[Study of the classes of immunoglobulins in various forms of bronchial asthma using the quantitative immunodiffusion technic].
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Adolescent↗
Biomedical subjects
A Pappalardo
Publications and source records attributed to A Pappalardo.
Progesterone and cell-cell adhesion interact to regulate rat granulosa cell apoptosis.
Ovarian follicles are composed of both small and large granulosa cells, but only the large granulosa cells undergo apoptosis within 24 h of culture in serum-free medium. The present study was designed to assess the relationship between cell-cell contact, progesterone treatment, and granulosa cell apoptosis. For this study, individual large granulosa cells were isolated from immature rat ovaries after sequential incubation with EGTA and EGTA-sucrose solutions. Granulosa cells were then cultured for 24 h in RPMI-1640 (control) supplemented with progesterone and (or) the progesterone antagonist RU 486. The cells were then fixed and assessed for apoptosis by either electron microscopy or in situ end labeling of DNA fragments. After 24 h of culture, the proportion of apoptotic granulosa cells was twofold lower for aggregated cells compared with single granulosa cells (p < 0.05). Aggregated granulosa cells were observed to be connected by gap junctions. Compared with controls, progesterone reduced and RU 486 increased the percentage of single and aggregated apoptotic granulosa cells present after culture. In the presence of RU 486, progesterone reduced the percentage of apoptotic single granulosa cells from 84 +/- 4% (RU 486 alone) to 66 +/- 8%. In granulosa cell aggregates, progesterone reduced the incidence of apoptosis from 86 +/- 3% to 44 +/- 7% (p < 0.05). Progesterone in the presence of RU 486 was more effective in inhibiting apoptosis of aggregated granulosa cells than in single granulosa cells (p < 0.05). Taken together, these data indicate that (i) progesterone acts through the progesterone receptor to inhibit granulosa cell apoptosis and (ii) cell-cell adhesion enhances progesterone's anti-apoptotic actions.
Animals↗
[Epidemiology and risk factors in osteoarthritis: literature review data from "OASIS" study].
Ostheoarthritis (OA) is a social disease characterized by pain, inflammation and stiffness due to an involvement of articular cartilage, soft tissues and bone. OA is the most common rheumatic disease, every age can be affected but prevalence increases dramatically with age with a greater incidence in subjects between 40 and 50 years of age. Hip OA has an important correlation with weight, genetic factors, sex, previous traumas, occupational factors and age. People older than 35 have a prevalence of hip OA of 10.8% that becomes 35.4% in people older than 85. Knee OA has a great correlation with weight ,life style and physical activity. An Italian study demonstrated that the prevalence of this kind of OA is highest in subjects older than 65 that becomes 44% in people older than 80. In this report we explain the results of a study conducted in the South of Italy called the OstheoArtrithis Southern Italy Study (OASIS) that involved 456 doctors and 1782 patients of three different regions. The mean age of these patients was 66.3 years and we evaluated prevalence of hip, knee, hand and spine OA and correlated it to sex, age, weight and BMI. We also evaluated what kind of drugs were used for these patients. Knee OA is the most common subset of OA, the one that requires the highest number of examinations and the one that causes the greatest disability. The most common used drugs are Fans and Coxibs. Condroprotectors were not used much, probably because they are not considered to be very effective.
Adult↗
[Experimental research on the use of deferoxamine in the prevention of renal damage from acute ischemia].
Oxygen free-radical reperfusion products play a critical role in postischemic tissues injury. In this study we used deferoxamine, an iron ligand that seems to inhibit hydroxyl radicals production, in renal normothermic acute ischemia in the rat. Our results demonstrated a significant protective effect of deferoxamine on kidneys subjected to normothermic acute ischemia.
Acute Disease↗
[Periungual capillaroscopy in psoriatic arthritis].
PURPOSE: The aim of the study is the evaluation of the microcirculation trough periungueal capillaroscopy in patients suffering from psoriatic arthritis. MATERIALS AND METHODS: Eighteen patients (mean age 44 years, nine males and nine females) were examined according to the different clinical forms (spondylitic, mutilans, simil-rheumatoid, onyco-arthritis, oligo-articular) of the disease. RESULTS: In most of the patients, the exam showed a reduction in ansas' density and in capillary length and calibre as well as interstitial edema and expansion of the ansa venular portion with coiling and kinking, demonstrating the re-organization of the veins and the neo-angiogenesis. Avascular areas and microaneurysm have been found only in the "mutilans" form. In the "simil-rheumatoid" form, ansa reduced in length and calibre have been observed at capillaroscopy, a pattern different from that reported by others, in rheumatoid arthritis (characterized by thin but lengthened ansa). In the "spondylitic" form, the video-microscopical pattern was negative. CONCLUSIONS: This study is still ongoing in order to evaluate the results in a more representative sample.
Adult↗
[Mirizzi syndrome].
Mirizzi's syndrome is a rare, but well described cause of obstructive jaundice which occurs in less than 1% of patients presenting for cholecystectomy. The syndrome is due to a stone impacted in the cystic duct or in the neck of gallbladder, causing compression or obstruction of the common emphatic duct. The clinic, physiopathologic, diagnostic and therapeutic aspects of this disease are described. The patient observed, arrived in emergency with obstructive jaundice and hyperpyrexia. Echography showed a remarkable dilatation of the biliary ducts, whereas endoscopic retrograde cholangiography (ERCP) showed an obstruction of the hepatic common duct of undefinable nature (stone, neoplasia). The surgical operation performed in emergency made clear the diagnostic doubt. Since inflammation impacted biliary duct and gallbladder, an incision of the gallbladder at its fundus was performed. In this way it was possible to extract about 40 stones of dimensions less than 1 cm, and one of 3 x 1 cm, impacted in the cystic duct, compressing the common hepatic duct. A partial cholecystectomy was performed and no connection between gallbladder and common emphatic duct (fistula) was found. The surgical operation led to complete resolution of the symptomatology. Therefore, the conclusions is drawn that Mirizzi's syndrome a rare but non infrequent pathology, finds its definition and complete resolution with surgical operation. Mirizzi's syndrome or obstructive jaundice due to extrinsic compression of principal biliary duct by a stone impacted in the cystic duct, is an uncommon complication of cholecystic lithiasis. Although this syndrome is rare (1%), it causes obstructive jaundice, sometimes dangerous, and serious complications as recurrent cholangitis.
Aged↗
[Parathyroid cyst: uncommon surgical disorder].
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Adult↗
[Anaplastic carcinoma of the thyroid: diagnosis and treatment].
Anaplastic thyroid carcinoma (ATC), accounting for 5% to 15% of primary malignant thyroid neoplasm, is one of the most aggressive solid tumors in humans. It is rapidly fatal, with a mean survival of 6 months after diagnosis. Multimodality treatment with surgery and/or external beam radiotherapy and chemotherapy are of fundamental importance for local control of disease and to enhance survival. Molecular biology studies have shown that ATC is associated with a p 53 mutation. ATC usually does not concentrate radioiodine or express thyroglobulin. It is essential to verify the diagnosis histologically because insular thyroid cancer, lymphomas, and medullary thyroid cancer are occasionally confused with undifferentiated neoplasms. Immunohistochemical study is helpful in establishing the diagnosis. Multimodal therapy and development of effective systemic chemotherapy agents would provide to result in improvements in survival although no single agent has yet been identified. Aggressive multimodality treatment regimens show promise in improving local control in patients with ATC. Survival rates however remain low. Despite intense applications of such integrated therapy, no standardized successful treatment protocol has yet been established.
Carcinoma↗
[Case of adeno-broncho-esophageal syndrome].
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Adult↗
[Neurogenic dysphagia: physiology, physiopathology and rehabilitative treatment].
Swallowing is both a voluntary than a reflex function. It consist in transporting feeding from mouth to the stomach. Swallowing function occurs with very frequency during the day and needs complex neuromuscular coordination. Several neurologic diseases determine swallowing disorders. Dysphagia, is the difficulty in swallowing. In slight disorders, swallowing function is sufficiently compensated, symptoms are few or absent. Sometimes the patient is able to compensate and obtains a safe deglutition. Rehabilitation of swallowing disorders is based on the assessment of all symptoms and troubles causing dysphagia and on the improvement of the specific disabilities. Rehabilitation is aimed to make patient able for a safe oral feeding. We can use classic specific physiotherapy, compensatory movements of head and neck, electrostimulation, and the chemical myotomia by botulinum toxin injection.
Botulinum Toxins↗
Impaired expression of erythrocyte glycosyl-phosphatidylinositol-anchored membrane CD59 in patients with psoriatic arthritis. Relation to terminal complement pathway activation.
OBJECTIVE: Complement-mediated injury is regulated by many factors; among these CD59 has been identified as a widely distributed glycoprotein that inhibits membrane C5b-9 (terminal complement component) formation. The aim of the study was to assess erythrocyte CD59 expression in patients with psoriatic arthritis in order to understand the role of CD59 in the pathogenesis. METHODS: Washed erythrocytes from 50 patients with psoriatic arthritis, 8 with cutaneous psoriasis and 24 healthy subjects were incubated with monoclonal anti-CD59 antibody followed by a second FITC conjugated antibody and fluorescence intensity analysed by FAC-Scan flow cytometer to assess their CD59 membrane expression. SC5b-9 levels were measured in the plasma by ELISA and results compared with CD59 values. Immune complexes, complement C3 and C4 and rheumatoid factor were also determined. RESULTS: Impaired expression of erythrocyte membrane-anchored CD59 was found in patients with psoriatic arthritis; the lowest levels were seen in active patients (p < 0.01). Increased SC5b-9 was seen in the plasma of patients with active disease. An inverse correlation was also found between plasma C5b-9 and the CD59 expression levels (r = -0.81, p < 0.001). CONCLUSION: The low CD59 expression on erythrocytes from patients with psoriatic arthritis may be an index of a low tissue CD59 expression. This impairment could facilitate the activation of complement pathway and increase the risk for arthritis. Membrane attack complex formation in deficient membrane bound CD59 may also exacerbate synovial cell injury and inflammation.
Adult↗
[Neuroprotective effects of topiramate].
Topiramate (TPM) is a new anti-convulsant drug, prescribed in epileptic seizure. Pharmacological actions of TPM are: a) a positive modulation of GABA receptors; b) inhibition of the kainite and aminohydroxymethylisoxazole propionic acid (AMPA) glutamate receptor sub-types; c) a use-dependent Na+ channel blocker. Recent studies suggest that TPM can have anti-excitotoxic properties, because it protects against motor neuron degeneration. Moreover, TPM enhances neuroprotection and reduces hemorrhagic incidence in focal cerebral ischemia.
Anticonvulsants↗
[Symptomatic management in multiple sclerosis].
Multiple sclerosis is an autoimmune disease, characyerized by demylinization of white matter of Central Nervous System (CNS). Its etiology is still unknown. In the world, about 2.000.000 of people are affected by MS, with higher prevalence in North-America and North-Europe. Two are the essential features of the therapeutical management in MS: 1) immunomodulating therapy, which consists of "disease modifing drugs"; 2) symptomatic treatment. Only some patients can benefit of immunomodulating therapy, whereas symptomatic treatment can be helpfull to everbody. In the following pages the authors will review the medical options used in the diagnostic, prognostic and therapeutic management of MS.
Deglutition Disorders↗
[Complete myocardial revascularization. Initial clinical and angiographic results in a consecutive series of 51 surgically treated patients].
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Angina Pectoris↗
[Osteoarticular involvement in thalassemia and sickle cell anemia].
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Adolescent↗
[Efficacy and tolerability of methotrexate in the treatment of rheumatoid arthritis].
OBJECTIVE: To verify, in an open study, the efficacy and safety of long-term administration of low weekly doses (5 mg) of methotrexate (MTX) i.m. in different stage rheumatoid arthritis patients. PATIENTS AND METHODS: The study has been performed for 24 months in 42 patients (37 females and 5 males), fulfilling the ARA criteria for rheumatoid arthritis. Main functional parameters, main serological data and some immunology indexes were periodically monitored (after 1, 3, 6, 12 and 24 months of therapy); moreover, some instrumental exams (X-ray of involved joints, liver ultrasound, respiratory function tests) have been performed. RESULTS: Thirty of 42 enrolled patients completed the whole 24 month therapy, and 22 are still using methotrexate. Results were as follows: therapeutic remission in one patient, marked improvement in 12 cases, moderate improvement in 16 and worsening in 1. Among the 12 remaining patients, 2 refused further treatment; 6 and 4 patients were withdrawn from the study because of inefficacy and toxicity, respectively. A significant improvement was observed in all of the main efficacy parameters taken into consideration. Moderate and reversible side effects were registered in 23 patients. CONCLUSIONS: Our results confirm the value of MTX in the treatment of rheumatoid arthritis. In our opinion this drug is very effective even in a relatively early stage of the disease, mainly in patients whose genetic and clinical markers may predict a more aggressive and severe outcome.
Arthritis, Rheumatoid↗
[Indication for a modern therapy of rheumatoid arthritis].
The treatment of rheumatoid arthritis is currently based on pathogenesis and pathophysiology, being the etiology still unknown. At cognition and activation phase of rheumatoid arthritis, there is a number of potential therapeutic approaches, still in development and in early trials. At inflammation and even more at invasive phase of rheumatoid arthritis, the treatment should take into consideration the parallel activation of several different processes, sustained by the heterogeneity of cells in the inflamed synovium. The early detection of potential severe rheumatoid arthritis patients is crucial, in order to be able to adjust the treatment according to the severity of disease in each patient. Evaluation of genetic and clinical markers for severe disease within the sixth month and in any case no later than the third year of disease is recommended. As far as pharmacotherapy is concerned, it is useful to distinguish anti-rheumatic agents in symptom-modifying drugs (SM-ARDs) and disease-controlling therapy (DC-ART). Discovering the causal agent of rheumatoid arthritis could dramatically change the treatment of rheumatoid arthritis. In the meantime, one can envisage a further development of immuno-pharmacotherapy and the introduction in the clinical practice of specific or selective immunotherapy.
Anti-Inflammatory Agents↗