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2.
Autoimmun Rev ; 11(5): 335-40, 2012 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-21985773

RESUMO

Interstitial lung disease (ILD) is a frequent complication of inflammatory myopathies with high rates of morbidity and mortality. Antibodies against aminoacyl-tRNA-synthetases are the strongest predictive factors in ILD. In this study, we reviewed the literature and we retrospectively analysed high-resolution computed tomography (HRCT) findings in a cohort of 131 consecutive subjects: 75 with polymyositis (PM), 43 with dermatomyositis (DM), one with amyophatic PM, two with paraneoplastic syndromes, and 10 with overlapping syndromes. The inclusion criteria were PM/DM, anti-Jo1 antibody positivity, and HRCT-assessed ILD. The effect of 12 months' treatment with cyclophosphamide (CYC) or cyclosporin A (CsA) plus steroids was assessed by comparing baseline and follow-up HRCT scans for evidence of stability, improvement or worsening. Fifteen patients (11.5%) had ILD and were Jo-1 positive. They were all women with PM, and had a mean age of 47.33 years and a median duration of symptoms of 7.26 months. At baseline, HRCT showed ground-glass attenuations in eight cases, septal thickening in seven, and honeycombing in four. Twelve months after diagnosis, ILD had worsened in nine patients (60%; exact confidence interval [ECI] 32-84) and was stable in four (two patients were lost to follow-up). Seven of the 15 patients were treated with CsA, and 12-month HRCT revealed a worsening in ILD in five cases (71%; ECI 0.29-0.96); ILD also worsened (ECI 16-84) in four of the eight patients treated with CYC pulses (50%). The evolution of the HRCT findings was not significantly different between the two groups. Our findings confirm that ILD is a common early manifestation in patients with Jo1-positive PM. Over twelve months, HRCT showed worsening ILD in most of our patients, with no difference in the HRCT changes between those treated with CYC or CsA.


Assuntos
Anticorpos Antinucleares/imunologia , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Doenças Pulmonares Intersticiais/etiologia , Polimiosite/complicações , Polimiosite/imunologia , Tomografia Computadorizada por Raios X , Adulto , Idoso , Ciclosporina/uso terapêutico , Dermatomiosite/diagnóstico por imagem , Dermatomiosite/etiologia , Feminino , Humanos , Imunossupressores/uso terapêutico , Pessoa de Meia-Idade , Polimiosite/diagnóstico por imagem , Polimiosite/tratamento farmacológico , Estudos Retrospectivos , Adulto Jovem
3.
Breast J ; 16(1): 55-9, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-19825003

RESUMO

This study was carried out to determine the underestimation rate of carcinoma upon surgical biopsy after a diagnosis of flat epithelial atypia and atypical ductal hyperplasia and 11-gauge vacuum-assisted breast biopsy. A retrospective review was conducted of 476 vacuum-assisted breast biopsy performed from May 2005 to January 2007 and a total of 70 cases of atypia were identified. Fifty cases (71%) were categorized as pure atypical ductal hyperplasia, 18 (26%) as pure flat epithelial atypia and two (3%) as concomitant flat epithelial atypia and atypical ductal hyperplasia. Each group were compared with the subsequent open surgical specimens. Surgical biopsy was performed in 44 patients with atypical ductal hyperplasia, 15 patients with flat epithelial atypia, and two patients with flat epithelial atypia and atypical ductal hyperplasia. Five cases of atypical ductal hyperplasia were upgraded to ductal carcinoma in situ, three cases of flat epithelial atypia yielded one ductal carcinoma in situ and two cases of invasive ductal carcinoma, and one case of flat epithelial atypia/atypical ductal hyperplasia had invasive ductal carcinoma. The overall rate of malignancy was 16% for atypical ductal hyperplasia (including flat epithelial atypia/atypical ductal hyperplasia patients) and 20% for flat epithelial atypia. The presence of flat epithelial atypia and atypical ductal hyperplasia at biopsy requires careful consideration, and surgical excision should be suggested.


Assuntos
Biópsia por Agulha Fina/métodos , Neoplasias da Mama/patologia , Carcinoma in Situ/patologia , Carcinoma Ductal de Mama/patologia , Lesões Pré-Cancerosas/patologia , Adulto , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/fisiopatologia , Carcinoma in Situ/epidemiologia , Carcinoma in Situ/fisiopatologia , Carcinoma Ductal de Mama/epidemiologia , Estudos de Coortes , Feminino , Humanos , Hiperplasia/epidemiologia , Hiperplasia/patologia , Imuno-Histoquímica , Incidência , Masculino , Mamografia/métodos , Pessoa de Meia-Idade , Lesões Pré-Cancerosas/epidemiologia , Prognóstico , Estudos Retrospectivos , Medição de Risco
4.
Eur J Radiol ; 74(1): 221-5, 2010 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-19233582

RESUMO

PURPOSE: To evaluate the diagnostic accuracy and indications of arthrography with Multidetector Computed Tomography (arthro-MDCT) of the wrist in patients with absolute or relative contraindications to magnetic resonance imaging (MRI) studies and in patients with periarticular metal implants using diagnostic arthroscopy as the gold standard. MATERIALS AND METHODS: After intra-articular injection of iodixanol and volumetric acquisition, 43 wrists in patients of both genders (18 females, 25 males, age range 32-60 years) were examined with a 16-detector-row CT scanner. Fifteen patients had prior wrist surgery. The patients had arthralgia, degenerative and traumatic arthropathies as well as limited range of motion, but no radiologically detected fractures. All examinations were interpreted by two experienced musculoskeletal radiologists. The findings were compared with arthroscopic findings carried out within 28 days of the CT study. RESULTS: In non-operated and operated wrists the comparison between arthro-MDCT and arthroscopy showed sensitivity, specificity and accuracy ranging between 92% and 94% for triangular fibrocartilage complex (TFCC), between 80% and 100% for intrinsic ligaments located within the proximal carpal compartment, and between 94% and 100% for articular cartilage. Inter-observer agreement between two radiologists, in the evaluation of all types of lesions, was almost perfect (k=0.96) and statistically significant (p<0.05). CONCLUSIONS: Arthro-MDCT of the wrist provides an accurate diagnosis to identify chondral, fibrocartilaginous and intra-articular ligament lesions in patients who cannot be evaluated by MRI, and in post-surgical patients.


Assuntos
Artropatias/diagnóstico por imagem , Artropatias/diagnóstico , Traumatismos do Punho/diagnóstico por imagem , Traumatismos do Punho/diagnóstico , Adulto , Artralgia/diagnóstico , Artralgia/diagnóstico por imagem , Artropatia Neurogênica/diagnóstico , Artropatia Neurogênica/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Estudos Retrospectivos , Sensibilidade e Especificidade , Tomografia Computadorizada por Raios X
5.
Eur Radiol ; 20(1): 88-94, 2010 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-19597819

RESUMO

The objective was to determine the prevalence of bronchial diverticula in smokers on thin-section CT and the relationship to clinical and other morphological features on CT. Thin-section CT images of 503 cigarette smokers were assessed for the profusion and location of diverticula in the major airways. The extent of the bronchial diverticula was recorded as follows: grade 0, none; grade 1, one to three diverticula; grade 2, more than three diverticula. The extent of emphysema, bronchial wall thickness, clinical features, and pulmonary function were compared in the sub-groups stratified according to the extent of bronchial diverticula. A total of 229/503 (45.5%) smokers had bronchial diverticula, with 168/503 (33.3%) and 61/503 (12.2%) having grade 1 and 2 bronchial diverticula respectively. Subjects with grade 2 bronchial diverticula were heavier smokers, reported a history of coughing more frequently, and showed more severe functional impairment, greater extent of emphysema and more severe bronchial wall thickening compared with subjects with grade 1 and those individuals without bronchial diverticula (P < 0.05). Multivariate regression analysis revealed that only bronchial wall thickness predicted the extent of the bronchial diverticula (P < 0.0001). Bronchial diverticula are a frequent finding in the major airways of smokers, and they are associated with other markers of smoking-related damage.


Assuntos
Broncopatias/diagnóstico , Broncopatias/epidemiologia , Divertículo/diagnóstico por imagem , Divertículo/epidemiologia , Enfisema/diagnóstico por imagem , Enfisema/epidemiologia , Fumar/epidemiologia , Comorbidade , Feminino , Humanos , Incidência , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Medição de Risco/métodos , Fatores de Risco , Tomografia Computadorizada por Raios X/estatística & dados numéricos
6.
Acta Biomed ; 78(2): 139-43, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17933282

RESUMO

Hemangiomas of the small bowel are rare benign tumors, that are dangerous since they may cause massive or occult gastrointestinal bleeding. We describe a case of a jejunum cavernous hemangioma detected by computed tomography (CT) and barium studies. An abdominal CT scan (with intravenous contrast agent) depicted a pronounced contrast enhanced lesion arising from the front wall of a loop of the proximal ileum. Enteroclysis revealed a small intramural nodular defect.


Assuntos
Hemangioma Cavernoso/diagnóstico , Neoplasias do Jejuno/diagnóstico , Adulto , Sulfato de Bário , Meios de Contraste , Enema , Feminino , Hemangioma Cavernoso/diagnóstico por imagem , Hemangioma Cavernoso/patologia , Hemangioma Cavernoso/cirurgia , Humanos , Neoplasias do Jejuno/diagnóstico por imagem , Neoplasias do Jejuno/patologia , Neoplasias do Jejuno/cirurgia , Jejuno/patologia , Laparotomia , Radiografia Abdominal , Tomografia Computadorizada por Raios X
7.
Fundam Clin Pharmacol ; 19(4): 497-501, 2005 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-16011738

RESUMO

It has been reported in literature that serum pepsinogen levels rise during omeprazole and lansoprazole administration. However, the influence of pantoprazole and esomeprazole on serum pepsinogens levels is still to be assessed. The aim of this study was to evaluate the influence of proton pump inhibitor (PPI) therapy on pepsinogen I (PGI) levels. PGI and gastrin (G17) levels (EIA; Biohit, Helsinki, Finland) in 126 consecutive patients (M 57; F 69, mean age 53, range 15-91), with upper gastrointestinal symptoms at baseline condition and after 2 months of PPI treatment, were evaluated. Patients underwent a therapy schedule based on: omeprazole 20 mg b.i.d. (20 patients), pantoprazole 40 mg b.i.d. (27 patients), esomeprazole 40 mg b.i.d. (29 patients), lansoprazole 30 mg b.i.d. (21 patients) and rabeprazole 20 mg b.i.d. (26 patients) for 2 months. A significant increase in serum PGI (sPGI) levels was found after a 2-month treatment for all five different PPIs: omeprazole, pantoprazole, esomeprazole, lansoprazole and rabeprazole (P < 0.05). The effect of rabeprazole on sPGI was less pronounced as compared with other PPIs, whereas esomeprazole achieved superior sPGI levels, with no overall statistically significant difference among the five groups (P > 0.05). However, a comparison within a single group of PPIs showed a statistical significance when the esomeprazole group was compared with the rabeprazole group (P = 0.007). sPGI levels are significantly influenced by antisecretory therapy, rising under PPI treatment. Moreover, a statistically significant difference in sPGI levels between the rabeprazole and esomeprazole groups has been demonstrated.


Assuntos
Antiulcerosos/farmacologia , Inibidores Enzimáticos/farmacologia , Pepsinogênio A/sangue , Inibidores da Bomba de Prótons , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Gastrinas/sangue , Humanos , Masculino , Pessoa de Meia-Idade
9.
J Clin Gastroenterol ; 36(5): 396-8, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-12702979

RESUMO

BACKGROUND: One-week triple therapy is the most frequently recommended treatment of Helicobacter pylori infection. The associated eradication rate is satisfactory; nevertheless, it is advisable to look for more effective therapies. Our aim was to test the efficacy of a standard triple therapy plus bovine lactoferrin for the eradication of H. pylori infection. STUDY: This open, randomized, single-center study was designed to include 150 consecutive H. pylori-positive patients with dyspeptic symptoms and gastritis who received triple therapy with rabeprazole, clarithromycin, and tinidazole plus lactoferrin for 7 days (group A), rabeprazole, clarithromycin, and tinidazole for 7 days (group B), or rabeprazole, clarithromycin, and tinidazole for 10 days (group C). H. pylori status was assessed 8 weeks after the end of treatment by means of the 13C-urea breath test or H. pylori stool antigen test. RESULTS: The 7-day treatment including lactoferrin (group A) was successful in 100% (24/24) of the patients. The eradication rates in groups B and C were 76.9% (20/26 patients; 95% CI, 61%-93%) and 70.8% (17/24 patients; 95% CI, 53%-89%), respectively. A significant difference was found between group A and group B (P = 0.023) and group A and group C (P = 0.022). No differences were found between group B and group C (P = 1.00). CONCLUSION: These results suggest that lactoferrin could be a new, effective agent when added to antimicrobial therapy for the eradication of H. pylori. This treatment schedule could be proposed for larger trials of H. pylori eradication therapy, focusing on the excellent preliminary cure rate, good compliance to the treatment schedule, and relatively low price of lactoferrin for full treatment.


Assuntos
Infecções por Helicobacter/tratamento farmacológico , Helicobacter pylori , Lactoferrina/uso terapêutico , Quimioterapia Combinada , Humanos
10.
Tumori ; 89(5): 485-7, 2003.
Artigo em Inglês | MEDLINE | ID: mdl-14870768

RESUMO

AIMS AND BACKGROUND: To determine the role of reflux esophagitis in the development of pharyngolaryngeal squamous cell carcinoma in non-smoking and non-drinking patients. METHODS: The study population consisted of 92 consecutive non-smoking and non-drinking patients with histologically confirmed squamous cell carcinoma of the pharynx and the larynx. As a control, a group of 125 lifetime non-smoking and non-drinking cancer-free subjects was selected. RESULTS: Patients with pharyngolaryngeal cancer had a higher prevalence of reflux esophagitis than the control subjects (P <0.0001). CONCLUSIONS: Our results confirm that reflux esophagitis in itself is associated with an increased risk of upper aerodigestive tract cancer.


Assuntos
Carcinoma de Células Escamosas/etiologia , Esofagite Péptica/complicações , Esofagite Péptica/epidemiologia , Neoplasias Laríngeas/etiologia , Neoplasias Faríngeas/etiologia , Idoso , Feminino , Humanos , Itália/epidemiologia , Masculino , Prontuários Médicos , Pessoa de Meia-Idade , Prevalência , Estudos Retrospectivos , Fatores de Risco , Índice de Gravidade de Doença
11.
Acta Biomed ; 73(5-6): 71-3, 2002.
Artigo em Inglês | MEDLINE | ID: mdl-12643075

RESUMO

Lactoferrin is an iron binding protein involved in a large spectrum of biological actions including antimicrobial actions. Lactoferrin plays a central role in ferrokinetics: it binds free iron with great affinity limiting the amount of ions available for microorganism's metabolism. Its role in the host defence mechanisms consists in bacteriostatic and bactericidal effects; moreover it inhibits the proliferation of other microbes such as fungi and viruses. Lactoferrin is also involved in the modulation of immune system and recent studies indicate that lactoferrin directly modulates both production and function of neutrophils and monocytes.


Assuntos
Lactoferrina/farmacologia , Lactoferrina/uso terapêutico
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