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1.
Cardiovasc Intervent Radiol ; 42(6): 812-819, 2019 Jun.
Article in English | MEDLINE | ID: mdl-30783778

ABSTRACT

OBJECTIVES: To evaluate the incidence and the time of onset of early micro-embolism after CAS (carotid artery stenting) with two different mesh-covered stents and to assess the role of DW-MRI (Diffusion-weighted magnetic resonance imaging) in their prediction. METHODS: Single-institution prospective study including 50 patients (33 male, median age 74 years) who underwent CAS with Roadsaver® or CGuard™. All patients with primary stenosis (37/50, 74%) had carotid plaque DW-MRI pre-procedure, with both qualitative evaluation of the hyperintensity and ADC (apparent diffusion coefficient) measurement of the plaque. All patients had brain DW-MRI pre-procedure, at 1 h, 24 h and 30 days post-procedure to evaluate the appearance of hyperintense lesions over time. Imaging analysis was performed in a double-blinded fashion by two radiologists. RESULTS: There were no statistically significant differences between the two stents both in the incidence at 1 h (P = 0.23) and 24 h (P = 0.36) and in the volume of new DWI hyperintense brain lesions at 24 h (P = 0.27). Thirty-four new asymptomatic lesions in 19 patients (38%) were reported: 4 (11.8%) at 1 h, 30 (88.2%) at 24 h. The 30-day DWI-MR showed complete resolution of all lesions and no evidence of new lesion. The incidence of new lesions at 24 h resulted significantly higher in patients with DWI hyperintense carotid plaques (12/16, 75% vs. 0/21, 0%, P < 0.0001). This result was paralleled by the difference in ADC value (0.83 ± 0.21 vs. 1.42 ± 0.52). CONCLUSION: The majority of early asymptomatic brain lesion occurred during the first 24 h after CAS. Pre-procedure high DWI signal of the plaque was associated with an increased incidence of post-procedure microembolizations.


Subject(s)
Carotid Stenosis/therapy , Diffusion Magnetic Resonance Imaging/methods , Embolization, Therapeutic/methods , Intracranial Embolism/diagnostic imaging , Postoperative Complications/diagnostic imaging , Stents/adverse effects , Aged , Carotid Arteries/diagnostic imaging , Carotid Arteries/surgery , Carotid Stenosis/diagnostic imaging , Equipment Design , Female , Humans , Intracranial Embolism/etiology , Male , Postoperative Complications/etiology , Prospective Studies , Surgical Mesh , Treatment Outcome
2.
Sports Med ; 46(8): 1183-90, 2016 Aug.
Article in English | MEDLINE | ID: mdl-26825778

ABSTRACT

BACKGROUND AND OBJECTIVE: Many studies concern the management of young patients with symptomatic Wolff-Parkinson-White (WPW) syndrome, but little information exists on the significance and prognosis of ventricular pre-excitation (VPE) in asymptomatic children. The aim of the study was to evaluate the risk of sudden death in young athletes with asymptomatic VPE by transesophageal electrophysiological study (TEEPS) and their sports eligibility after the risk assessment and/or ablative treatment. METHODS: Ninety-one asymptomatic children and adolescents underwent TEEPS both at rest and during adrenergic stress (exercise testing or isoproterenol infusion). After electrophysiological testing, patients were assessed in the 36 months of follow-up. RESULTS: Thirty-three patients (36.3 %) had a benign form of VPE and were allowed to participate in competitions. Ten patients (11 %) were at borderline risk; thus, sport eligibility was evaluated individually. Forty-eight patients (52.7 %) showed inducible sustained atrioventricular reentrant tachycardia and/or atrial fibrillation (AF), 11 of whom (12.1 % of total population) had a potential risk of sudden cardiac death due to AF inducibility during physical stress. Forty-five young athletes underwent transcatheter ablation (TCA). TCA was interrupted in 12 patients (26.7 %) because of the high procedural risk linked to septal accessory pathway (AP) location. There were no TCA-related complications, and all patients remained asymptomatic during follow-up. CONCLUSION: Most of the young athletes with asymptomatic VPE may be allowed to participate in competitive sports after an adequate risk assessment and/or ablative treatment. However, in our opinion, special care should be taken to avoid procedural complications, which are unacceptable in asymptomatic patients.


Subject(s)
Pre-Excitation Syndromes/complications , Pre-Excitation Syndromes/therapy , Risk Assessment , Sports , Adolescent , Asymptomatic Diseases , Catheter Ablation , Child , Death, Sudden, Cardiac/etiology , Electrophysiologic Techniques, Cardiac , Female , Humans , Male , Pre-Excitation Syndromes/physiopathology
3.
AJNR Am J Neuroradiol ; 34(10): 2000-4, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23721896

ABSTRACT

BACKGROUND AND PURPOSE: The hypothesis that MS could be provoked by a derangement of the blood outflow from the brain has been largely discredited. In part, it was because data on the normal pattern of outflow are scarce and obtained with different methods. The aim of this study was to evaluate the normal pattern of outflow for the vertebral and internal jugular veins in healthy subjects with multigate color Doppler. MATERIALS AND METHODS: Twenty-five volunteers were studied to assess vessel area, mean velocity, and flow for the vertebral and internal jugular veins in the supine and sitting positions. RESULTS: In the sitting position, flow decreases, both in vertebral veins and internal jugular veins, as the total vessel area decreases (from 0.46 ± 0.57 to 0.09 ± 0.08 cm(2)), even if the mean velocity increases (from 12.58 ± 10.19 to 24.14 ± 17.60 cm/s). Contrary to what happens to the blood inflow, outflow in the supine position, through vertebral and internal jugular veins, is more than twice the outflow in the sitting position (739.80 ± 326.32 versus 278.24 ± 207.94 mL/min). In the sitting position, on application of very low pressure to the skin with the sonography probe, internal jugular veins rarely appear to occlude. A pronounced difference of diameter between internal jugular veins was present in approximately one-third of subjects. CONCLUSIONS: Our results support the view that other outflow pathways, like the vertebral plexus, play a major role in the normal physiology of brain circulation and must be assessed to obtain a complete picture of blood outflow.


Subject(s)
Blood Flow Velocity/physiology , Jugular Veins/diagnostic imaging , Jugular Veins/physiology , Pulsatile Flow/physiology , Ultrasonography, Doppler, Color , Adult , Brachiocephalic Veins/diagnostic imaging , Brachiocephalic Veins/physiology , Catheterization, Central Venous , Female , Healthy Volunteers , Humans , Male , Middle Aged , Multiple Sclerosis/complications , Multiple Sclerosis/physiopathology , Posture , Subclavian Vein/diagnostic imaging , Subclavian Vein/physiology , Supine Position , Venous Insufficiency/complications , Venous Insufficiency/physiopathology , Young Adult
4.
Cerebellum ; 12(5): 623-31, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23553468

ABSTRACT

Cerebellum seems to have a role both in feeding behavior and emotion regulation; therefore, it is a region that warrants further neuroimaging studies in eating disorders, severe conditions that determine a significant impairment in the physical and psychological domain. The aim of this study was to examine the cerebellum intrinsic connectivity during functional magnetic resonance imaging resting state in anorexia nervosa (AN), bulimia nervosa (BN), and healthy controls (CN). Resting state brain activity was decomposed into intrinsic connectivity networks (ICNs) using group spatial independent component analysis on the resting blood oxygenation level dependent time courses of 12 AN, 12 BN, and 10 CN. We extracted the cerebellar ICN and compared it between groups. Intrinsic connectivity within the cerebellar network showed some common alterations in eating disordered compared to healthy subjects (e.g., a greater connectivity with insulae, vermis, and paravermis and a lesser connectivity with parietal lobe); AN and BN patients were characterized by some peculiar alterations in connectivity patterns (e.g., greater connectivity with the insulae in AN compared to BN, greater connectivity with anterior cingulate cortex in BN compared to AN). Our data are consistent with the presence of different alterations in the cerebellar network in AN and BN patients that could be related to psychopathologic dimensions of eating disorders.


Subject(s)
Cerebellum/pathology , Cerebral Cortex/pathology , Emotions/physiology , Feeding and Eating Disorders/physiopathology , Adolescent , Adult , Brain Mapping/methods , Cerebellum/physiopathology , Cerebral Cortex/physiopathology , Feeding and Eating Disorders/pathology , Female , Functional Neuroimaging/methods , Humans , Magnetic Resonance Imaging/methods , Male , Nerve Net/pathology , Nerve Net/physiopathology , Young Adult
5.
Radiol Med ; 118(3): 386-400, 2013 Apr.
Article in English | MEDLINE | ID: mdl-22872455

ABSTRACT

PURPOSE: We sought to evaluate the feasibility and efficacy of percutaneous treatment of early postoperative biliary complications. The primary aims were to evaluate clinical and technical success and complications and perioperative mortality, and secondary aims were to evaluate treatment duration and recurrence rate. MATERIALS AND METHODS: Between March 2007 and March 2010, 75 patients (42 men and 33 women; age range, 17-88 years; mean age, 60.8 years) underwent interventional radiology procedures to treat early postoperative biliary complications of biliary and pancreatic-duodenal surgery with biliodigestive anastomosis (37.7%), laparoscopic cholecystectomy (30.6%), hepatic resection (21.1%) and several other surgical procedures (10.6%). Complications included fistulas (73%), stenoses (20%) and complete bile duct transections (7%). RESULTS: Interventional radiology achieved complete clinical success in 74 cases (85.9%) and in particular in 95.2% of fistulas, 76.5% of stenoses and 33.3% of complete bile duct transections. Mean indwelling catheter time was 34.9 days, with an average of 4.1 procedures. There were two cases of severe haemobilia (2.3%). Minor complications occurred in 7% of cases. Perioperative mortality rate was 1.2% and overall recurrence rate 6.7% (range, 1-18 months; mean, 10 months), with recurrences occurring predominantly in stenoses. All patients were retreated successfully. CONCLUSIONS: Percutaneous procedures are feasible, effective and safe for treating early postoperative biliary complications. They provide a valuable alternative to presendoscopy, which is precluded in many of these patients, and to surgery, which has higher morbidity and mortality rates.


Subject(s)
Biliary Tract Diseases/surgery , Duodenal Diseases/surgery , Liver Diseases/surgery , Pancreatic Diseases/surgery , Postoperative Complications/surgery , Radiography, Interventional , Ultrasonography, Interventional , Adolescent , Adult , Aged , Aged, 80 and over , Feasibility Studies , Female , Humans , Laparoscopy , Male , Middle Aged , Recurrence , Reoperation , Treatment Outcome
6.
Radiol Med ; 118(3): 379-85, 2013 Apr.
Article in English | MEDLINE | ID: mdl-22744357

ABSTRACT

PURPOSE: This retrospective analysis was carried out to assess the feasibility and results of transjugular intrahepatic portal systemic shunt (TIPS) performed with ultrasound (US)-guided percutaneous puncture of the hepatic veins. MATERIAL AND METHODS: Over a period of 3 years, 153 patients were treated with TIPS at our centre. In eight cases, a percutaneous puncture of the middle (n=7) or right (n=1) hepatic vein was required because the hepatic vein ostium was not accessible. Indications for TIPS were bleeding (n=1), Budd-Chiari syndrome (n=1), ascites (n=2), reduced portal flow (n=1) and incomplete portal thrombosis (n=3). A 0.018-in. guidewire was anterogradely introduced into the hepatic vein to the inferior vena cava (IVC) through a 21-gauge needle. In the meantime, a 25-mm snare-loop catheter was introduced through the jugular access to retrieve the guidewire, achieving through-andthrough access. Then, a Rosch-Uchida set was used to place the TIPS with the traditional technique. RESULTS: Technical success was achieved in all patients. There was one case of stent thrombosis. One patient died of pulmonary oedema. Three patients were eligible for liver transplantation, whereas the others were excluded due to shunt thrombosis (n=1) and previous nonhepatic neoplasms (n=3). CONCLUSIONS: The percutaneous approach to hepatic veins is rapid and safe and may be useful for avoiding traumatic liver injuries.


Subject(s)
Hepatic Veins/surgery , Hypertension, Portal/etiology , Hypertension, Portal/surgery , Portasystemic Shunt, Transjugular Intrahepatic/methods , Ultrasonography, Interventional , Adult , Aged , Contrast Media , Feasibility Studies , Female , Humans , Iohexol/analogs & derivatives , Male , Middle Aged , Postoperative Complications , Punctures , Retrospective Studies , Treatment Outcome
7.
Radiol Med ; 117(1): 46-53, 2012 Feb.
Article in English, Italian | MEDLINE | ID: mdl-21509549

ABSTRACT

PURPOSE: We conducted a single-centre retrospective analysis of the results and predictors of early mortality in emergency transjugular intrahepatic portosystemic shunt (TIPS). MATERIALS AND METHODS: Between 1992 and 2009, 82 patients with refractory variceal bleeding underwent emergency TIPS at our Institution. The success and complications of the procedure were assessed for each patient. Child class, platelet count, prothrombin time, serum creatinine levels and venous pressure before and after TIPS were studied statistically as possible prognostic factors of early mortality. RESULTS: The technical, haemodynamic, and clinical success rates were 91.6%, 78% and 86.6%, respectively. Complications occurred in 21 cases (25.6%): eight were major (two stent migrations, one pulmonary embolism, one haemoperitoneum, one haemobilia, three intrahepatic haematomas) and 13 were minor (encephalopathy responsive to medical therapy). Twenty-one patients (25.6%) died due to the following causes: disseminated intravascular coagulation (DIC) (n=2), haemorrhage (n=8), cardiopulmonary failure (n=2) and liver failure (n=9). The predictors of mortality were Child's class C, high serum creatinine and prolonged prothrombin time. CONCLUSIONS: The technical success of TIPS may not lead to haemodynamic and clinical success. Complications are often due to impaired coagulation and inadequacy of the stent-graft. Early mortality is only influenced by pre-existing clinical and laboratory factors.


Subject(s)
Esophageal and Gastric Varices/mortality , Esophageal and Gastric Varices/surgery , Portasystemic Shunt, Transjugular Intrahepatic/adverse effects , Portasystemic Shunt, Transjugular Intrahepatic/mortality , Adult , Aged , Aged, 80 and over , Creatinine/blood , Emergency Treatment , Female , Follow-Up Studies , Humans , Male , Middle Aged , Platelet Count , Postoperative Complications/epidemiology , Predictive Value of Tests , Prognosis , Prothrombin Time , Retrospective Studies , Treatment Outcome , Venous Pressure
9.
Braz. j. med. biol. res ; 42(10): 912-917, Oct. 2009. ilus, tab
Article in English | LILACS | ID: lil-526193

ABSTRACT

Cyhalothrin, a pyrethroid insecticide, induces stress-like symptoms, increases c-fos immunoreactivity in the paraventricular nucleus of the hypothalamus, and decreases innate immune responses in laboratory animals. Macrophages are key elements in cellular immune responses and operate at the tumor-host interface. This study investigated the relationship among cyhalothrin effects on Ehrlich tumor growth, serum corticosterone levels and peritoneal macrophage activity in mice. Three experiments were done with 10 experimental (single gavage administration of 3.0 mg/kg cyhalothrin daily for 7 days) and 10 control (single gavage administration of 1.0 mL/kg vehicle of cyhalothrin preparation daily for 7 days) isogenic BALB/c mice in each experiment. Cyhalothrin i) increased Ehrlich ascitic tumor growth after ip administration of 5.0 x 106 tumor cells, i.e., ascitic fluid volume (control = 1.97 ± 0.39 mL and experimental = 2.71 ± 0.92 mL; P < 0.05), concentration of tumor cells/mL in the ascitic fluid (control = 111.95 ± 16.73 x 106 and experimental = 144.60 ± 33.18 x 106; P < 0.05), and total number of tumor cells in the ascitic fluid (control = 226.91 ± 43.22 x 106 and experimental = 349.40 ± 106.38 x 106; P < 0.05); ii) increased serum corticosterone levels (control = 200.0 ± 48.3 ng/mL and experimental = 420.0 ± 75.5 ng/mL; P < 0.05), and iii) decreased the intensity of macrophage phagocytosis (control = 132.3 ± 19.7 and experimental = 116.2 ± 4.6; P < 0.05) and oxidative burst (control = 173.7 ± 40.8 and experimental= 99.58 ± 41.7; P < 0.05) in vitro in the presence of Staphylococcus aureus. These data provide evidence that cyhalothrin simultaneously alters host resistance to Ehrlich tumor growth, hypothalamic-pituitary-adrenocortical (HPA) axis function, and peritoneal macrophage activity. The results are discussed in terms of data suggesting a link between stress, HPA axis activation and resistance to tumor growth.


Subject(s)
Animals , Male , Mice , Carcinoma, Ehrlich Tumor/pathology , Insecticides/pharmacology , Macrophages, Peritoneal/drug effects , Nitriles/pharmacology , Phagocytosis/drug effects , Pyrethrins/pharmacology , Carcinoma, Ehrlich Tumor/blood , Corticosterone/blood , Hypothalamo-Hypophyseal System/drug effects , Mice, Inbred BALB C , Tumor Cells, Cultured
10.
Braz J Med Biol Res ; 42(10): 912-7, 2009 Oct.
Article in English | MEDLINE | ID: mdl-19784476

ABSTRACT

Cyhalothrin, a pyrethroid insecticide, induces stress-like symptoms, increases c-fos immunoreactivity in the paraventricular nucleus of the hypothalamus, and decreases innate immune responses in laboratory animals. Macrophages are key elements in cellular immune responses and operate at the tumor-host interface. This study investigated the relationship among cyhalothrin effects on Ehrlich tumor growth, serum corticosterone levels and peritoneal macrophage activity in mice. Three experiments were done with 10 experimental (single gavage administration of 3.0 mg/kg cyhalothrin daily for 7 days) and 10 control (single gavage administration of 1.0 mL/kg vehicle of cyhalothrin preparation daily for 7 days) isogenic BALB/c mice in each experiment. Cyhalothrin i) increased Ehrlich ascitic tumor growth after ip administration of 5.0 x 106 tumor cells, i.e., ascitic fluid volume (control = 1.97 +/- 0.39 mL and experimental = 2.71 +/- 0.92 mL; P < 0.05), concentration of tumor cells/mL in the ascitic fluid (control = 111.95 +/- 16.73 x 106 and experimental = 144.60 +/- 33.18 x 106; P < 0.05), and total number of tumor cells in the ascitic fluid (control = 226.91 +/- 43.22 x 106 and experimental = 349.40 +/- 106.38 x 106; P < 0.05); ii) increased serum corticosterone levels (control = 200.0 +/- 48.3 ng/mL and experimental = 420.0 +/- 75.5 ng/mL; P < 0.05), and iii) decreased the intensity of macrophage phagocytosis (control = 132.3 +/- 19.7 and experimental = 116.2 +/- 4.6; P < 0.05) and oxidative burst (control = 173.7 +/- 40.8 and experimental= 99.58 +/- 41.7; P < 0.05) in vitro in the presence of Staphylococcus aureus. These data provide evidence that cyhalothrin simultaneously alters host resistance to Ehrlich tumor growth, hypothalamic-pituitary-adrenocortical (HPA) axis function, and peritoneal macrophage activity. The results are discussed in terms of data suggesting a link between stress, HPA axis activation and resistance to tumor growth.


Subject(s)
Carcinoma, Ehrlich Tumor/pathology , Insecticides/pharmacology , Macrophages, Peritoneal/drug effects , Nitriles/pharmacology , Phagocytosis/drug effects , Pyrethrins/pharmacology , Animals , Carcinoma, Ehrlich Tumor/blood , Corticosterone/blood , Hypothalamo-Hypophyseal System/drug effects , Male , Mice , Mice, Inbred BALB C , Tumor Cells, Cultured
11.
Int Immunopharmacol ; 9(1): 148-52, 2009 Jan.
Article in English | MEDLINE | ID: mdl-19000787

ABSTRACT

Synthetic type II pyrethroids induce anxiety, immunosuppression or, alternatively, immunostimulatory effects in laboratory animals. Macrophages and neutrophils are known to be key elements in cellular immune responses. The present study was designed to investigate the in vivo effects of cyhalothrin (1.0 and 3.0 mg/kg/once daily for 7 days) on macrophage and neutrophil activities, using a flow cytometry method. Results showed that cyhalothrin treatment decreased the percentage and intensity of phagocytosis performed by macrophages, but did not alter these parameters in neutrophils; and also decreased basal neutrophil oxidative burst and increased S. aureus-induced neutrophil oxidative burst, but did not alter these responses in macrophages. The present results are discussed in the light of a possible indirect action of cyhalothrin on macrophage and neutrophil activities via hypothalamic pituitary adrenal (HPA) axis activation. A possible direct effect of cyhalothrin on macrophage and neutrophil activities is also considered.


Subject(s)
Immunity, Innate/drug effects , Insecticides/toxicity , Nitriles/toxicity , Pyrethrins/toxicity , Animals , Flow Cytometry , Hypothalamo-Hypophyseal System/drug effects , Hypothalamo-Hypophyseal System/immunology , In Vitro Techniques , Indicators and Reagents , Macrophages, Peritoneal/drug effects , Macrophages, Peritoneal/immunology , Male , Mycobacterium bovis/immunology , Neutrophils/drug effects , Neutrophils/immunology , Phagocytosis/drug effects , Rats , Rats, Wistar , Respiratory Burst/drug effects
12.
Radiol Med ; 114(1): 83-94, 2009 Feb.
Article in English, Italian | MEDLINE | ID: mdl-19082786

ABSTRACT

PURPOSE: The authors present a retrospective analysis of a large series of patients who underwent transjugular intrahepatic portosystemic shunt (TIPS) placement. MATERIALS AND METHODS: Between March 1992 and December 2006, 658 patients were referred to our centre for TIPS placement. Indications for the procedure were digestive tract bleeding (52.8%), refractory ascites (35.3%), preservation of portal vein patency prior to liver transplantation (3.0%) and thrombosis of the suprahepatic veins (2.3%). Other indications (6.6%) included pleural ascites, portal thrombosis and hepatorenal and hepatopulmonary syndromes. All patients were evaluated with colour Doppler ultrasonography and in a few cases with computed tomography. The portal system was punctured under sonographic guidance. Wallstent, Palmaz and Nitinol thermosensitive stents were used. Embolisation of persistent varices was performed in 6.8% of cases. RESULTS: Technical success was 98.9%. During a 1,500-day follow-up, the cumulative incidence of stent revision was 25.7% (Nitinol), 32.9% (Wallstent) and 1.8% (Palmaz). Mortality rates were 31.1%, 38.5% and 56.4%, respectively. The technical complications included six cases of heart failure, six of haematobilia, three of stent migration, two of intrahepatic haematoma and one of haemoperitoneum. Eight patients with severe portosystemic encephalopathy (PSE) were treated with a reduction stent. CONCLUSIONS: TIPS placement is safe and effective and may act as a bridge to liver transplantation. Ultrasonography plays a fundamental role in the preliminary assessment, in portal vein puncture and during the follow-up. Stent patency is satisfactory.


Subject(s)
Hypertension, Portal/surgery , Liver Failure/surgery , Portasystemic Shunt, Transjugular Intrahepatic , Radiology, Interventional , Ultrasonography, Doppler, Color , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Follow-Up Studies , Humans , Male , Middle Aged , Portasystemic Shunt, Transjugular Intrahepatic/instrumentation , Portasystemic Shunt, Transjugular Intrahepatic/methods , Retrospective Studies , Safety , Stents , Time Factors , Tomography, X-Ray Computed , Treatment Outcome
13.
Environ Toxicol Pharmacol ; 27(1): 96-102, 2009 Jan.
Article in English | MEDLINE | ID: mdl-21783926

ABSTRACT

Synthetic type II pyrethroid insecticides, such as cyhalothrin at certain dosage levels, simultaneously induce stress-like symptoms and innate immunosuppressive effects in laboratory animals. The present study was designed to further analyze the stress-like effects induced by cyhalotrin and also investigate the role of Hypothalamus-Hypophysis-Adrenal (HHA) axis and Sympathetic Nervous Systems (SNS) and their effects on macrophage activity of rats. Results showed that cyhalothrin treatment (3.0mg/kg/day, for 7 days) increased corticosterone serum levels and c-fos immunoreactivity at the paraventricular nucleus of the hypothalamus (PVN) but induced no changes in c-fos expression at the basolateral amygdala (BLA). Both areas were related to HHA axis and SNS activations by stress. Further analysis showed that adrenalectomy partially abrogated the suppression effects of cyhalothrin on macrophage activity and that 6-OHDA-induced peripheral symphatectyomy had no effects on this innate immune cell activity. The present observed data support and reinforce the notion that cyhalotrin at this treatment schedule induces stress-like symptoms and suggest that other factors, beyond indirect neuroadaptative responses, are necessary for the suppression effects of insecticide on innate immune response.

14.
Radiol Med ; 113(3): 429-38, 2008 Apr.
Article in English, Italian | MEDLINE | ID: mdl-18493778

ABSTRACT

PURPOSE: This study was undertaken to evaluate patient dose in paediatric liver transplant recipients treated by percutaneous biliary drainage and bilioplasty procedures. MATERIALS AND METHODS: Effective dose rates and entrance skin-dose (ESD) rates per minute of fluoroscopy were measured by using a plexiglas phantom (thickness 10 cm) simulating the patient and by varying the exposure parameters (type of pulsed fluoroscopy, image intensifier diameter, presence of diaphragms) to identify the technique delivering the lowest patient dose. In vivo measurements were performed during three interventional procedures. RESULTS: The effective dose rate proved to be lowest for a particular type of pulsed fluoroscopy, with maximum magnification and with field-limiting diaphragms. The in vivo measurements showed a maximum ESD value of around 50 MGY (the threshold for transient erythema is 2,000 MGY, ICRP 60). The effective dose values were in the range of 0.9-1.5 MSV. CONCLUSIONS: We established exposure parameters providing the desired image quality with the lowest dose for the equipment used and for a specific type of interventional procedure. The measured ESD values allow us to exclude the risk of deterministic effects on the skin. The effective dose values and considerations regarding the likelihood of radiation-induced cancer led to the conclusion that the radiological risk for the patient is largely justified by the benefits of these kinds of procedure.


Subject(s)
Bile Duct Diseases/therapy , Bile Ducts/surgery , Biliary Tract Surgical Procedures/methods , Drainage/methods , Liver Transplantation , Bile Duct Diseases/diagnostic imaging , Bile Duct Diseases/etiology , Catheterization , Child, Preschool , Cholangiography , Cholangiopancreatography, Endoscopic Retrograde , Female , Fluoroscopy , Humans , Infant , Male , Radiation Dosage , Radiation Injuries/prevention & control , Radiation Monitoring/methods , Radiography, Interventional , Retrospective Studies
15.
Anat Histol Embryol ; 37(1): 60-2, 2008 Feb.
Article in English | MEDLINE | ID: mdl-18197901

ABSTRACT

The arterial vascularization of agoutis' penis (Dasyprocta prymnolopha) were analysed using ten male adults from 'Núcleo de Estudos e Preservação de Animais Silvestres da Universidade Federal do Piauí' (FUFPI/IBAMA n degrees 02/99). Among the total number of specimens, six animals had natural death and were members of the research collection of the Laboratory of Anatomy, and four were killed after anaesthesia. Stained bi-centrifugated-Cis-I-4 latex was injected in arterial vessels responsible for penis vascularization throughout the abdominal portion of aorta. The samples were fixed in 10% formaldehyde solution and arteries were dissected. The penile artery is originated as a branch of internal pudendal artery. At the level of ischiatic arch, the penile artery project two branches, the penile dorsal and the deep arteries; those arteries irrigates the penile dorsal surface and the corpus cavernosum penis. The penile dorsal arteries have an independent course up to the glans penis. Based on the conditions of this work a remarkable similarity regarding the distribution of vessels destined to the agouti penis when compared to other domestic, wild and lagomorph rodents as rabbits.


Subject(s)
Arteries/anatomy & histology , Penis/blood supply , Rodentia/anatomy & histology , Animals , Male , Regional Blood Flow
16.
Arq. bras. med. vet. zootec ; 59(5): 1231-1235, out. 2007.
Article in Portuguese | LILACS | ID: lil-471206

ABSTRACT

Avaliou-se a cromatografia em camada delgada (CCD) como método de diagnóstico toxicológico para os casos de intoxicação por aldicarb em cães e gatos, utilizando-se 50 amostras de conteúdo gástrico obtidas durante a necropsia e 50 amostras de alimentos utilizados como iscas para intoxicar criminalmente os animais. Todas as amostras resultaram positivas para o aldicarb, mostrando ser a CCD uma técnica qualitativa eficiente, rápida e de baixo custo, com uso potencial na toxicologia veterinária forense


The present study concerns about the identification of aldicarb residues using thin-layer chromatography (TLC) in 50 samples of gastric content obtained from the necropsy of dogs and cats and 50 samples of foods suspected of being used as baits. All samples resulted positive for aldicarb showing that the TLC is an efficient, fast and not expensive qualitative method for the detection of aldicarb, being useful for this purpose in the forensic veterinary toxicology


Subject(s)
Animals , Cats , Dogs , Aldicarb/poisoning , Cats , Chromatography, Thin Layer/instrumentation , Chromatography, Thin Layer/methods , Chromatography, Thin Layer/veterinary , Dogs , Gastrointestinal Contents
17.
Radiol Med ; 112(3): 456-71, 2007 Apr.
Article in English, Italian | MEDLINE | ID: mdl-17440700

ABSTRACT

PURPOSE: The aim of our study was to evaluate the radiologist's role in managing paediatric orthotopic liver transplantation (OLT) through a retrospective review of our experience in diagnosing and treating post-OLT complications. MATERIALS AND METHODS: Forty children (mean age 4.6 years) underwent 44 OLTs over 71 months. The follow-up period (mean 724 days) was divided into three phases: hospital stay, up to three months after discharge and subsequent period. The number and type of radiological examinations, radiologically detectable complications and interventional procedures were analysed. RESULTS: Most examinations were carried out with ultrasound (US) (859/931 of all radiological studies performed during the first two phases, 92.3%). Colour-Doppler US enabled early detection and treatment of all vascular complications (9/40, 22.5% of patients; 13 complications in nine patients, eight arterial and five portal complications; 1.4 for each patient with complications). Computed tomography (CT) or angiography was very rarely employed. US also detected biliary complications (11 patients, 27.5%: three cases of segmental ducts excluded from the anastomosis, four cases of stenosis of the biliodigestive anastomosis, one lithiasis, three stenoses associated with lithiasis), which were successfully managed in 75% of the cases treated with interventional radiology procedures (percutaneous bilioplasty and/or lithotripsy). At the time of writing this paper, the patient survival rate was 100%, and the organ survival rate was 91% (40/44). There were four re-transplantations: three due to hepatic artery thrombosis and one to biliary stenosis with lithiasis. CONCLUSIONS: The radiologist's role is fundamental for early sonographic diagnosis of post-OLT complications in children. Vascular complications are often associated in a single patient, and early treatment may improve the prognosis. Interventional radiology represents a safe and effective treatment for many biliary complications.


Subject(s)
Liver Transplantation/diagnostic imaging , Postoperative Complications/diagnostic imaging , Ultrasonography, Doppler , Adolescent , Age Factors , Angiography , Child , Child, Preschool , Female , Follow-Up Studies , Graft Survival , Humans , Infant , Liver Transplantation/adverse effects , Liver Transplantation/mortality , Male , Postoperative Complications/therapy , Reoperation , Retrospective Studies , Survival Analysis , Time Factors , Tomography, X-Ray Computed
19.
Toxicology ; 212(2-3): 98-106, 2005 Sep 01.
Article in English | MEDLINE | ID: mdl-15905015

ABSTRACT

Synthetic type II pyrethroids induce anxiety, immunosuppressive or, alternatively, immunostimulatory effects in laboratory animals. Macrophages are known to be key elements in cellular immune responses. The present study was designed to investigate the in vivo effects of cyhalothrin (0.6, 1.0 and 3.0 mg/kg/once daily for 7 days) on macrophage activity. The in vitro effects of cyhalothrin (100 nM, 1 and 10 microM) were also analyzed to verify a possible direct action of this pyrethroid on macrophage. Results showed that in vivo cyhalothrin treatment: (1) decreased macrophage spreading and phagocytosis indexes; (2) decreased macrophage nitric oxide (NO) production; (3) did not change spontaneous or PMA-induced macrophage H2O2 release. The no effect level dose (NOEL) obtained for cyhalothrin on macrophage activity was 0.6 mg/kg/day. In-vitro data showed that cyhalothrin decreased (1) macrophage NO production and (2) macrophage spontaneus and PMA-induced H2O2 releases. The present results were explained through an indirect action for cyhalothrin on macrophage activity via hypothalamic pituitary adrenals (HPA) axis activation. A direct effect for cyhalothrin on macrophage, most probably through an action on Na+ membrane channels, was also suggested. Finally, it is possible that both direct and indirect mechanisms would be involved with cyhalothrin effects on macrophage activity.


Subject(s)
Insecticides/toxicity , Macrophages, Peritoneal/drug effects , Nitriles/toxicity , Pyrethrins/toxicity , Animals , Hydrogen Peroxide/metabolism , Macrophages, Peritoneal/immunology , Macrophages, Peritoneal/physiology , Male , Mycobacterium bovis , Nitric Oxide/metabolism , No-Observed-Adverse-Effect Level , Phagocytosis/drug effects , Rats , Rats, Wistar
20.
Radiol Med ; 109(1-2): 118-24, 2005.
Article in English, Italian | MEDLINE | ID: mdl-15729192

ABSTRACT

PURPOSE: The aim of this study is to assess the effectiveness and safety of the use of Vasoseal ES collagen plug in heavily anticoagulated patients with high risk of complications at the vascular access site who had undergone vascular radiological intervention. MATERIALS AND METHODS: Between January 2002 and March 2003 180 consecutive transfemoral arterial accesses in 169 patients subjected to vascular radiological procedures were performed (bilateral access was performed in 11 patients): 140 percutaneous transluminal angioplasties and 40 transarterial chemoembolisations. All the patients who underwent angioplasty were given 3,000 IU of sodic heparin intravenously during the procedure and later a prolonged antiaggregant therapy was undertaken (ticlopidine 500 mg/day and aspirin 150 mg/day). The sheaths were removed at the end of the surgical manoeuvre and two cartridges of collagen were positioned on the external surface of the artery. The mean values of platelets and partial thromboplastin time were 42,000/ml and 170 s, respectively, in cirrhotic patients against 250,000/ml and 200 s in patients with peripheral arteriopathy. The next day a colour Doppler examination was performed at the puncture site. RESULTS: The technique proved successful in 89.4% of cases (161/180). In 19/180 vascular accesses placement of the haemostatic cartridges was not possible owing to the inability to compress the common femoral artery proximal to the release site (4/19), owing to a pre-existing haematoma (5/19) and owing to the limited presence of subcutaneous tissue (10/19). The mean time required for the placement of Vasoseal ES was 4 min. The mean time-to-haemostasis was 6 min. The mean time-to-mobilisation was 4 hr. Only in two patients was there an onset of a pseudoaneurysm of the right common femoral artery; the lesions were treated with ultrasonography -guided compression. In addition, 16 small local haematomas were recorded. In 4 cases early re-puncture of the femoral artery was performed (24-48 hr following the use of the device) without consequences. CONCLUSIONS: Vasoseal ES is a safe collagen closure device characterised by a high success rate. In anticoagulated patients the device can reduce the time-to-mobilisation and the incidence of complications.


Subject(s)
Catheterization, Peripheral , Femoral Artery , Hemostatic Techniques/instrumentation , Adult , Aged , Aged, 80 and over , Catheterization, Peripheral/adverse effects , Collagen/administration & dosage , Female , Hemostatic Techniques/adverse effects , Humans , Male , Middle Aged
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