológico. Métodos: El estudio incluye 11 pacientes portadores de carcinomatosis, tratados por medio de citorreducción y quimioterapia hipertérmica intraoperatoria y operados entre enero del 2005 y enero del 2008. Resultados: La mediana de edad de los pacientes fue de 50 años (rango = 22-56) y pertenecieron al sexo masculino el 54.5%. La mediana de duración del procedimiento citorreductivo fue de 630 min (rango 205-840). La citorreducción completa fue obtenida en el 54,6% (6/11) de los pacientes. La mediana de órganos resecados por paciente fue 4 (rango = 2 - 5) y la mediana de peritonectomia por paciente fue de 3 (rango = 0-6). Las drogas utilizadas para el baño hipertérmico fueron la Mitomicina C en las carcinomatosis por cancer de colon y del apéndice y el Cisplatino en carcinomatosis por cáncer de ovario. El tiempo d irrigación fue de 90 min y la mediana de la temperatura alcanzada fue de 41º C (39ºC - 43ºC). La mortalidad posoperatoria fue del 9,1% (1/11) y la morbilidad del 63,6% (7/11). La mediana de internación fue de 10 días (4-67), en los pacientes complicados la media de internación fue de 44 días para las severas y de 9 días para las leves. La supervivencia libre de tumor fue del 30% (mediana de seguimiento de 8,3 meses).

Nuestra experiencia en resección de metástasis pulmonares de carcinoma colorrectal / Our experience in resection of pulmonary metastases of rectocolonic carcinoma

Antecedentes y Objetivos: La metastasectomía pulmonar es un procedimiento aceptado para tratamiento de lsa metástasis (Mts) pulmonares del carcinoma colorrectal. Los pacientes no tratados presentan supervivencia a 5 años por debajo del 5%. No existe actualmente quimioterapia efectiva. Se relata en la bibliografía internacional una supervivencia actuarial de 20-40% con carciroma colorrectal con/sin resección previa de secundarismo hepático. Lugar de aplicación: Hospital privado universitario. Diseño: Modelo retrospectivo. Método: Se analizan 40 pacientes, estudiándose la supervivencia según diferentes criterios. La metastasectomía fue indicada en casos de: tumor primario controlado, ausencia de Mts extratorácicas y condición clínica favorable. Se incluyeron sólo los pacientes con resección completa de las Mts. Todos ellos fueron evaluados previamente para recidiva local o compromiso sistémico del cáncer primario. Resultados: La supervivencia actuarial a 5 años de toda la población desde la metastasectomía pulmonar fue 37,9%. Factores como: edad, sexo, tamaño y número de metástasis, intervalo libre de enfermedad, metastesectomía hepática previa y nivel preoperatorio de CEA no influyeron significatimente en los resultados. Conclusión: Una bien seleccionada población de pacientes con Mts pulmonares de carcinoma colorrectal de beneficia claramente con la resección quirúrgica de las mismas por toracotomía.

Occupational exposure of Brazilian neonatal intensive care workers to latex antigens.

BACKGROUND: Frequent exposure to latex causes various reactions such as respiratory symptoms and anaphylactic shock. In these cases, proteins found in natural latex are responsible for the serious systemic antilatex-mediated immediate hypersensitive reactions. METHODS: Cross-sectional descriptive survey focusing on 96 Brazilian health care workers (HCW) in the neonatal intensive care unit at CAISM, State University of Campinas UNICAMP, Brazil. All subjects were interviewed, donated blood samples for the latex-specific immunoglobulin E measurement and underwent the skin prick test (SPT) with an antigen extracted from latex gloves. RESULTS: The prevalence of latex positive SPT was 8%. There were eight SPT positive and only one serologic test was in agreement with the SPT. Overall, there was evidence of an association between the latex SPT and reported eczema (P = 0.01); food allergy (P = 0.009) with pineapple (P = 0.01). CONCLUSIONS: These results suggest that the identification of reactions of immediate hypersensitivity mediated by antilatex antibodies in HCW should be encouraged to prevent occupational exposure to latex products.

[Occupational accidents among nursing personnel caused by perforating instruments]. / Acidente do trabalho por material perfurocortante em trabalhadores de enfermagem.

The purpose was to conduct a survey on work accidents which occur due to sharp cutting instruments. The population studied consisted of nursing personnel who had suffered work accidents. A sample of 22 female workers was selected and the individuals were interviewed. The average age of this sample was 38 years old and there were 59.1% nursing assistants, 22.7% nurses, 9.1% nursing technicians and 9.1% nursing attendants. The highest number of accidents occurred during the month of June and most of them around 3 PM. Most of the accidents reported were from the neonatal unit. The hands were the most affected parts of the body and the majority of the accidents were due to perforating instruments. When the accidents occurred, 50% were wearing gloves and 86.4% were vaccinated.

[Work accidents among nursing workers at a university hospital]. / Acidentes do trabalho entre trabalhadores de enfermagem de um hospital universitário.

A descriptive study was conducted to assess the epidemiological aspects of the work accidents that occur among nursing personnel. The study consisted of a population of 1,218 workers and assessed 100 accídents, that corresponded to 8.2% of all accidents that took place during the period, January 1st 1995 to June 3rd 1995. The summary of this study evaluates the work accidents that occur among these nursing personnel and the risk factors presented by the working conditions of a university hospital.

[Development and implementation of an environmental risk map for the prevention of occupational accidents in an intensive care unit at a university hospital]. / Elaboração e implantação do mapa de riscos ambientais para prevenção de acidentes do trabalho em uma unidade de terapia intensiva de um hospital universitário.

This study has the objective to discuss some questions related to occupational risks that health professionals are exposed to in the Intensive Care Unit environment. A questionnaire was used, asking the health care workers to describe the occupational risks they know about. As a result, the participants indicated risks related to biological, physical, chemical, ergonomic and occupational risks.

[Accidents with sharp instruments in nurses in a university hospital in Campinas, Sao Paolo]. / Ocorrência de acidente do trabalho por material perfurocortante entre trabalhadores de enfermagem de um hospital universitário da cidade de Campinas, Estado de São Paulo.

This study has the objective to evaluate certain aspects of the occurrence of accidents of work with perforative cutting tool in nursing workers of a university hospital. Forty-six workers who had accidental needlesticks and injuries from other sharp objects (from June to/December 1994) were interviewed. The data found are likely to help programs of prevention of accidents with nursing workers.

[Occupational accidents involving the spine: study on nurses at a university hospital]. / Acidentes de trabalho afetando a coluna vertebral: um estudo realizado com trabalhadores de enfermagem de um hospital universitário.

In order to evaluate certain characteristics of the occurrence of occupational back injury among nursing staff, all workers affected during a period of six months were interviewed. These individuals were 43.2 years old on average and were basically female. There was no statistical significative difference showing a predominance among working turns and among the different nursing ranks involved in the accident. Most of the accidents happened within the hospital unit while they were moving or transporting patients and equipment, because of falls due to slipping floor. The most affected regions of the spinal column were the lumbar and cervical portions. The majority of the subjects affirmed that they had some type of back problem.

[Gow-Gates block for beginners]. / Il blocco di Gow-Gates nel neofita.

The study was carried out with two groups of 49 patients to evaluate the incidence of failures and re-injections when the blockade of the mandibular nerve was carried out according to Gow-Gates by untrained young dentists. Such an incidence was compared to that of the blockade of the inferior alveolar nerve by the same dentists trained for this specific task. Both the observed failures and re-injections in the Gow-Gates blockade progressively decrease and disappear, theoretically, after 50 blockades, while they remain almost constant in the inferior alveolar nerve blockade. The induction of the blockade was more prolonged after the Gow-Gates blockade (9 minutes) compared to the inferior alveolar nerve blockade (7 minutes). The pain induced by the injection, that due to the anesthetic and that experienced during the subsequent surgery were lower after the Gow-Gates blockade.