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Biomedical subjects

A De Luca

Publications and source records attributed to A De Luca.

At least 289 records · Page 16Linked to original sources
PubMedDate not supplied

Antibody response to Helicobacter pylori CagA and heat-shock proteins in determining the risk of gastric cancer development.

OBJECTIVE: To investigate whether the systemic antibody response to Helicobacter pylori heat shock protein B can be considered, in addition to anti cytotoxin-associated protein [CagA) antibody determination, a further serological marker of increased risk of gastric cancer development. METHODS: A total of 98 Giemsa positive Helicobacter pylori patients (28 with gastric cancer, 30 with duodenal ulcer and 40 with nonulcer dyspepsia) were studied. Serum samples obtained from all patients were tested for IgG antibodies to CagA (116 kDa), VacA [89kDa) and heat skock protein B (54 kDa) antigens of Helicobacter pylori by the Western blot technique. RESULTS: 26/28 patients [(92.9% with gastric carcinoma, 29/30 patients [96.7%) with duodenal ulcer and 30/40 patients (75.0%) with non-ulcer dyspepsia were seropositive for CagA protein. The prevalence of serum IgG antibody to CagA in the cancer patients was not significantly higher than in duodenal ulcer and non-ulcer dyspepsia patients. The prevalence of antibodies to VacA was not significantly different between gastric carcinoma and non-ulcer dyspepsia patients. In contrast the prevalence of systemic antibodies to heat skock protein B was significantly higher in gastric cancer patients (78.6%) than in duodenal ulcer (36.7%, p=0.002) or nonulcer dyspepsia patients (52.5%, p=0.029). CONCLUSIONS: The detection of antibodies to heat shock protein B is proposed as an additional test which, in association with the determination of serum antibodies to CagA, could help in determining the risk of developing severe gastroduodenal disease, and gastric cancer, in particular.

Antibodies, Bacterial↗
PubMedDate not supplied

Vasoactive intestinal peptide stimulation modulates the expression of Bcl-2 family members in the adrenal gland of the lizard Podarcis sicula.

The adrenal gland of the lizard Podarcis sicula is formed by a dorsal ribbon of chromaffin cells, generally defined as medullary tissue, arranged along a central part of steroidogenic cells considered as cortical tissue. These two tissues produce catecholamines and steroids as part of the hypothalamo-hypophyseal-adrenal gland axis. Recent studies have demonstrated that Podarcis sicula adrenal gland is not only under hypothalamo-hypophyseal axis control but that several peptides may influence the physiological activity of the gland; among these, vasoactive intestinal peptide is able to enhance strongly both catecholamine and steroid hormone production. The aim of the present study was to verify whether vasoactive intestinal peptide administration could become deleterious. For this reason, we monitored the pattern of expression of two members of the Bcl-2 family, Bcl-2 and Bax, in control and vasoactive intestinal peptide treated specimens. Furthermore, we also tested if peptide treatment induces apoptosis by TUNEL assay.

Adrenal Glands↗
PubMedDate not supplied

Impairment of recent thymic emigrants in HCV infection.

Hepatitis C Virus (HCV) often has a more favorable course in younger patients. Considering the involution of the thymic function with age, we investigated the output of recent thymic emigrants (RTE) in HCV patients. To evaluate RTE, we used a competitive quantitative PCR in order to determine the percentages of cells with cj-T cell receptor excision circles (TREC). This study was performed in 14 HCV patients at diagnosis and before any anti-HCV treatment. The results obtained in this group were compared to those obtained in a group of age-matched controls. We found that in the 14 HCV patients naive for anti-HCV treatment the mean percentage of cj-TREC was 3%. We could not detect a correlation between the percentages of cj-TREC and age or patients' viremia. In contrast, in the 26 age-matched controls mean percentage of cj-TREC was 5.6% (P=0.01). Our study describes a novel immune defect in HCV patients. Additional studies are needed to get further insight in the possible role of TREC defect in the pathogenesis and prognosis of the disease.

Adult↗
PubMedDate not supplied

Self-reported nonadherence with antiretroviral drugs predicts persistent condition.

PURPOSE: To assess variables predictive of nonadherence persisting over time in HIV-infected people treated with highly active antiretroviral therapy. METHOD: Prospective study of consecutive HIV-infected patients who were prescribed ritonavir- or indinavir-containing regimens in a university-based HIV clinic in Rome. A patient questionnaire assessing knowledge of treatment regimen, adherence behavior, reasons for taking and missing therapy, factors influencing adherence, and health behaviors was administered at baseline and 1 year later. A predose protease inhibitor plasma level was measured concurrently. Persistent nonadherence was defined as patient self-reported nonadherence both at enrollment and at follow-up questionnaires. RESULTS: From April 1998 to July 1998, 140 patients were enrolled into the study. At follow-up, 10% remained persistently nonadherent, and 15% of the previously adherent patients became nonadherent. On bivariate analysis, being less than 35 years old (odds ratio [OR] 8.9; 95% CI 1.8-43.1; p =.002), self-reporting nonadherence at enrollment (OR 14.5; 95% CI 3.5-5.8; p <.001), and having experienced "a fair amount" or "a lot" of vomiting (OR 11.1;95% CI 1.6-74.7; p =.02) or pruritus (OR 16.4; 95% CI 2.6-102.8; p =.004) during the 4 weeks before enrollment were significantly correlated to persistent nonadherence. CONCLUSION: Previous self-reported nonadherence was a strong predictor of persistent nonadherence during follow-up. Moreover, being of younger age and self-reporting vomiting or pruritus were also associated with a higher risk of nonadherence persisting over time.

Adult↗
PubMedDate not supplied

Synergistic growth inhibition and induction of apoptosis by a novel mixed backbone antisense oligonucleotide targeting CRIPTO in combination with C225 anti-EGFR monoclonal antibody and 8-Cl-cAMP in human GEO colon cancer cells.

We have evaluated the antiproliferative effect of a novel mixed backbone antisense oligonucleotide generated against the 5'-coding region of the human CRIPTO mRNA in GEO human colon cancer cells. We have also evaluated the effects of this anti-CRIPTO antisense oligonucleotide in combination with a chimeric anti-human epidermal growth factor receptor (EGFR) monoclonal antibody (MAb C225) and with 8-Cl-cAMP, a cAMP analog that specifically inhibits type I protein kinase A (PKAI), since a functional EGFR-driven autocrine pathway is operative and PKAI is overexpessed in GEO colon cancer cells. Treatment with a single agent at low doses determined a 15-35% growth inhibition. A synergistic antiproliferative effect was observed when combinations of two agents were used with a co-operativity quotient ranging between 1.5 and 2.2. Furthermore, the combined treatment with all three drugs caused an almost complete suppression of the ability of GEO cells to form colonies in soft agar. We next evaluated whether any combination of 8-Cl-cAMP, the anti-CRIPTO antisense oligonucleotide and MAb C225 could induce programmed cell death in GEO cells. Treatment with each agent alone at all doses tested did not cause DNA fragmentation. The treatment with any combination of two agents was not able to induce apoptosis. In contrast, treatment with all three compounds determined an approximately three-fold increase in DNA fragmentation. In conclusion, the combination of selective antineoplastic agents directed against different but related key signal tranduction pathways efficiently inhibits cell growth and causes apoptosis in human colorectal cancer cells.

8-Bromo Cyclic Adenosine Monophosphate↗
PubMedDate not supplied

Bcl-2 protein expression correlates with nodal status in non small cell lung cancer.

We investigated the immunohistochemical expression of bcl-2 in 55 non small cell lung cancer patients in order to understand if the altered expression of this gene is involved in the development of this kind of neoplasm. Our results showed bcl-2 immunopositivity to be a frequent event in non small cell lung cancer (54.5%) with a higher expression in squamous carcinomas compared to adenocarcinomas (p = .04). In addition, we found a positive correlation between bcl-2 expression levels and nodal status (p < .003). We suggest that bcl-2 immunostaining could be considered as marker of loco-regional invasivity.

Adenocarcinoma↗
PubMedDate not supplied

Frequent high expression of bax pro-apoptotic protein in non-small cell lung cancer.

Bax, bcl-2 and their homologues regulate a distal step in an evolutionary very well conserved pathway of apoptotic cell death. It plays a crucial role in the balance between proliferation rate and cell viability. Thus in the last years the attention of the scientific community towards these proteins has remarkably increased, in particular in the oncologic field. We developed an immunohistochemical assay allowing us to evaluate the bax expression in formalin fixed and paraffin embedded lung cancer tissues to investigate bax expression in a cohort of 55 patients affected by non-small cell lung cancer. We detected high expression of bax in 72.7% of our patients. When we statistically analyzed our data we did not find any correlation between bax expression and any clinicopathologic parameters (sex, age, TNM status, tumor grade, histological type). In conclusion, our study shows the frequent overexpression of bax, and this highlights the "apoptotic tendency" of cells during the neoplastic proliferation. But, the role of bax in non-small cell lung cancer pathogenesis still remains unclear and further studies of large numbers of patients, including different stage groups, are needed to better define the involvement of this protein in the complex mechanism of lung carcinogenesis.

Adenocarcinoma↗
PubMedDate not supplied

Cystic dilatation of common bile duct. Case report and review.

The cystic dilatation of the common bile duct is a rare disease in Europe and in the USA; even rarer in adults. In fact less than 30% of cases are described in the over 20's. There are some reports in the elderly. When observed in adults the diagnosis is usually due to the onset of symptoms of associated pathologies or to complications such as cholangitis or cancer. Ultrasound, CT and ERCP allow, in the majority of cases, an adequate pre-operative characterization of the lesion. Intra-operative cholangiography verifies the completeness of surgery--always resective--and excludes residual biliary pathologies. The treatment in patients who already underwent conservative surgery is more complex, in fact, in symptomatic patients a second observation and resection is mandatory while in asymptomatic patients a careful and complete follow-up is adequate without underestimating the cancer risk. Septic and inflammatory complications, especially if chronic or recurring, can damage the liver; here resection or liver transplantation can be necessary. The case here reported is a 24-year-old woman with recurring cholangitis for at least 2 years in which US, CT and ERCP showed a Todani's type I cystic dilatation of the CBD. The total excision of the cyst with hepatic-jejunal anastomosis was carried out. A two-year follow up demonstrated no symptoms and normal laboratory findings; cholangioscintigraphy showed a good hepatic-biliary and anastomotic function.

Adult↗
PubMedDate not supplied

Vesical telangiectasias as a cause of macroscopic hematuria in systemic sclerosis.

A 36-year-old female with diffuse cutaneous systemic sclerosis (dcSSc) developed macrohematuria due to vesical telangiectasias that was responsive to diathermocoagulation of the vasal lesions. This is the first report of a patient with dcSSc and vesical telangiectasias leading to severe macrohematuria that was successfully treated with diathermocoagulation.

Adult↗
PubMedDate not supplied

Laparoscopic repair vs open surgery for incisional hernias: a comparison study.

BACKGROUND: Incisional Hernias complicate 2-11% of laparotomies and the primary closure of the defect is followed by recurrence in 20-46% of patients. In spite of introduction of prosthetic materials and new techniques the rate of failure reduced but a gold standard has not been defined. Laparoscopic approach, recently introduced appears promisingly effective but only few and small series have been published. MATERIALS AND METHODS: Two series of patient, 11 treated by laparoscopic repair (LR) and 15 undergone to open prosthetic repair (OR) are compared with regard to age, sex, previous surgery, number of fascial defects, size and location of hernias, ASA status, operating time, intra and postoperative complications, length of hospital stay, follow up evaluation and hernia recurrence. Prosthetic materials were e-PTFE in LR group and e PTFE or Polypropilene in OR group. Peripherical hernias have been excluded from the study. RESULTS: In LR group has been observed a longer mean operative time and a shorter hospital stay than in OR group. No intraoperative complication was observed in LR and 1 in OR group. Early and late complications were more frequent in OR than in LR group but the removal of prosthesis was not needed in any case. Mean follow up is 40 months for OR and 18 for LR group with no recurrences in both groups. CONCLUSIONS: Laparoscopic repair of incisional hernias appears in our experience as good as open prosthetic repair, with all generic vantages related with mini-invasive approach and the specific one of lesser manipulation of prosthesis and fewer infective complications.

Aged↗
PubMedDate not supplied

[Psychoanalytic studies and examination of imputability].

The Author points out that the recent contributions to the study of the crime require an improvement of the traditional principles followed for the investigation and qualification of the crime, as regards both its psychological dynamics and any juridical implications. The Author also shows that psychoanalysis is able to determine a decisive evolution in the eitology as well in the therapy of criminality. After a few preliminary considerations on the ambiguity of the idea of insanity, in accordance with the ordinary nosographic principles formulated in psychiatry, the Author emphasizes the uncertainties and discrepancies that, in the legislative systems from different countries, result from a limited view of the psychological phenomena. Then, he examines the utility of considering again the whole intra-psychic process which is involved in the crime dynamics through a psychoanalytical methodology. Particularly, he highlights the clarification which psycho-analysis may bring to the understanding of certain forms of aggressiveness which cannot be properly diagnosed according to the conventional medical and juridical methods. The Author finally considers the opening of the psycho-analytical application in the delicate examination of imputability. In this regard, he suggests to avoid any strict qualification, even in the evaluation of the most abnormal processes of psyche and he recommends--in conformity with a few juridical trends appeared in some countries--not to limit the investigation on the ability of understanding and will to the moment when a crime is committed, but to extend it to a single evaluation of the whole personality of the criminal.

Criminal Psychology↗
PubMedDate not supplied

Implementation of a surveillance system for stroke based on administrative and clinical data in the Lazio region (Italy): methodological aspects.

Stroke is the third leading cause of death and the most important cause of long-term disability in Italy and other developed countries, heavily influencing quality of life and costs of health care. In spite of the widespread occurrence of the disease and its relevant impact in Italy, there is neither a national nor a regional surveillance system of cerebrovascular diseases. A regional surveillance system for stroke has two important aims: to help to interpret the geographical and temporal trends of the disease for health care planning and resource allocation and to allow close monitoring of the quality of stroke services. Age-standardized mortality rates for cerebrovascular diseases in the Lazio region (5,242,709 inhabitants) in the period 1998-99 were 69.4 for males and 59.4 for females per 100,000 inhabitants. In the year 2000, about 3% of all hospital discharges were for cerebrovascular diseases with a hospitalisation rate of 4.36 per 1000 inhabitants. The mean length of stay is 12 days (median of 9 days) and in-hospital death is 15.4%. The admission rate for cerebrovascular diseases to emergency departments is 3.40 per 1000 inhabitants. The goal of the Lazio Regional Health Authority is to implement a surveillance system for stroke based both on current data (mortality and discharge data) and on information collected in a registry for quality assessment of stroke care. The first step of the study is to develop a regional register of acute stroke using an 'ad hoc' data sheet integrated in the computer-based patient record system of clinical and administrative data (GIPSE) operating in all emergency departments in the region.

Aged↗