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Biomedical subjects

A Carella

Publications and source records attributed to A Carella.

At least 19 recordsLinked to original sources
PubMed2006

Multimodal MR examination in acute ischemic stroke.

In recent years, combined diffusion-weighted imaging (DWI) with perfusion imaging (PI) has become an important investigational tool in the acute phase of ischemic stroke, as it may differentiate reversible from irreversible brain tissue damage. We consecutively examined 20 subjects within 12 h of stroke onset using a multiparametric magnetic resonance (MR) examination consisting of DWI, mean transit time (MTT) as PI parameter, and MR angiography (MRA). T2-weighted and fluid-attenuated inversion recovery (FLAIR) on day 7 were also acquired in order to obtain final infarct volume. The following MR parameters were considered: volumetric measures of lesion growth and MTT abnormalities, quantification of regional apparent diffusion coefficient (ADC) and visual inspection of MRA findings. Our results showed: (1) an acute DWI lesion was not predictive of lesion growth and the DWI abnormality did not represent the irreversibly infarcted tissue; (2) ADC values in the ischemic penumbra could not predict tissue at risk; (3) the DWI-PI mismatch did not predict lesion growth, and the PI abnormality overestimated the amount of tissue at risk; and (4) patients with proximal middle cerebral artery occlusion had greater initial and final infarct volumes. This study did not demonstrate the prognostic value of a multimodal MR approach in early ischemic stroke; MRA alone provided predictive information about the volumetric evolution of the lesion.

Acute Disease↗
PubMed2005

Emergencies in hereditary haemorrhagic telangiectasia.

BACKGROUND: Hereditary haemorrhagic telangiectasia (HHT) is a systemic autosomal dominant vascular disease. Although the clinical picture is that of a chronic disabling disease, vascular malformations can suddenly lead to life-threatening conditions. AIM: To assess the frequency and type of emergency acute complications in HHT. DESIGN: Retrospective case-note review. METHODS: From August 2000 to December 2004, our specialized HHT centre saw 139 patients (74 males, 65 females, mean age 45.5 years, range 14-77) with a definite diagnosis of HHT. We reviewed their clinical files and recorded all visits for acute complications (massive nosebleeds, haematemesis, melaena, haematochezia, haemothorax, haemoptysis, TIA/ischaemic stroke, haemorrhagic stroke, brain abscess). RESULTS: Fifty patients (35.9%) had at least one acute complication. There were a total of 93 visits potentially involving the emergency department. Most commonly, patients sought urgent medical attention for nosebleeds and gastrointestinal bleeding (63.4%), but there were also disorders of the brain, lung, heart and liver. DISCUSSION: Acute complications of HHT are not uncommon and can be severe and wide-ranging. Physicians should be aware of HHT and its major complications, as a prompt diagnosis is essential to direct patients to the most appropriate therapies, and to suggest screening for visceral involvement in their relatives.

Adolescent↗
PubMed2004

Ischaemic stroke in progressive systemic sclerosis.

Progressive systemic sclerosis (PSS) or scleroderma is a multisystem disease affecting the skin, lungs, myocardium, kidneys and gastrointestinal tract. Primary involvement of cerebral arteries in PSS has been reported but is very rare. A 61-year-old woman suffering from scleroderma for six years was hospitalised for two subsequent episodes of transient acute dysarthria and left hemiparesis. After five hours from the first onset of symptoms, she was submitted to brain magnetic resonance (MR) protocol that showed a right subinsular ischaemic lesion and whole right middle cerebral artery (MCA) territory hypoperfusion. Intracranial and epiaortic MR angiography reported a focal stenosis in the M2 portion of MCA. She was immediately treated with i.v. high dose steroids and oral acetylsalicylic acid. At one-month follow up, MR findings were confirmed. We have documented a cerebral infarct in a PSS patient. In our opinion, the ischaemic stroke was caused by a localised autoimmune angiopathy.

Aspirin↗
PubMed2002

Safety and efficacy of STI-571 (imatinib mesylate) in patients with bcr/abl-positive chronic myelogenous leukemia (CML) after autologous peripheral blood stem cell transplantation (PBSCT).

We examined safety and efficacy of STI-571 in 24 bcr/abl-positive patients with CML post PBSCT. At start of STI-571 therapy, nine patients presented in blast crisis (BC) or in accelerated phase (AP), and 15 in chronic phase (CP). Patients were evaluated for hematologic, cytogenetic and molecular response, survival and toxicity. In general, STI-571 was well tolerated in this heavily pretreated group of patients with a non-hematologic and hematologic toxicity profile similar to that observed in a previous phase I trial at comparable doses. Five of nine patients with CML in transformation (AP, BC) were evaluable for hematologic response. Two of five patients had transient reductions in WBC and blasts, and three patients achieved a sustained hematologic response (>4 weeks). Cytogenetic analysis in these patients revealed numerical and/or structural responses. In CML chronic phase, STI-571 induced complete hematologic responses in all patients and major cytogenetic responses in 61% of patients with a complete cytogenetic response rate of 46%. This report indicates that STI-571 is a safe and effective drug in heavily pretreated patients. No apparent additional side-effects were noted in this patient cohort. The high rate of complete hematologic and complete cytogenetic responses in CP patients is remarkable, as intensive treatment approaches plus IFN-alpha failed to be efficient in achieving long-term stabilization of CML in this patient cohort.

Adult↗
PubMed2002

Efficacy of the liquid formulation of some nematicides.

Bunches of 25 g of tomato galled roots containing ca. 270 eggs and juveniles/g of Meloidogyne incognita were buried on 29 September 2001 in gauze bags at the depth of 15, 30 and 45 cm in a sandy loam. The liquid formulation of the nematicides 1,3 dichloropropene (at the rate of 100, 200 and 300 l/ha), metam sodium (at the rate of 500, 1000, and 1500 l/ha), oxamyl (at the rate of 50, 100 and 150 l/ha) and fenamiphos (at the rate of 30, 60, and 90 l/ha) were then applied in 10, 20 or 40 l/m2 of water. Control plots received only plain water. One month later all bags were recovered and the roots mixed with steamed soil and filled in plastic pots in which two tomato seeds were planted. Fifty days later plants were uprooted and aliquots of roots were macerated in blender to determine the number of eggs and juveniles. 1,3 dichloropropene, metam sodium and oxamyl were equally effective in controlling root-knot nematodes; fenamiphos was less effective. For all chemicals degree of control increased with the increase of rate of application and the volume of water of application, but decreased in the increase of depth of nematode burial.

Allyl Compounds↗
PubMed2001

Combinatorial synthesis of CCR5 antagonists.

Herein we report the preparation of a combinatorial library of compounds with potent CCR5 binding affinity. The library design was aided by SAR generated in a traditional medicinal chemistry effort. Compounds with novel combinations of subunits were discovered that have high binding affinity for the CCR5 receptor. A potent CCR5 antagonist from the library, compound 11 was found to have moderate anti-HIV-1 activity.

CCR5 Receptor Antagonists↗
PubMed2001

Antagonists of the human CCR5 receptor as anti-HIV-1 agents. Part 4: synthesis and structure-activity relationships for 1-[N-(methyl)-N-(phenylsulfonyl)amino]-2-(phenyl)-4-(4-(N-(alkyl)-N-(benzyloxycarbonyl)amino)piperidin-1-yl)butanes.

(2S)-2-(3-Chlorophenyl)-1-[N-(methyl)-N-(phenylsulfonyl)amino]-4-[spiro(2,3-dihydrobenzthiophene-3,4'-piperidin-1'-yl)]butane S-oxide (1b) has been identified as a potent CCR5 antagonist having an IC50=10 nM. Herein, structure-activity relationship studies of non-spiro piperidines are described, which led to the discovery of 4-(N-(alkyl)-N-(benzyloxycarbonyl)amino)piperidine derivatives (3-5) as potent CCR5 antagonists.

Animals↗
PubMed2001

Antagonists of the human CCR5 receptor as anti-HIV-1 agents. part 1: discovery and initial structure-activity relationships for 1 -amino-2-phenyl-4-(piperidin-1-yl)butanes.

Screening of the Merck sample collection for compounds with CCR5 receptor binding afforded (2S)-2-(3,4-dichlorophenyl)-1-[N-(methyl)-N-(phenylsulfonyl)amino]-4-[spiro(2,3-dihydrobenzthiophene-3,4'-piperidin-1'-yl)]butane S-oxide (4) as a potent lead structure having an IC50 binding affinity of 35 nM. Herein, we describe the discovery of this lead structure and our initial structure activity relationship studies directed toward the requirement for and optimization of the 1-amino fragment.

Animals↗
PubMed2001

Antagonists of the human CCR5 receptor as anti-HIV-1 agents. Part 2: structure-activity relationships for substituted 2-Aryl-1-[N-(methyl)-N-(phenylsulfonyl)amino]-4-(piperidin-1-yl)butanes.

(2S)-2-(3,4-Dichlorophenyl)-1-[N-(methyl)-N-(phenylsulfonyl)amino]-4-[spiro(2,3-dihydrobenzthiophene-3,4'-piperidin-1'-yl)]butane S-oxide (3) has been identified as a potent CCR5 antagonist lead structure having an IC50 = 35 nM. Herein, we describe the structure-activity relationship studies directed toward the requirement for and optimization of the C-2 phenyl fragment. The phenyl was found to be important for CCR5 antagonism and substitution was limited to small moieties at the 3-position (13 and 16: X= H, 3-F, 3-Cl, 3-Me).

Animals↗
PubMed2001

Paroxysmal dystonia with thalamic lesion in multiple sclerosis.

Paroxysmal dystonia (PD) is a usually painful, unilateral dystonic posture, precipitated by voluntary movement, tactile stimulation, startling noise or hyperventilation. We describe two cases of paroxysmal dystonia in multiple sclerosis, both with a critically localized lesion in the thalamus, contralateral to the paroxysmal symptoms. Only one other case of paroxysmal dystonia with a demyelinated lesion of the thalamus has been reported previously.

Adolescent↗
PubMed2001

Control of Pratylenchus vulnus in stone fruit nurseries.

Almond, peach and olive nurseries were prepared in sandy soil infested by Pratylenchus vulnus in southern Italy. Soil treatments before or at sowing included methyl bromide at the rate of 40 g/m2; 1.3 D at the rate of 15 ml/m2; dazomet at the rate of 100 g/m2 without plastic tarping, or at the rate of either 100 or 50 g/m2 with tarping, and fenamiphos Gr 5 at the rate of 100 g/m2 or 240 CS at the rate of 40 g/m2 as single application; fenamiphos Gr 10 and 240 CS were also applied at planting and two, four and six months after sowing, each time at the rate of 10 g/m2. The experiment was discontinued ten and thirteen months after sowing, respectively for olive and peach and almond. Methyl bromide, 1.3 D or fenamiphos, or dazomet, under certain circumstances, produced agronomically suitable plants, but none of the treatments eradicated the nematode.

Allyl Compounds↗
PubMed2000

Genetic epidemiology of hepatitis C virus throughout egypt.

Hepatitis C virus (HCV) infection is a major health problem in Egypt, where the seroprevalence is 10-20-fold higher than that in the United States. To characterize the HCV genotype distribution and concordance of genotype assessments on the basis of multiple genomic regions, specimens were obtained from blood donors in 15 geographically diverse governorates throughout Egypt. The 5' noncoding, core/E1, and NS5B regions were amplified by reverse transcription-polymerase chain reaction and analyzed by both restriction fragment length polymorphism (RFLP) and phylogenetic tree construction. For the 5' noncoding region, 122 (64%) of 190 specimens were amplified and analyzed by RFLP: 111 (91%) were genotype 4, 1 (1%) was genotype 1a, 1 (1%) was genotype 1b, and 9 (7%) could not be typed. Phylogenetic analyses of the core/E1 and NS5B regions confirmed the genotype 4 preponderance and revealed evidence of 3 new subtypes. Analysis of genetic distance between isolates was consistent with the introduction of multiple virus strains 75-140 years ago, and no clustering was detected within geographic regions, suggesting widespread dispersion at some time since then.

Blood Donors↗
PubMed2000

Wernicke's encephalopathy induced by total parenteral nutrition in patient with acute leukaemia: unusual involvement of caudate nuclei and cerebral cortex on MRI.

We report a 13-year-old girl with leukaemia and Wernicke's encephalopathy induced by total parenteral nutrition. MRI showed unusual bilateral lesions of the caudate nuclei and cerebral cortex, as well as typical lesions surrounding the third ventricle and aqueduct. After intravenous thiamine, the patient improved, and the abnormalities on MRI disappeared.

Acute Disease↗
PubMed2000

An unusual association of intracranial aneurysms and oesophageal duplication in a case of Klippel-Trenaunay syndrome.

The Klippel-Trenaunay syndrome (KTS) is a congenital disorder resulting from a mesodermal abnormality, characterised by cutaneous capillary haemangiomas, hypertrophy of bone and soft tissues and varicose veins. The presence of intracranial aneurysms has rarely been described, while oesophageal duplication has not been reported previously. We describe a patient with the KTS with both there additional abnormalities, which could be explained by a postulated mosaic gene abnormality.

Abnormalities, Multiple↗