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1.
Clin Ter ; 175(2): 125-127, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38571470

RESUMO

Abstract: There is only limited epidemiological information on Orthorexia Nervosa; the aim of the present study is, therefore, to assess the prevalence of ON in a population of young adults and to identify possible specific features and eventual psychopatological dimensions. 1317 participants (732 females and 585 males; mean age 22.36 yrs) completed a battery containing the orthorexia measure (ORTHO-15), statements about demographic characteristics as well as physiological parameters. The mean ORTO-15 score was 31.89; considering the cut-off of 40 in the reference test, our results showed a 11.9% prevalence of ON. Analyzing the characteristics of the orthorexic group, the prevalence in females compared to males appears to be statistically very significant (115 vs 43; 72.8% vs 27.2%); moreover shows higher and statistically significant scores in each of the 15 items of the reference test compared to the non-orthorexic group. Our data confirming that ON might be a relevant and potentially underestimate phenomenon in the community. Further studies are warranted in order to explore the diagnostic boundaries of this syndrome, its course and outcome, and the possible therapeutic strategies.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Comportamentos Relacionados com a Saúde , Masculino , Feminino , Humanos , Adulto Jovem , Adulto , Ortorexia Nervosa , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Prevalência , Comportamento Alimentar , Inquéritos e Questionários , Itália/epidemiologia
2.
Braz J Biol ; 83: e270740, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37585926

RESUMO

Logging and agricultural exploitation have led to the degradation of Araucaria Forest remnants and the alteration of its last preserved patches. This forest typology contains many endangered plant species, as is the case of the tree Oreopanax fulvus Marchal. To support conservation of this species and understand how different landscape matrices can influence its populations, we evaluated the demographic structure and spatial distribution of O. fulvus in two Araucaria Forest remnants in Paraná state. We delimited two plots (urban and rural population), each with 1 ha, subdivided them into 100 subplots (10 x 10 m), and recorded diameter at ground level (DGL), height, and coordinates of two post-germinative developmental stage of individuals. In each subplot, we measured slope, luminosity, and canopy height. We used Ripley's K function analysis to describe distribution patterns of the species and the spatial relationship between mature and juvenile trees. We performed correlations between abundance and environmental and structural variables of the O. fulvus populations. Abundance varied between remnants, from 183 individuals/ha (12 mature and 171 juvenile) to 1306 individuals/ha (10 and 1296). The remnants varied in abundance and plant frequency. The species showed an investment in seedling banks. Most juvenile had DGL up to 3.0 cm and height up to 1.0 m and presented aggregated spatial distribution, while adults had random distribution. In the rural population juvenile abundance were correlated with canopy height (positively) and distance to mature trees (negatively). The slope was correlated for both sites, but oppositely, indicating that other factors might have interfered in the regeneration abundance. The urban remnant showed a high abundance of this endangered species, calling attention for potential studies in urban arborization, management and conservation of these remnants.


Assuntos
Espécies em Perigo de Extinção , População Rural , Humanos , Animais , Brasil , Florestas , Árvores , Densidade Demográfica
3.
Ann Ig ; 33(4): 381-392, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33270076

RESUMO

Abstract: Many of the devastating pandemics and outbreaks of last centuries have been caused by enveloped viruses. The recent pandemic of Coronavirus disease 2019 (COVID-19) has seriously endangered the global health system. In particular, hospitals have had to deal with a frequency in the emergency room and a request for beds for infectious diseases never faced in the last decades. It is well-known that hospitals are environments with a high infectious risk. Environmental control of indoor air and surfaces becomes an important means of limiting the spread of SARS-CoV-2. In particular, to preserve an adequate indoor microbiological quality, an important non-pharmacological strategy is represented by Heating, Ventilation and Air Conditioning (HVAC) systems and finishing materials. Starting from the SARS-CoV-2 transmission routes, the paper investigates the hospital risk analysis and management, the indoor air quality and determination of microbial load, surface management and strategies in cleaning activities, HVAC systems' management and filters' efficiency. In conclusion, the paper suggests some strategies of interventions and best practices to be taken into considerations for the next steps in design and management.


Assuntos
Microbiologia do Ar , Poluição do Ar em Ambientes Fechados , COVID-19/prevenção & controle , Instalações de Saúde , Pandemias , SARS-CoV-2/isolamento & purificação , Ar Condicionado , COVID-19/transmissão , Materiais de Construção , Infecção Hospitalar/prevenção & controle , Infecção Hospitalar/transmissão , Contaminação de Equipamentos , Desenho de Equipamento , Filtração/instrumentação , Filtração/métodos , Calefação , Arquitetura Hospitalar , Humanos , Material Particulado , Medição de Risco , Ventilação/instrumentação
5.
Infect Genet Evol ; 46: 78-84, 2016 12.
Artigo em Inglês | MEDLINE | ID: mdl-27810499

RESUMO

The understanding of the processes occurring in Nature has been a continuing concern throughout the history of mankind. Intellectual tools employed towards this goal were specific for each period and have been largely based on the prevailing paradigms that reigned in the past. In this work we present evidence that supports the idea of viruses as key agents mediating natural processes linked to the evolution of organisms, particularly those involved in the flux of genes in the environment. This point of view tinges our perception of Nature and prompts us to include "viral" creativity and plasticity among the tools we employ to analyze those processes far beyond actual paradigms. Experimental data to support this proposal arose during the study of the interaction of the human pathogen, herpes simplex virus (HSV) with sulfated polysaccharides during multiplication of the virus in vitro. Sulfated polysaccharides are the main chemical structures found in carrageenans (CGNs) that are natural products obtained from seaweeds, which proved to be strong inhibitors for the virus. Here we describe the interaction between virus and CGNs as a suitable scenario for the emergence of viral variants which proved to be markedly attenuated for mice. A striking feature of these variants is that they showed changes at the level of conserved regions of the genome such as the DNA polymerase and thymidine kinase genes. In view of these findings, the importance of HSV evolution towards attenuated variants by the action of polysaccharides is also discussed. Attenuation may be considered part of a natural evolutionary process enabling the virus to contribute with valuable information for the host.


Assuntos
Evolução Molecular , Vírus , Animais , Transferência Genética Horizontal , Vida , Camundongos , Polissacarídeos , Simplexvirus , Sulfatos
6.
J Environ Manage ; 183(Pt 3): 754-762, 2016 Dec 01.
Artigo em Inglês | MEDLINE | ID: mdl-27649608

RESUMO

This study investigates the relationship between fine resolution, local-scale biophysical and socioeconomic contexts within which land degradation occurs, and the human responses to it. The research draws on experimental data collected under different territorial and socioeconomic conditions at 586 field sites in five Mediterranean countries (Spain, Greece, Turkey, Tunisia and Morocco). We assess the level of desertification risk under various land management practices (terracing, grazing control, prevention of wildland fires, soil erosion control measures, soil water conservation measures, sustainable farming practices, land protection measures and financial subsidies) taken as possible responses to land degradation. A data mining approach, incorporating principal component analysis, non-parametric correlations, multiple regression and canonical analysis, was developed to identify the spatial relationship between land management conditions, the socioeconomic and environmental context (described using 40 biophysical and socioeconomic indicators) and desertification risk. Our analysis identified a number of distinct relationships between the level of desertification experienced and the underlying socioeconomic context, suggesting that the effectiveness of responses to land degradation is strictly dependent on the local biophysical and socioeconomic context. Assessing the latent relationship between land management practices and the biophysical/socioeconomic attributes characterizing areas exposed to different levels of desertification risk proved to be an indirect measure of the effectiveness of field actions contrasting land degradation.


Assuntos
Conservação dos Recursos Naturais , Mineração de Dados/métodos , Política Ambiental , Agricultura , Política Ambiental/economia , Incêndios , Grécia , Humanos , Marrocos , Análise de Componente Principal , Fatores Socioeconômicos , Solo , Espanha , Tunísia , Turquia , Abastecimento de Água
7.
J Crohns Colitis ; 9(7): 558-64, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25895877

RESUMO

BACKGROUND AND AIMS: Recent epidemiological studies showed an increase in ulcerative colitis among children, especially in its aggressive form, requiring surgical treatment. Although medical therapeutic strategies are standardized, there is still no consensus regarding indications, timing and kind of surgery. This study aimed to define the surgical management of paediatric ulcerative colitis and describe attitudes to it among paediatric surgeons. METHODS: This was a retrospective cohort study. All national gastroenterology units were invited to participate. From January 2009 to December 2013, data on paediatric patients diagnosed with ulcerative colitis that required surgery were collected. RESULTS: Seven units participated in the study. Seventy-one colectomies were performed (77.3% laparoscopically). Main surgical indications were a severe ulcerative colitis attack (33.8%) and no response to medical therapies (56.3%). A three-stage strategy was chosen in 71% of cases. Straight anastomosis was performed in 14% and J-pouch anastomosis in 86% of cases. A reconstructive laparoscopic approach was used in 58% of patients. Ileo-anal anastomosis was performed by the Knight-Griffen technique in 85.4% and by the pull-through technique in 9.1% of patients. Complications after colectomy, after reconstruction and after stoma closure were reported in 12.7, 19.3 and 35% of cases, respectively. CONCLUSIONS: This study shows that there is general consensus regarding indications for surgery. The ideal surgical technique remains under debate. Laparoscopy is a procedure widely adopted for colectomy but its use in reconstructive surgery remains limited. Longer follow-up must be planned to define the quality of life of these patients.


Assuntos
Atitude do Pessoal de Saúde , Colite Ulcerativa/cirurgia , Gastroenterologia , Proctocolectomia Restauradora/métodos , Adolescente , Criança , Pré-Escolar , Colite Ulcerativa/tratamento farmacológico , Colostomia/efeitos adversos , Defecação , Resistência a Medicamentos , Incontinência Fecal/etiologia , Feminino , Humanos , Itália , Masculino , Pouchite/etiologia , Proctocolectomia Restauradora/efeitos adversos , Estudos Retrospectivos , Índice de Gravidade de Doença
8.
J Pediatr Surg ; 50(9): 1441-56, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25783403

RESUMO

BACKGROUND: Our study aims at disclosing epidemiology and most relevant clinical features of esophageal atresia (EA) pointing to a model of multicentre collaboration. METHODS: A detailed questionnaire was sent to all Italian Units of pediatric surgery in order to collect data of patients born with EA between January and December 2012. The results were crosschecked by matching date and place of birth of the patients with those of diagnosis-related group provided by the Italian Ministry of Health (MOH). RESULTS: A total of 146 questionnaires were returned plus a further 32 patients reported in the MOH database. Basing on a total of 178 patients with EA born in Italy in 2012, the incidence of EA was calculated in 3.33 per 10,000 live births. Antenatal diagnosis was suspected in 29.5% patients. 55.5% showed associated anomalies. The most common type of EA was Gross type C (89%). Postoperative complications occurred in 37% of type C EA and 100% of type A EA. A 9.5% mortality rate was reported. CONCLUSIONS: This is the first Italian cross-sectional nationwide survey on EA. We can now develop shared guidelines and provide more reliable prognostic expectations for our patients.


Assuntos
Atresia Esofágica/epidemiologia , Diagnóstico Pré-Natal , Inquéritos e Questionários , Fístula Traqueoesofágica/epidemiologia , Adulto , Estudos Transversais , Grupos Diagnósticos Relacionados , Atresia Esofágica/diagnóstico , Feminino , Humanos , Incidência , Recém-Nascido , Itália/epidemiologia , Masculino , Gravidez , Fístula Traqueoesofágica/diagnóstico , Adulto Jovem
9.
Microb Pathog ; 71-72: 68-72, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24768928

RESUMO

Immune evasion strategies are important for the onset and the maintenance of viral infections. Many viruses have evolved mechanisms to counteract or suppress the host immune response. We have previously characterized two syncytial (syn) variants of Herpes simplex 1 (HSV-1) strain F, syn14-1 and syn17-2, obtained by selective pressure with a natural carrageenan. These variants showed a differential pathology in vaginal and respiratory mucosa infection in comparison with parental strain. In this paper, we evaluated the modulation of immune response in respiratory mucosa by these HSV-1 variants. We observed altered levels of Tumor Necrosis Factor-α and Interleukin-6 in lungs of animals infected with the syn14-1 and syn17-2 variants compared with the parental strain. Also, we detected differences in the recruitment of immune cells to the lung in syn variants infected mice. Both variants exhibit one point mutation in the sequence of the gene of glycoprotein D detected in the ectodomain of syn14-1 and the cytoplasmic tail of syn17-2. Results obtained in the present study contribute to the characterization of HSV-1 syn variants and the participation of the cellular inflammatory response in viral pathogenesis.


Assuntos
Citocinas/metabolismo , Herpesvirus Humano 1/imunologia , Infecções Respiratórias/imunologia , Infecções Respiratórias/patologia , Animais , Feminino , Herpesvirus Humano 1/genética , Camundongos , Camundongos Endogâmicos BALB C , Mucosa/imunologia , Mucosa/patologia , Mutação Puntual , Infecções Respiratórias/virologia , Proteínas do Envelope Viral/genética
10.
Minerva Pediatr ; 65(2): 179-85, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23612263

RESUMO

AIM: The aim of this paper was to provide the main clinical features, surgical details, and long term outcome of patients with gastroschisis and omphalocele operated on at Giannina Gaslini Institute between 1976 and 2009. METHODS: All patients who were operated on between 1976 and 2009 for omphalocele or gastroschisis were included. Detailed informations regarding demographics, maternal history, type of delivery, associated anomalies, surgical details, complications, morbidity and mortality were collected. RESULTS: Sixty-one patients were included. Type of delivery did not interfere with outcome. Although patients with omphalocele had higher incidence of associated anomalies with their obvious impact on survival and quality of life, they showed a quicker recovery from surgery. Mortality rate was around 5%. Long-term outcome was available in 18 of them and proved to be satisfactory in all although almost 70% of them complained some gastrointestinal issues. CONCLUSION: Gastroschisis and Omphalocele showed improving survival and outcome during the last decades. Caesarean section proved not to confer advantages over vaginal delivery. Associated anomalies have the highest impact on survival being cardiac malformation the most significant risk factors. Although overall outcome is good in the majority of the patients, gastrointestinal and cosmetic issues seem to have a significant impact on quality of life and overall patients' perspectives.


Assuntos
Parede Abdominal/cirurgia , Adolescente , Adulto , Feminino , Humanos , Masculino , Fatores de Tempo , Adulto Jovem
11.
Eur J Vasc Endovasc Surg ; 43(6): 690-7, 2012 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-22507924

RESUMO

INTRODUCTION: Recognition of acute mesenteric ischaemia (AMesI) in patients with aortic dissection (AoD) may be a challenge and exploratory laparotomy is often performed. METHODS: We retrospectively analysed our experience with the use of diagnostic laparoscopy (DL) for the early detection of AMesI in patients with AoD, either undergoing medical treatment or after open/endovascular interventions. RESULTS: Between 2004 and 2011, 202 consecutive AoDs were treated in our centre (71 acute type A AoD; 131 acute and chronic type B AoD). Among the 17 (8.4%) patients in which AMesI was suspected, nine (52.9%) were selected for DL. Three DLs were performed during medical treatment of patients with acute type B AoD, six after treatment of AoD (both surgical and endovascular). Three second-look DLs were also performed. Eight DLs were negative, three showed AMesI and the patients underwent successful emergent revascularisation. One DL was not conclusive and laparotomy was required. Among the eight patients not submitted to DL, one case of bowel infarction was recorded. CONCLUSIONS: In our series DL was feasible and safe. The low invasiveness and repeatability were the main advantages. Although additional experience is mandatory, DL seems a promising technique for the detection of AMesI in patients with AoD.


Assuntos
Aneurisma Aórtico/complicações , Dissecção Aórtica/complicações , Isquemia/diagnóstico , Laparoscopia , Doenças Vasculares/diagnóstico , Adulto , Idoso , Dissecção Aórtica/diagnóstico por imagem , Dissecção Aórtica/terapia , Aneurisma Aórtico/diagnóstico por imagem , Aneurisma Aórtico/terapia , Aortografia/métodos , Diagnóstico Precoce , Estudos de Viabilidade , Feminino , Humanos , Isquemia/diagnóstico por imagem , Isquemia/etiologia , Isquemia/patologia , Isquemia/terapia , Itália , Masculino , Isquemia Mesentérica , Valor Preditivo dos Testes , Estudos Retrospectivos , Tomografia Computadorizada por Raios X , Doenças Vasculares/diagnóstico por imagem , Doenças Vasculares/etiologia , Doenças Vasculares/patologia , Doenças Vasculares/terapia , Adulto Jovem
12.
Infect Genet Evol ; 11(5): 798-802, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21345381

RESUMO

Despite the advances in biomedical knowledge, there remain many challenging and significant unsolved problems among which are included viral pathogenesis and antiviral therapy, as main topics in human health. On this respect, for instance, our knowledge about human immunodeficiency virus and AIDS is still insufficient to deal with problems of immense significance, such as the possible "natural cure" for a chronic infection or the induction of protective immunity against this agent. At the same time, new viral diseases of humans and animals continue to emerge or re-emerge, due to changes in host susceptibility and/or in virus virulence as well as to re-introduction of a virus that had disappeared from a defined population. These changes, at least in part, may appear as a consequence of antiviral therapies and lead to the selection of viral mutants. Moreover, taking into account that viruses have been studied as causative agents of conspicuous diseases a broad spectrum of uncertainty is still present when unapparent persistent infections are considered. Based on Hippocrates (460-357 b.C.E) natural philosophy, "Natura Morborum Medicatrix" which represents the natural healing force, i.e.: "Nature cures diseases"; and "Similia Similibus Curantur" which means "like cure like", we propose the use of natural compounds with chemical structures similar to cellular membrane components. On this approach, sulfated polysaccharides obtained from marine algae may act as a driving force for the emergence of attenuated viruses, enabling this way a practical approach for preventive therapies for herpes simplex virus infection. At the same time, viruses would be creative tools and their contribution by adding new genetic identity to their host are set points of genesis in the growth of the tree of life.


Assuntos
Evolução Biológica , Viroses/imunologia , Vírus , Animais , Interações Hospedeiro-Patógeno , Humanos , Vírus/imunologia
13.
Gene Ther ; 16(6): 805-14, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19262613

RESUMO

Large-scale production of gene therapeutics comprising equine infectious anaemia virus (EIAV) -based lentiviral vectors (LVs) would benefit from the development of producer cell lines enabling the generation of larger quantities of vector than achievable by transient systems. Such cell lines would contain three vector components (Gag/Pol, VSV-G envelope and genome expression constructs). As the vesicular stomatitis virus (VSV-G) envelope protein is cytotoxic, its expression must be regulated. It is also desirable to regulate Gag/Pol expression to minimise metabolic burden on the cell. The Tet repressor (TetR) system was selected to regulate expression of VSV-G and Gag/Pol, necessitating the introduction of a fourth construct, encoding TetR, into the cell line. We have generated an inducible packaging cell line that shows tight control of the packaging components, and high-titre vector production on transient transfection of the EIAV genome. The cell line is stable for at least 7 weeks in the absence of selective pressure. To verify that this packaging cell line can support the generation of producer cell lines it was transfected stably with an EIAV genome cassette encoding ProSavin; a gene therapeutic for Parkinson's disease. Producer cell lines were generated, which on induction, yielded ProSavin with titres comparable to the transient system.


Assuntos
Regulação da Expressão Gênica/genética , Vetores Genéticos , Vírus da Anemia Infecciosa Equina/genética , Lentivirus/genética , Glicoproteínas de Membrana/genética , Proteínas Repressoras/genética , Proteínas do Envelope Viral/genética , Animais , Antibacterianos/farmacologia , Western Blotting , Técnicas de Cultura de Células/métodos , Linhagem Celular , Células Clonais , Doxiciclina/farmacologia , Proteínas de Fusão gag-pol/genética , Regulação da Expressão Gênica/efeitos dos fármacos , Terapia Genética/métodos , Instabilidade Genômica/genética , Fases de Leitura Aberta , Plasmídeos , DNA Polimerase Dirigida por RNA , Proteínas Repressoras/farmacologia , Transfecção/métodos , Montagem de Vírus/genética , Replicação Viral
14.
Minerva Pediatr ; 60(6): 1451-4, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18971906

RESUMO

Kluyvera species are described infrequently in association with clinically significant infections, and infections caused by these gram negative rods are rare in children. The spectrum of disease due to Kluyvera infection in children includes urinary tract infections, enteritis, soft tissue infections, sepsis, central venous catheter infections and peritonitis. The authors report a case of Kluyvera ascorbata urinary tract infection in a 3-month-old female baby, and they review the literature on Kluyvera infections in children.


Assuntos
Infecções por Enterobacteriaceae , Kluyvera/isolamento & purificação , Infecções Urinárias/microbiologia , Adolescente , Fatores Etários , Antibacterianos/administração & dosagem , Antibacterianos/uso terapêutico , Criança , Pré-Escolar , Infecções por Enterobacteriaceae/tratamento farmacológico , Infecções por Enterobacteriaceae/epidemiologia , Infecções por Enterobacteriaceae/urina , Feminino , Seguimentos , Humanos , Lactente , Recém-Nascido , Masculino , Fatores Sexuais , Fatores de Tempo , Resultado do Tratamento , Infecções Urinárias/tratamento farmacológico , Urina/microbiologia
15.
Urologia ; 74(2): 95-8, 2007.
Artigo em Italiano | MEDLINE | ID: mdl-21086406

RESUMO

Diabetes is an important risk factor in erectile dysfunction (ED), acting via several mechanisms. We assessed the efficacy of intracavernous injections (ICI) rehabilitation and oral systematic therapy in diabetic patients, as well as the response of controls to oral therapy 'on demand'. MATERIALS AND METHODS. Sixteen diabetic patients with ED were treated with vasoactive drugs orally when needed, without satisfactory erections. The patients underwent then ICI rehabilitation with PGE1 20 mcg twice weekly for 4 weeks, followed by the administration of oral drugs twice weekly for 4 weeks. Before and after rehabilitation, the patients completed a detailed anamnestic protocol to study their libido (always present); they answered questions Q3 and Q4 of the IIEF questionnaire. During ICI, a study with dynamic echocolordoppler (ECCD) was carried out. All patients had Type 2 diabetes: 10 were treated with oral antidiabetics, 4 were treated with insulin, and in the other 2 patients, treated with insulin, a sensitive neuropathy of the lower limbs was diagnosed. Fourteen patients were treated with antihypertensive drugs. RESULTS. Before rehabilitation, the mean responses to questions 3 and 4 of the IIEF (International Index of Erectile Function) questionnaire were 1.6 and 1.5 respectively; after rehabilitation, the mean responses were 2.68 and 2.5, respectively. The ECCD test showed an arterial component in 4 cases and a high end-diastolic velocity (EDV) in 14 cases. Four patients (25%), 2 of which had neuropathy, and 2 were in advanced age, did not respond to PGE1 or to oral therapy, 4 patients (25%) (2 treated with insulin and 2 by oral therapy) responded to ICI but not to oral therapy, while 8 patients (50%) showed a good response to both injectable and oral therapy, with good Q3 and Q4 scores. CONCLUSIONS. Good endothelial function appears to be essential for the maintenance of acceptable erectile function. Diabetes has a negative effect on this function, as does hypoxia and low perfusion. Based on the principle that a good erection improves endothelial function, we tried to determine if oral systematic and intracavernous rehabilitation would improve erectile function in diabetic patients. The results indicate that diabetes interferes with erectile function, compromising the effects of the vasoactive drugs. However, integrated systematic rehabilitation appears to allow a good erectile response to both intracavernous and oral therapy in a large number of cases. Therefore, we support this kind of rehabilitative protocol in the treatment of ED in diabetic patients.

16.
Transplant Proc ; 37(6): 2461-3, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16182709

RESUMO

AIM: To evaluate factors affecting patient and kidney survival after renal transplant. PATIENT AND METHODS: Among 361 patients undergoing renal transplant: 52% (n = 189) were simultaneous with pancreas transplant (SPKT group) and 48% (n = 172), a kidney transplant alone (KT group). Out of 361 patients, 75% (n = 270) were diabetics. The patients were 220 (61%) men and 141 (39%) women of mean age 41 +/- 9 years. The mean time of dialysis was 42 +/- 21 months (range 0 to 126), and the mean duration of diabetes 24 +/- 7 years (range 5 to 51). A Cox regression analysis was done. RESULTS: The multivariate analysis revealed that in the final model diabetes and donor age were significant predictors of kidney graft survival; moreover, diabetes and recipient age were predictors of patient survival. Overall patient survival was significantly greater among nondiabetic patients (P = .002) or in diabetic patients who received SPKT, when compared with diabetics in whom only the kidney was transplanted (P = .001). CONCLUSIONS: Diabetes and donor age were independent prognostic factors affecting kidney graft survival after renal transplant, and recipient age and diabetes were prognostic factors affecting patient survival. Combined pancreas and kidney transplantation should be offered to patients with end-stage diabetic nephropathy.


Assuntos
Sobrevivência de Enxerto/fisiologia , Transplante de Rim/fisiologia , Adulto , Cadáver , Diabetes Mellitus Tipo 1/cirurgia , Nefropatias Diabéticas/cirurgia , Feminino , Humanos , Doadores Vivos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Transplante de Pâncreas/fisiologia , Análise de Regressão , Doadores de Tecidos/estatística & dados numéricos
17.
Suppl Tumori ; 4(3): S86-7, 2005.
Artigo em Italiano | MEDLINE | ID: mdl-16437921

RESUMO

AIM: The aim of our study was to identify clinicopathological predictors of survival among patients undergoing potentially curative resections for gastric carcinoma. PATIENTS AND METHODS: From January 1987-March 2004, 1074 patients have been submitted to curative gastric resection for gastric cancer (647 males and 427 females, mean age, 65 +/- 12, min 22, max 92). The surgical procedure consisted of 289 (27%) total and 785 (63%) subtotal gastrectomies. The extent of lymph node dissection was limited D1 (n = 376, 35%) or extended D2 (n = 578, 54%) and D3 (n = 12, 1%); no lymphadenectomy was performed in 108 (10%) cases. The pathological nodal status has been defined based on the number of involved lymph nodes (N1: 1 to 6 positive nodes; N2: 7 to 15 positive nodes; N3: more than 15 positive nodes). The distribution of N stage was: N0 = 278 (26%), N1 = 344 (32%); N2 = 215 (20%); N3 = 129 (12%). Univariate analyses were performed for gender, age, pT stage, pN stage, tumor site, tumor size, and extent of lymphadenectomy. Significant factors were then entered into a Cox regression analysis. RESULTS: The median number of examined lymph nodes was 17 (mean, 18). Overall, 688 (64%) of patients had lymph node metastases. Of these patients, the median number of involved nodes was 2 (mean, 6). In the univariate analysis age, pT stage, pN stage, tumor size, and extent of lymphadenectomy were found to be significant factors. In the multivariate analysis T stage, N stage, and extent of lymphadenectomy were all independent predictors of survival. The median and mean survival time were 69 and 87 months, respectively. Overall survival was 80%, 51% and 40% at 1, 5, and 10 years, respectively. CONCLUSIONS: T stage, N stage, and extent of lymphadenectomy were all independent predictors of survival in patients submitted to curative gastric resections.


Assuntos
Adenocarcinoma/cirurgia , Neoplasias Gástricas/cirurgia , Adenocarcinoma/mortalidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Neoplasias Gástricas/mortalidade , Taxa de Sobrevida
18.
Suppl Tumori ; 4(3): S129, 2005.
Artigo em Italiano | MEDLINE | ID: mdl-16437948

RESUMO

BACKGROUND: Adenocarcinoma of lower esophagus and GEJ shows worldwide an increasing incidence. The optimal approach to resection is still controversial. One of the major disadvantages of radical esophagectomy with extensive lymphadenectomy with open technique is its high rate of morbidity and mortality. Recent advances in minimally invasive surgical technology have allowed surgeons to apply laparoscopy and thoracoscopy to perform esophagectomy. PATIENT AND METHODS: In the video we report the case of a 79 years old man with Siewert I adenocarcinoma of GEJ, who was submitted to a 3-stage minimally invasive esophagectomy by laparoscopy, right thoracoscopy and cervicotomy. Preoperative endoscopic ultrasound and CT scan showed a marked thickening of the wall of the distal esophagus, with extension proximal to the mediastinal pleura and the anterior surface of the aorta, but still showing features of resectability. Four ports were used for the abdominal approach. A complete mobilization of the stomach preserving the right gastroepiploic arcade was achieved. The patient was then turned to the left lateral decubitus position proned to 30 degrees. Three ports were needed for right thoracoscopy. Mobilization of the thoracic esophagus was carried out from the diaphragm to the thoracic inlet. After extraction of the specimen through a small abdominal incision, the stomach was pulled up to the neck and esophagogastric anastomosis with the Orringer technique was constructed through a left cervicotomy. Pathology showed pT3 pN1 G3 adenocarcinoma. CONCLUSIONS: The minimally invasive approach to adenocarcinoma of the lower esophagus, in center with expertise in minimally invasive surgical technique, is feasible and safe.


Assuntos
Adenocarcinoma/cirurgia , Neoplasias Esofágicas/cirurgia , Esofagectomia/métodos , Junção Esofagogástrica , Idoso , Humanos , Masculino , Procedimentos Cirúrgicos Minimamente Invasivos
19.
Suppl Tumori ; 4(3): S138, 2005.
Artigo em Italiano | MEDLINE | ID: mdl-16437953

RESUMO

BACKGROUND: Laparoscopic surgery has been used in the treatment of gastric cancer with low mortality and morbidity and improvement in patient's quality of life. AIM: To evaluate the results of laparoscopic gastric resection. METHODS: A retrospective review of 59 patients after laparoscopic surgery for gastric cancer was performed. The patients were 31 males and 28 females with a mean age of 67 (+/- 11) years (min 39, max 90). RESULTS: Tumor stage was IA in 15 patients, IB in 10, II in 9, IIIA in 6, IIIB in 9, and IV in 10. In 15 cases the tumor was an early gastric cancer. The mean number of dissected lymph nodes was 29 +/-10. Conversion rate was 16%. Morbidity rate was 37%. The median length of hospital stay was 10 days. Operative mortality was 3%. The mean time of follow-up was 23 months. Two-year survival was 75%. CONCLUSIONS: Laparoscopic radical total or subtotal gastrectomy with extended lymphadenectomy for gastric cancer is a feasible, safe, and oncologically effective procedure.


Assuntos
Carcinoma/cirurgia , Gastrectomia , Excisão de Linfonodo/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
20.
Antiviral Res ; 64(2): 137-41, 2004 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-15498610

RESUMO

In the present study, the protective effect of 1T1, a lambda-carrageenan extracted from the red seaweed Gigartina skottsbergii was evaluated in a murine model of herpes simplex virus type 2 (HSV-2) genital infection. Six to eight-week-old female BALB/c mice were intravaginally inoculated with a lethal dose of HSV-2 (MS strain) and pre- or post-infection treated with different doses of a 10mg/ml solution of 1T1. A single topical administration of 1T1 shortly before infection of BALB/c mice with HSV-2 protected 9 out of 10 mice from HSV-2-induced lesions and mortality, compared with only 10% survival in control mice. In addition, 1T1 produced a total blockade in virus shedding in the vaginal secretions. When 1T1 pre-treatment was reinforced with a second dose 2h after infection, total protection was observed even when the prophylactic administration had taken place at 60min before infection. The irreversible virucidal action of 1T1 against herpes virus seems to be responsible of its protective effect against virus replication and mortality following vaginal HSV-2 infection.


Assuntos
Antivirais/administração & dosagem , Carragenina/administração & dosagem , Herpes Genital/prevenção & controle , Doenças Vaginais/prevenção & controle , Animais , Chlorocebus aethiops , Feminino , Herpes Genital/mortalidade , Herpes Genital/fisiopatologia , Herpesvirus Humano 2 , Camundongos , Camundongos Endogâmicos BALB C , Vagina/virologia , Doenças Vaginais/mortalidade , Doenças Vaginais/fisiopatologia , Doenças Vaginais/virologia , Células Vero , Eliminação de Partículas Virais
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