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1.
Domest Anim Endocrinol ; 81: 106747, 2022 10.
Article in English | MEDLINE | ID: mdl-35728298

ABSTRACT

Plastic is one of the main sources of marine and terrestrial pollution. This material can fragment into micro- (<-5 mm) and nanoplastics (NPs) (<100 nm) following degradation. Animals are exposed to these particles by ingesting contaminated food, respiration or filtration, and transdermally. In organisms, NPs can cross biological membranes, and cause oxidative stress, cell damage, apoptosis, and endocrine interference. We previously demonstrated that polystyrene - NPs interfered with ovarian cell functions. Since reproduction involves a high energy expenditure and a crucial role is played by adipose tissue, the aim of the present study was to evaluate the effects of NPs on primary adipose stromal cells (ASCs) isolated from swine adipose tissues. In particular, the effects on cell viability, proliferation, metabolic activity, inflammatory process mediators and oxidative stress markers were assessed. The obtained results did not reveal a significant variation in cell proliferation, metabolic activity was increased (P < 0.01) but only at the lowest concentration, while viability showed a significant decrease after prolonged exposure to NPs (P < 0.01). TNF-α was increased (P < 0.05), while PAI-1 was inhibited (P < 0.001). Redox status was significantly modified; in particular, the production of O2-, H2O2 and NO was stimulated (P < 0.05), the non-enzymatic antioxidant power was reduced (P < 0.05) while catalase activity was significantly (P < 0.01) increased.


Subject(s)
Nanoparticles , Water Pollutants, Chemical , Adipose Tissue , Animals , Hydrogen Peroxide , Microplastics/toxicity , Stromal Cells , Swine
2.
Domest Anim Endocrinol ; 76: 106611, 2021 07.
Article in English | MEDLINE | ID: mdl-33662764

ABSTRACT

Soil, water, and air pollution by plastic represents an issue of great concern since the particles produced by degradation of plastic materials can be ingested by animals and humans, with still uncertain health consequences. As a contribution on this crucial subject, the present work reports an investigation on the in vitro effects of different concentrations of polystyrene nanoplastics (5, 25, and 75 µg/mL) on swine granulosa cells, a model of endocrine reproductive cells. In particular, cell growth (BrDU incorporation and ATP production), steroidogenesis (17-ß estradiol and progesterone secretion) and redox status (superoxide and nitric oxide production, enzymatic and non-enzymatic scavenging activity) were studied. Nanoplastics, at the highest concentration, stimulated cell proliferation (P < 0.05), while cell viability resulted unaffected. Steroidogenesis was disrupted (P < 0.05). Both enzymatic and non-enzymatic scavenging activity were increased after exposure at the highest nanoplastic dose (P < 0.05, P < 0.001). Nitric oxide secretion was increased by 25 and 75 µg/mL (P < 0.05) while superoxide generation was stimulated (P < 0.001) only by the highest concentration tested. Taken together, main features of cultured swine granulosa cells resulted affected by exposure to nanoplastics. These results raise concerns since environment nanoplastic contamination can represents a serious threat to animal and human health.


Subject(s)
Granulosa Cells , Microplastics , Animals , Cell Survival , Cells, Cultured , Estradiol/pharmacology , Female , Granulosa Cells/physiology , Progesterone/metabolism , Superoxides/metabolism , Swine
3.
J Vet Pharmacol Ther ; 41(2): 246-253, 2018 Apr.
Article in English | MEDLINE | ID: mdl-29164631

ABSTRACT

We investigated the effects of different selective α2 -adrenergic receptor (AR) agonists (detomidine, medetomidine, xylazine, and brimonidine) on the contractions of horse-isolated bronchi induced by electrical field stimulation (EFS) and by carbachol. No effects were observed on the contraction induced by carbachol, while α2 -AR agonists reduced EFS-evoked contractions in a concentration-related fashion. The rank order of potency (pD2 ) was brimonidine (7.40 ± 0.20) >medetomidine (7.09 ± 0.24) >detomidine (6.13 ± 0.55) >xylazine (4.59 ± 0.16). The maximal effects (Emax ) were -56.3% ± 6.3%, -40.4% ± 6.9%, -48.6% ± 9.9%, and -72.7% ± 12.7% for brimonidine, medetomidine, detomidine, and xylazine, respectively. Adrenergic block by guanethidine enhanced the potency (8.10 ± 0.05, 7.30 ± 0.15, 6.83 ± 0.41, and 5.40 ± 0.22) and the efficacy (-95.2% ± 0.7%, -45.2% ± 11.7%, -58.5% ± 9.8%, and -97.9% ± 0.6%) of brimonidine, medetomidine, detomidine, and xylazine, respectively. Selective α2 -AR antagonist, atipamezole, competitively antagonized the inhibition of EFS-evoked contractions induced by all agonists except xylazine. These results suggest the existence of presynaptic α2 -ARs on cholinergic neurons, negatively regulating the release of acetylcholine in horse bronchial muscle, and that α2 -AR agonists may be beneficial against vagally mediated bronchoconstriction.


Subject(s)
Adrenergic alpha-2 Receptor Agonists/pharmacology , Bronchi/drug effects , Muscle Contraction/drug effects , Animals , Brimonidine Tartrate/pharmacology , Bronchi/physiology , Carbachol/pharmacology , Electric Stimulation , Horses , Imidazoles/pharmacology , Male , Medetomidine/pharmacology , Muscle Contraction/physiology , Muscle, Smooth/drug effects , Muscle, Smooth/physiology , Xylazine/pharmacology
4.
Eur Heart J Suppl ; 19(Suppl D): D151-D162, 2017 May.
Article in English | MEDLINE | ID: mdl-28751841

ABSTRACT

The wide availability of effective drugs in reducing cardiovascular events together with the use of myocardial revascularization has greatly improved the prognosis of patients with coronary artery disease. The combination of antithrombotic drugs to be administered before the knowledge of the coronary anatomy and before the consequent therapeutic strategies, can allow to anticipate optimal treatment, but can also expose the patients at risk of bleeding that, especially in acute coronary syndromes, can significantly weigh on their prognosis, even more than the expected theoretical benefit. In non ST-elevation acute coronary syndromes patients in particular, we propose a 'selective pre-treatment' with P2Y12 inhibitors, based on the ischaemic risk, on the bleeding risk and on the time scheduled for the execution of coronary angiography. Much of the problems concerning this issue would be resolved by an early access to coronary angiography, particularly for patients at higher ischaemic and bleeding risk.

5.
Vet Rec ; 180(16): 404, 2017 Apr 22.
Article in English | MEDLINE | ID: mdl-28188161

ABSTRACT

We evaluated the efficacy of oral sildenafil citrate in dogs with congenital idiopathic megaoesophagus (CIM). Twenty-one puppies were randomly assigned to two groups (treatment and control). The dogs were given sildenafil oral suspension 1 mg/kg every 12 hours for 14 days or placebo in a masked fashion. Clinical signs (frequency of regurgitation and weight gain) and oesophagrams (relative oesophageal diameter, ROD) were evaluated in order to assess the efficacy of drug treatment, by examiners who were unaware of the study protocol. In addition, a set of in vitro experiments on isolated samples of canine lower oesophageal sphincter (LOS) was performed, and the effects of increasing concentrations of sildenafil on basal tone and electrically-stimulated motility were assessed. Sildenafil administration significantly reduced the number of regurgitation episodes (0.88±1.40 v 2.65±1.56, P<0.0001) and significantly increased weight gain in the treated dogs compared to controls (79.76±28.30 per cent v 53.40±19.30 per cent, P=0.034). ROD values, at the end of the treatment period, were significantly decreased in the sildenafil group, compared to pre-treatment values (0.97±0.19 v 0.24±0.14, P<0.0001), in contrast to control subjects (0.98±0.17 v 1.10±0.25, P=0.480). In accordance with the in vivo findings, sildenafil dose-dependently reduced basal tone and increased electrically-induced relaxation of dog LOS samples. These results suggest that sildenafil citrate helps ameliorate clinical and radiographic signs in dogs with CIM by reducing LOS tone, and could represent a novel therapeutic tool for the treatment of this disease.


Subject(s)
Dog Diseases/congenital , Dog Diseases/drug therapy , Esophageal Achalasia/veterinary , Sildenafil Citrate/therapeutic use , Animals , Dog Diseases/diagnostic imaging , Dogs , Esophageal Achalasia/congenital , Esophageal Achalasia/diagnostic imaging , Esophageal Achalasia/drug therapy , Female , Male , Radiography/veterinary , Treatment Outcome
6.
Vet Parasitol ; 209(3-4): 281-4, 2015 Apr 30.
Article in English | MEDLINE | ID: mdl-25769472

ABSTRACT

Sera from Dirofilaria immitis-experimentally infected dogs treated with a combination of ivermectin/doxycycline were analysed for doxycycline levels by HPLC and anti-Wolbachia Surface Protein (rWSP) antibodies by ELISA and compared with sera from dogs treated with doxycycline alone. Results show that doxycycline levels were not statistically different between the two groups. Circulating anti-WSP antibody titres were markedly lower in both treatment groups when compared to control D. immitis infected dogs, indicating that doxycycline is able to reduce Wolbachia and prevent the immune response against the bacteria. The combination treatment protocol has been shown to be highly adulticidal and further studies are needed to better understand the interaction between doxycycline and ivermectin in D. immitis infected dogs.


Subject(s)
Antibodies, Bacterial/blood , Dirofilariasis/drug therapy , Dog Diseases/parasitology , Doxycycline/blood , Ivermectin/therapeutic use , Wolbachia/immunology , Animals , Anti-Bacterial Agents/administration & dosage , Anti-Bacterial Agents/blood , Anti-Bacterial Agents/therapeutic use , Antiparasitic Agents/administration & dosage , Antiparasitic Agents/therapeutic use , Dog Diseases/drug therapy , Dog Diseases/immunology , Dogs , Doxycycline/administration & dosage , Doxycycline/therapeutic use , Drug Therapy, Combination , Enzyme-Linked Immunosorbent Assay , Female , Ivermectin/administration & dosage , Male
7.
J Vet Pharmacol Ther ; 37(4): 325-31, 2014 Aug.
Article in English | MEDLINE | ID: mdl-24602109

ABSTRACT

We investigated the effects of nonselective muscarinic antagonist (atropine) and of selective muscarinic subtype 1 (M1), 2 (M2), 3 (M3) antagonists (VU0255035, methoctramine, pFHHSiD, respectively) on the contractions evoked by electrical field stimulation (EFS) or by exogenous ACh in isolated horse bronchial muscle. Atropine completely inhibited neurogenic contractions in a concentration-dependent fashion, whereas selective muscarinic antagonists induced relevant modifications only at the highest concentration tested. Experiments with selective muscarinic antagonists in combination showed that only the simultaneous blockade of M1 /M3 or M2 /M3 receptors was able to induce a nearly complete suppression of contractions. The contractions induced by exogenous ACh were competitively antagonized only by atropine (pA2 = 9.01 ± 0.05). M3 selective antagonist, up to 10(-6) m, caused a moderate concentration-dependent rightward shift of ACh curve (pA2 = 7.96 ± 0.10). These data show that M3 muscarinic receptors possess a central role in mediating cholinergic contraction of horse bronchi, while M1 and M2 receptors seem to have a cooperative role. Selective muscarinic antagonists seem unlikely to be useful against bronchoconstriction associated with airway diseases in horses. Conversely, compounds with selectivity for both M1 and M3 receptors could be as effective as traditional anticholinergics and induce fewer cardiac side effects.


Subject(s)
Bronchi/metabolism , Bronchial Spasm/drug therapy , Horses , Receptor, Muscarinic M1/antagonists & inhibitors , Receptor, Muscarinic M2/antagonists & inhibitors , Receptor, Muscarinic M3/antagonists & inhibitors , Animals , Bronchial Spasm/metabolism , Diamines/pharmacology , Gene Expression Regulation/physiology , Male , Parasympatholytics/pharmacology , Piperidines/pharmacology , Receptor, Muscarinic M1/genetics , Receptor, Muscarinic M1/metabolism , Receptor, Muscarinic M2/genetics , Receptor, Muscarinic M2/metabolism , Receptor, Muscarinic M3/genetics , Receptor, Muscarinic M3/metabolism , Sulfonamides/pharmacology , Thiadiazoles/pharmacology
8.
J Small Anim Pract ; 53(7): 411-5, 2012 Jul.
Article in English | MEDLINE | ID: mdl-22747734

ABSTRACT

OBJECTIVE: To evaluate the effect of intraurethral administration of atracurium besylate for urinary obstruction resulting from urethral plugs in male cats. METHODS: Forty-five male cats were divided into the treatment group (n=25), in which 4 mL atracurium besylate solution (0·5 mg/mL) was injected into the urethral lumen, and the control group (n=20), treated with saline. All cats were then submitted to retrograde flushing until the removal of the occlusion was obtained. RESULTS: The percentage of cats in which the plug was removed at the first attempt was significantly (P<0·05) higher in the treatment group (64%) than in the control group (15%). Moreover, the mean (±SD) time required for the removal of the urethral obstruction was significantly shorter in the treatment group than in the control group (21·1 ±16·2 seconds versus 235·2 ±132·4 seconds; P<0·001). CLINICAL SIGNIFICANCE: The results of this study indicate that in adult male cats with urethral plugs, urethral administration of atracurium besylate increases the proportion of animals in which the obstruction is removed at the first attempt and reduces the time required to remove the urethral plugs.


Subject(s)
Atracurium/therapeutic use , Cat Diseases/drug therapy , Neuromuscular Nondepolarizing Agents/therapeutic use , Urethral Obstruction/veterinary , Animals , Atracurium/administration & dosage , Cats , Male , Neuromuscular Nondepolarizing Agents/administration & dosage , Time Factors , Treatment Outcome , Urethral Obstruction/drug therapy
9.
Equine Vet J ; 44(3): 368-70, 2012 May.
Article in English | MEDLINE | ID: mdl-21883413

ABSTRACT

The effects of preferential µ (morphine), selective µ (fentanyl), selective κ (compound U69593) opioid receptor agonists, and nonselective (naloxone) and selective µ (naloxonazine) antagonists on equine small intestinal motility were evaluated in vitro. Samples of circular muscle from equine jejunum were placed in isolated organ baths and drug-induced modifications of both spontaneous and electrically evoked contractile activity were measured. None of the opioid agonists induced a significant change in spontaneous contractions. Fentanyl and U69593 reduced electrically induced contractions, whereas morphine reduced them only slightly. Naloxone competitively antagonised U69593, but both naloxone and naloxonazine were unable to counteract the inhibition of contractions induced by fentanyl. The inhibition of contractions shown by fentanyl is therefore probably not mediated by opioid receptors, but due to an anticholinergic activity of this drug. In summary, these data showed an inhibitory effect exerted by κ receptors on equine small intestinal motility, whereas the role of µ receptors seemed marginal and would need further characterisation.


Subject(s)
Analgesics, Opioid/pharmacology , Gastrointestinal Motility/physiology , Horses/physiology , Intestine, Small/physiology , Receptors, Opioid, kappa/metabolism , Receptors, Opioid, mu/metabolism , Animals , Benzeneacetamides/pharmacology , Dose-Response Relationship, Drug , Fentanyl/pharmacology , Male , Morphine/pharmacology , Naloxone/analogs & derivatives , Naloxone/pharmacology , Narcotic Antagonists/pharmacology , Pyrrolidines/pharmacology , Receptors, Opioid, kappa/agonists , Receptors, Opioid, mu/agonists
10.
Musculoskelet Surg ; 94(1): 33-40, 2010 May.
Article in English | MEDLINE | ID: mdl-20204562

ABSTRACT

Prosthetic exposure is a severe complication of total knee arthroplasty. Many factors are responsible for failed wound healing, and successful salvage of total knee arthroplasty requires early identification of infection, antecedent events related with wound healing failure, aggressive surgical debridement and early appropriate soft-tissue coverage with local skin, fasciocutaneous, muscle, neurocutaneous or perforator flaps. In this report, we present 15 cases of exposed knee prosthesis treated with island sural neurocutaneous flap. Follow-up showed favorable clinical outcomes: all flaps survived and only two cases of hematoma and one of aseptic phystula occurred. According to our results, the island neurofasciocutaneous sural flap represents a sensate reconstructive alternative for providing fine and dependable soft tissue for covering skin defects around the knee.


Subject(s)
Knee Prosthesis , Surgical Flaps , Surgical Wound Dehiscence/surgery , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged
11.
Radiol Med ; 115(3): 354-67, 2010 Apr.
Article in English, Italian | MEDLINE | ID: mdl-19902329

ABSTRACT

PURPOSE: This study aimed to evaluate the diagnostic accuracy of stress electrocardiogram (ECG) and computed tomography coronary angiography (CTCA) for the detection of significant coronary artery stenosis (> or =50%) in the real world using conventional CA as the reference standard. MATERIALS AND METHODS: A total of 236 consecutive patients (159 men, 77 women; mean age 62.8+/-10.2 years) at moderate risk and with suspected coronary artery disease (CAD) were enrolled in the study and underwent stress ECG, CTCA and CA. The CTCA scan was performed after i.v. administration of a 100-ml bolus of iodinated contrast material. The stress ECG and CTCA reports were used to evaluate diagnostic accuracy compared with CA in the detection of significant stenosis > or =50%. RESULTS: We excluded 16 patients from the analysis because of the nondiagnostic quality of stress ECG and/or CTCA. The prevalence of disease demonstrated at CA was 62% (n=220), 51% in the population with comparable stress ECG and CTCA (n=147) and 84% in the population with equivocal stress ECG (n=73). Stress ECG was classified as equivocal in 73 cases (33.2%), positive in 69 (31.4%) and negative in 78 (35.5%). In the per-patient analysis, the diagnostic accuracy of stress ECG was sensitivity 47%, specificity 53%, positive predictive value (PPV) 51% and negative predictive value (NPV) 49%. On stress ECG, 40 (27.2%) patients were misclassified as negative, and 34 (23.1%) patients with nonsignificant stenosis were overestimated as positive. The diagnostic accuracy of CTCA was sensitivity 96%, specificity 65%, PPV 74% and NPV 94%. CTCA incorrectly classified three (2%) as negative and 25 (17%) as positive. The difference in diagnostic accuracy between stress ECG and CTCA was significant (p<0.01). CONCLUSIONS: CTCA in the real world has significantly higher diagnostic accuracy compared with stress ECG and could be used as a first-line study in patients at moderate risk.


Subject(s)
Coronary Angiography/methods , Coronary Stenosis/diagnosis , Electrocardiography/methods , Exercise Test , Tomography, X-Ray Computed/methods , Adult , Aged , Aged, 80 and over , Chi-Square Distribution , Contrast Media , Coronary Stenosis/diagnostic imaging , Coronary Stenosis/physiopathology , Diagnosis, Differential , Female , Humans , Male , Middle Aged , Predictive Value of Tests , Retrospective Studies , Sensitivity and Specificity
12.
Res Vet Sci ; 86(1): 129-35, 2009 Feb.
Article in English | MEDLINE | ID: mdl-18565556

ABSTRACT

We investigated the effects of nonselective cyclooxygenase (COX) inhibitors (indomethacin and flunixin meglumine) and selective COX-1 (SC-560) or COX-2 (celecoxib, DUP-398 and NS-697) inhibitors on horse small bowel motility in vitro. At this purpose, samples of equine ileum were put in isolated organ baths for the motility experiments. Nonselective COX inhibitors were devoid of major effects on motility, except for an inhibition of tonic contraction shown by flunixin meglumine. SC-560, selective COX-1 inhibitor, was devoid of significant effects on ileal motility. Selective COX-2 inhibitors reduced both tonic contraction and spontaneous phasic contractions, while prostaglandin (PG) receptor antagonists were uneffective. Some of the intestinal samples were submitted to histological investigation or reverse transcription-polymerase chain reaction (RT-PCR), which revealed the presence of an inflammation reaction and the presence of both COX isoforms mRNAs. Present data support the hypothesis that the effects of COX inhibitors on horse small intestinal motility are not linked to PG depletion.


Subject(s)
Cyclooxygenase Inhibitors/pharmacology , Gastrointestinal Motility/drug effects , Horses/physiology , Intestine, Small/drug effects , Animals , Celecoxib , Clonixin/analogs & derivatives , Clonixin/pharmacology , Cyclooxygenase 1/biosynthesis , Cyclooxygenase 1/genetics , Cyclooxygenase 2/biosynthesis , Cyclooxygenase 2/genetics , Gastrointestinal Motility/physiology , Histocytochemistry/veterinary , In Vitro Techniques , Indomethacin/pharmacology , Intestine, Small/enzymology , Intestine, Small/physiology , Male , Pyrazoles/pharmacology , RNA, Messenger/biosynthesis , RNA, Messenger/genetics , Reverse Transcriptase Polymerase Chain Reaction/veterinary , Sulfonamides/pharmacology
13.
Drug Discov Ther ; 3(2): 71-6, 2009 Apr.
Article in English | MEDLINE | ID: mdl-22495480

ABSTRACT

Nonsteroidal anti-inflammatory drug (NSAID)-induced injury on gastrointestinal tract is well documented, and jejunal inflammation caused by indomethacin in rats is a broadly used experimental model of enteritis. We evaluated the effect of oral curcumin, a compound known to possess anti-inflammatory and anti-oxidant properties, on indomethacin-induced enteritis in the rat. Curcumin (50, 100, and 300 mg/kg) was given to rats by oral gavage 48, 24, and 1 h before enteritis was induced by intragastric administration of 20 mg/kg indomethacin. After 24 h, intestinal macroscopic lesions, myeloperoxidase activity and lipid peroxidation levels were assessed. Curcumin at the dose of 50 mg/kg was uneffective, while at the dose of 100 and 300 mg/kg significantly reduced macroscopic damage caused by indomethacin. By contrast, curcumin at all tested doses was unable to modify indomethacin-induced increases of myeloperoxidase and lipid peroxidation. Curcumin (100 and 300 mg/kg) significantly increased lipid peroxidation level in normal intestinal tissues of rats. Present data show that oral curcumin protects against macroscopic injury induced by indomethacin, leaving unaffected neutrophil infiltration and oxidative cell damage, thus suggesting that this beneficial effect is due to mechanisms not involving anti-inflammatory or antioxidant activities.

14.
Radiol Med ; 113(2): 163-80, 2008 Mar.
Article in English, Italian | MEDLINE | ID: mdl-18386119

ABSTRACT

PURPOSE: This study was done to evaluate the diagnostic accuracy of 64-slice computed tomography coronary angiography (CTCA) for the detection of significant coronary artery stenosis in the real clinical world. MATERIALS AND METHOD: From the CTCA database of our institution, we enrolled 145 patients (92 men, 52 women, mean age 63.4 +/- 10.2 years) with suspected coronary artery disease. All patients presented with atypical or typical chest pain and underwent CTCA and conventional coronary angiography (CA). For the CTCA scan (Sensation 64, Siemens, Germany), we administered an IV bolus of 100 ml of iodinated contrast material (Iomeprol 400 mgI/ml, Bracco, Italy). The CTCA and CA reports used to evaluate diagnostic accuracy adopted > or =50% and > or =70%, respectively, as thresholds for significant stenosis. RESULT: Eleven patients were excluded from the analysis because of the nondiagnostic quality of CTCA. The prevalence of disease demonstrated at CA was 63% (84/134). Sensitivity, specificity and positive and negative predictive values for CTCA on a per-segment, per-vessel, and per-patient basis were 75.6%, 85.1%, 97.6%; 86.9%, 81.8%, 58.0%; 48.2%, 68.1%, 79.6%; and 95.7%, 92.3%, 93.5%, respectively. Only two out of 134 eligible patients were false negative. Heart rate did not significantly influence diagnostic accuracy, whereas the absence or minimal presence of coronary calcification improved diagnostic accuracy. The positive and negative likelihood ratios at the per-patient level were 2.32 and 0.041, respectively. CONCLUSION: CTCA in the real clinical world shows a diagnostic performance lower than reported in previous validation studies. The excellent negative predictive value and negative likelihood ratio make CTCA a noninvasive gold standard for exclusion of significant coronary artery disease.


Subject(s)
Coronary Angiography , Coronary Artery Disease/diagnostic imaging , Coronary Stenosis/diagnostic imaging , Tomography, X-Ray Computed , Aged , Contrast Media/pharmacology , Coronary Angiography/methods , Female , Humans , Iopamidol/analogs & derivatives , Italy , Male , Medical Records , Middle Aged , Odds Ratio , Predictive Value of Tests , Research Design , Sensitivity and Specificity , Tomography, X-Ray Computed/methods
15.
Minerva Cardioangiol ; 56(1): 1-11, 2008 Feb.
Article in English | MEDLINE | ID: mdl-18432163

ABSTRACT

AIM: Elective percutaneous coronary intervention (PCI) of left main coronary artery disease remains an important challenge in interventional cardiology. Nonetheless, this procedure is useful for patients with significant left main stenosis who are candidates for revascularization but unsuitable for coronary artery bypass graft. In this study the Authors sought to evaluate the safety and long-term mortality of PCI of left main coronary artery disease. Secondary endpoints were to analyse long-term mortality in various categories (patients<75 years vs patients<75 years, males vs females, drug eluting stents [DES] vs bare metal stents [BMS]). METHODS: Between January 2003 and December 2006, 131 patients who consecutively under-went PCI on left main stem were reviewed. The mean follow-up time was 14.0+/-10.8 months. Survival curves were plotted with the Kaplan-Meier method and compared with the Log-rank test. RESULTS: The Kaplan-Meier curves did not show statistically significant differences in terms of all-cause mortality at follow-up between protected and unprotected left main coronary disease (12% vs 14% respectively, P=0.67). In the protected left main group, there was a significantly higher use of DES compared with unprotected left main group (59% vs 43%, P=0.02). CONCLUSION: The data show that PCI for left main coronary disease is feasible, safe and with an acceptable long-term mortality rate in patients at high-surgical risk unsuitable for surgical revascularization.


Subject(s)
Angioplasty, Balloon, Coronary , Coronary Artery Disease/mortality , Coronary Artery Disease/therapy , Myocardial Revascularization/methods , Aged , Aged, 80 and over , Coronary Artery Bypass/methods , Coronary Artery Disease/surgery , Drug-Eluting Stents , Elective Surgical Procedures/methods , Feasibility Studies , Female , Humans , Italy , Kaplan-Meier Estimate , Male , Middle Aged , Retrospective Studies , Severity of Illness Index , Stents , Survival Analysis
16.
Radiol Med ; 112(7): 969-81, 2007 Oct.
Article in English, Italian | MEDLINE | ID: mdl-17952682

ABSTRACT

PURPOSE: Our aim was to evaluate the diagnostic accuracy of 64-slice computed tomography coronary angiography (MSCT-CA) for detecting significant stenosis (>or=50% lumen reduction) in a population of patients at low to intermediate risk. MATERIALS AND METHODS: We studied 72 patients (38 men, 34 women, mean age 53.9+/-8.0 years) with atypical or typical chest pain and stratified in the low-to intermediate risk category. MSCT-CA (Sensation 64 Cardiac, Siemens, Germany) was performed after IV administration of 100 ml of iodinated contrast material (Iomeprol 400 mgI/ml, Bracco, Italy). Two observers, blinded to the results of conventional coronary angiography (CAG), assessed the MSCT-CA scans in consensus. Diagnostic accuracy for detecting significant stenosis was calculated. RESULTS: CAG demonstrated the absence of significant disease in 70.1% of patients (51/72). No patient was excluded from MSCT-CA. There were 37 significant lesions on 1,098 available coronary segments. Sensitivity, specificity and positive and negative predictive value of MSCT-CA for detecting significant coronary artery on a per-segment basis were 100%, 98.6%, 71.2% and 100%, respectively. All patients with at least one significant lesion were correctly identified by MSCT-CA. MSCT-CA scored 15 false positives on a per-segment base, which affected only marginally the per-patient performance (only one false positive). CONCLUSIONS: We concluded that 64-slice CT-CA is a diagnostic modality with high sensitivity and negative predictive value in patients at low to intermediate risk.


Subject(s)
Coronary Angiography/methods , Coronary Disease/diagnostic imaging , Tomography, Spiral Computed/methods , Algorithms , Chest Pain , Contrast Media , Coronary Stenosis/diagnostic imaging , Data Interpretation, Statistical , Electrocardiography , Female , Humans , Iopamidol/analogs & derivatives , Male , Middle Aged , Predictive Value of Tests , Risk Factors , Sensitivity and Specificity , Ventricular Function, Left
17.
Radiol Med ; 112(4): 526-37, 2007 Jun.
Article in English, Italian | MEDLINE | ID: mdl-17568993

ABSTRACT

PURPOSE: The purpose of this study was to assess the diagnostic accuracy of 64-slice computed tomography (64-CT) coronary angiography in the detection of coronary in-stent restenosis. MATERIALS AND METHODS: Ninety-five patients (72 men and 23 women, mean age 58+/-8 years) with previous percutaneous coronary intervention with stenting and suspected restenosis underwent 64-CT (Sensation 64, Siemens). The mean time between stent deployment and 64-CT was 6.1+/-4.2 months. The scan parameters were: slices 32 x 2, individual detector width 0.6 mm, rotation time 0.33 s, feed 3.84 mm/rotation, 120 kV, 900 mAs. After the intravenous administration of iodinated contrast material (Iomeprol 400 mgI/ml, Iomeron, Bracco) and a bolus chaser (40 ml of saline), the scan was completed in <12 s. All coronary segments with a stent were assessed on 64-CT by two observers in consensus and judged as: patent, with intimal hyperplasia (lumen reduction of <50%), with in-stent restenosis (> or =50%), or with in-stent occlusion (100%). The consensus reading was compared with conventional coronary angiography. RESULTS: Four patients were excluded because of insufficient image quality. In the remaining 91, we assessed 102 stents (31 RCA; 10 LM; 54 LAD; 7 CX). In 14 (13.7%) stents, in-stent restenosis (n=8) or in-stent occlusion (n=6) was found. Intimal hyperplasia was detected in 11 (10.8%) stents. The sensitivity and negative predictive value of 64-CT for in-stent occlusion were 100% and 100%, respectively, whereas for all stenoses, >50% they were 92.9% and 98.7%, respectively. CONCLUSIONS: We found that 64-CT has a high diagnostic accuracy for the detection of in-stent restenosis in a selected patient population.


Subject(s)
Coronary Angiography/methods , Coronary Restenosis/diagnostic imaging , Stents , Tomography, X-Ray Computed , Female , Humans , Male , Middle Aged , Reproducibility of Results
18.
Inflamm Res ; 55(10): 416-22, 2006 Oct.
Article in English | MEDLINE | ID: mdl-17109068

ABSTRACT

OBJECTIVE AND DESIGN: To investigate the severity and duration of colitis induced by two different doses of 2,4,6-trinitrobenzenesulfonic acid (TNBS) and the changes in mast cell number in acute inflammation and in the recovery process of colitis. METHODS: Colitis was induced in rats by an enema of TNBS (10 or 30 mg) in 25% ethanol. Macroscopic and histologic changes of the colon, colon weight and mast cell counts were examined at various times (7, 30 and 60 days) after colitis induction. RESULTS: TNBS induced a colonic damage which was dose-related for both severity and time necessary to complete recovery. On day 7 after colitis induction 10 mg TNBS induced macroscopic and microscopic alterations of colonic architecture that completely resolved at day 60. By contrast, 30 mg TNBS induced massive necrosis, thickening of the colon, severe histologic changes that were only partially reversed after two months. Mast cell number in the submucosa and muscularis propria decreased significantly in the acute phase of inflammation (7 days) and slowly increased thereafter, reaching a maximum level (up to about 5-fold) at day 60 after both doses of TNBS. CONCLUSIONS: Present data confirm the ability of TNBS to induce in rats damage to the colon that was dose-dependent for severity and duration. Moreover, these data unravel a different role of mast cells in TNBS-induced colitis: an early degranulation in the acute phase of inflammation and a subsequent accumulation of mast cells in the late phase of the disease, associated with tissue repair.


Subject(s)
Colitis/immunology , Mast Cells/immunology , Animals , Cell Degranulation/drug effects , Colitis/chemically induced , Colitis/pathology , Colon/drug effects , Colon/immunology , Colon/pathology , Male , Mast Cells/drug effects , Mast Cells/physiology , Rats , Rats, Wistar , Trinitrobenzenesulfonic Acid
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