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91.
Pelosi E Pellerito R Clerico P Migliaretti G Rosso U Bisi G 《Nuclear medicine communications》2004,25(6):603-608
OBJECTIVES: (1). To identify the main parameters that positively influence the outcome of knee radiosynoviorthesis (RSO) in patients with rheumatoid arthritis (RA) and (2). to determine the ideal candidate for this procedure. METHODS: We considered 80 knees (in 57 patients) that had undergone follow-up for at least 5 years and/or prosthesis implantation after RSO treatment. The parameters evaluated included age, gender, oligo-articular or polyarticular involvement, disease progression, radiological joint damage (Larsen scale), instability and/or axial deviation, body mass index (BMI), and psychological motivation for prosthesis implantation. RESULTS: Knee Larsen stage IV, presence of instability-axial deviation, disease progression, psychological motivation to the surgical replacement and BMI higher than the 85th percentile were associated with a negative outcome for RSO (prosthesis implantation). CONCLUSIONS: The ideal candidate for the RSO treatment is a patient with a low Larsen stage, no instability and/or axial deviation and a BMI below the 85th percentile. A patient's psychological motivation for the treatment should be evaluated before the RSO procedure. 相似文献
92.
Barbagli G Palminteri E Balò S Vallasciani S Mearini E Costantini E Constantini E Mearini L Zucchi A Vivacqua C Porena M 《Urologia internationalis》2004,73(1):1-5
INTRODUCTION: The true incidence of urethral involvement in patients with genital lichen sclerosus (LS) is unknown. We review the epidemiology and discuss the pathogenesis of LS and urethral stricture diseases. MATERIALS AND METHODS: During the period 1991-2002, of 925 patients who underwent urethroplasty for anterior urethral stricture, 130 patients (14%) received the diagnosis of LS. In all patients with LS the histology was re-examined to confirm the clinical diagnosis. Retrograde and voiding urethrography was used to establish urethral involvement in the disease. RESULTS: In 106 patients (82%) the histology provided the classical features of LS, and 24 patients (18%) showed some histological variations. In 49 patients (37%) the LS involved the pendolous urethra (meatus-navicularis-penile), and in 53 cases (41%) a panurethral stricture was evident. CONCLUSIONS: LS urethral involvement appears to be a much more common and extensive disease than previously reported, and requires particular care in its early diagnosis. 相似文献
93.
The efficacy and tolerability of the combination of valsartan and hydrochlorothi-azide (HCTZ) were compared with that of amlodipine
in reducing ambulatory blood pressure and plasma norepinephrine levels in patients with mild to moderate hypertension and
at least 1 cardiovascular risk factor. At the end of a 2-week washout period, 92 outpatients with a sitting diastolic blood
pressure ≥95 and <110 mm Hg, associated with at least 1 additional risk factor, were randomly assigned to receive either valsartan
160 mg and HCTZ 12.5 mg once daily (n=46) or amlodipine 10 mg alone once daily (n=46) for 12 weeks, according to a prospective,
randomized, open-label, blinded end point, parallel-group design. At the end of the washout period and after 6 and 12 weeks
of active treatment, 24-hour ambulatory blood pressure monitoring was performed, and clinical blood pressure and heart rate
and plasma norepinephrine levels were assessed (by high-performance liquid chromatography). Both the valsartan/HCTZ combination
and amlodipine had a demonstrable antihypertensive effect, but the combination showed an antihypertensive effect significantly
greater than that of amlodipine, as demonstrated by the 24-hour (P < .001), daytime (P < .001), and nighttime ambulatory blood pressure values (P < .01) and by the clinical blood pressure values at trough, which were all significantly lower. Although the trough-to-peak
ratios were similar in both groups, the smoothness indexes pertaining to both systolic and diastolic pressures were significantly
higher (P < .05 andP < .001, respectively) in patients receiving valsartan/HCTZ, suggesting the combination produces a more homogeneous antihypertensive
effect. A significant increase in plasma norepinephrine levels was associated with amlodipine (+9% at 6 weeks, +15% at 12
weeks) but not with the valsartan/HCTZ combination. The valsartan/HCTZ combination was better tolerated than amlodipine, which
was associated with a higher frequency of ankle edema. These results indicate that the combination of valsartan 160 mg and
HCTZ 12.5 mg provides more sustained and homogeneous control of blood pressure than does amlodipine 10 mg in high-risk hypertensive
patients, without producing reflex sympathetic activation. 相似文献
94.
Acute respiratory distress syndrome (ARDS) is a clinical syndrome of non-cardiogenic pulmonary oedema associated with bilateral pulmonary infiltrates, stiff lungs and refractory hypoxaemia. ARDS is characterized by an explosive acute inflammatory response in the lung parenchyma, leading to alveolar oedema, decreased lung compliance and, ultimately, hypoxaemia. Although our understanding of the causes and pathophysiology of ARDS has increased, the mortality rate remains in the range of 30-50%. No major advances in pharmacological therapy have been achieved. Mechanical ventilation is the main therapeutic intervention in the management of ARDS. The only approach that has been shown to reduce the inflammatory response and mortality is the use of lung-protective ventilatory strategy with a low tidal volume and high positive-end expiratory pressure. This chapter will review the current state of the literature on the pathogenesis of ARDS and ventilatory and pharmacotherapy approaches to its management. 相似文献
95.
Bolognese A Correale G Manfra M Lavecchia A Mazzoni O Novellino E La Colla P Sanna G Loddo R 《Journal of medicinal chemistry》2004,47(4):849-858
New antiproliferative compounds, the 1-aryl-3-ethoxycarbonyl-pyrido[2,3-g]isoquinolin-5,10-diones (PIQDs, 1-7), were designed on the basis of a molecular model obtained by aligning the common quinolinquinone substructure of 5H-pyrido[3,2-a]phenoxazin-5-one (PPH) and some known anticancer agents. A Diels-Alder reaction between quinolin-5,8-dione (QD) and a 2-azadiene, formed by demolition of 2-aryl-1,3-thiazolidine ethyl esters (T compounds), was used to produce 1-7 and the isomeric 1-aryl-3-ethoxycarbonylpyrido[3,2-g]isoquinolin-5,10-diones (8-14). Two other compounds, the 3-amino-3-ethoxycarbonyldihydrothieno[2,3-g]quinolin-4,9-dione (15) and the 3-amino-3-ethoxycarbonyldihydrothieno[3,2-g]quinolin-4,9-dione (16), arising from a 1,4 Michael reaction of QD with a thiolate species formed by opening of T compounds, were recovered from the reaction mixture. The antiproliferative activity of 1-16 was evaluated against representative human liquid and solid neoplastic cell lines. The IC(50) of these compounds had median values in the range 2.00-0.01 microM, with 2-4 and 15 exhibiting significantly higher in vitro cytotoxic activity. Compound 2, also evaluated against KB subclones (KB(MDR), KB(7D), and KB(V20C)), was shown to be scarcely subject to the MDR1/P-glycoprotein drug efflux pump responsible for drug resistance. The noncovalent DNA-binding properties of PIQDs were examined using UV-vis and (1)H NMR spectroscopy experiments. Accordingly, these compounds were confirmed to have an ability to intercalate into double-stranded DNA by topoisomerase I superhelix unwinding assay. Interesting structure-activity relationships were found. Three important features seem to contribute to the cytotoxic activity of these anticancer ligands: (i) the DNA intercalating capability of the three-cyclic quinonic system, typical of this class of compounds, (ii) the position of the pendant phenyl ring that, according to the superimposition model, must occupy the same area of the corresponding benzo-fused ring A of PPH, and (iii) the effect of electron-withdrawing substituents on the phenyl ring, which can contribute improving the pi-pi stacking interactions between ligand and DNA base pairs. Besides, a mechanism of action suspected to involve topoisomerases could be hypothesized to interpret the antiproliferative activity of the thienoquinolindione 15, which can be regarded as a cyclic cysteine derivative. 相似文献
96.
Bosetti C Talamini R Montella M Negri E Conti E Franceschi S La Vecchia C 《International journal of cancer. Journal international du cancer》2004,112(4):689-692
Several studies have evaluated the possible association between intakes of retinoids and carotenoids and the risk of prostate cancer, but the evidence is still inconsistent. Further, only a few studies have investigated the role of specific carotenoids other than beta-carotene. We have thus considered the association between retinol and various carotenoids using data from a multicentric case-control study conducted in Italy between 1991 and 2002. This included 1,294 incident, histologically confirmed prostate cancer cases below age 75 years admitted to major teaching and general hospitals in the areas under study, and 1,451 controls below age 75 years selected among patients admitted to the same hospitals as cases for a wide spectrum of acute nonneoplastic conditions not related to long-term modifications of diet. Subjects' usual diet was investigated by means of a validated food-frequency questionnaire. Multivariate odds ratios and the corresponding 95% confidence intervals were estimated using unconditional logistic regression models. The risk of prostate cancer tended to decrease with increasing intake of retinol (OR=0.79 for the highest versus the lowest quintile of intake), carotene (OR=0.70), alpha-carotene (OR=0.85) and beta-carotene (OR=0.72), although the estimates were significant for carotene and beta-carotene only. No meaningful associations emerged for nonprovitamin A carotenoids, such as lycopene (OR=0.94) and lutein/zeaxanthin (OR=0.91). No systematic heterogeneity was observed across strata of age, education and body mass index. Thus, our study supports the hypothesis of a weak protective effect of carotene, particularly beta-carotene, on the risk of prostate cancer, while it indicates that other carotenoids, including lycopene, and retinol are not appreciably related to the risk of this neoplasm. 相似文献
97.
98.
Tiraboschi E Giambelli R D'Urso G Galietta A Barbon A de Bartolomeis A Gennarelli M Barlati S Racagni G Popoli M 《Neuroreport》2004,15(15):2393-2396
CaM kinase II, a regulator of synaptic plasticity, is implicated in pathophysiology and pharmacology of psychiatric disorders. Chronic treatment with antidepressants desipramine and reboxetine up-regulated CaM kinase II in neuronal cell bodies of hippocampus. mRNA/protein expression for alphaCaM kinase II was unchanged, whereas Thr phosphorylation was increased in pyramidal/granular cell bodies, suggesting that increased phosphorylation is responsible for kinase activation. Short-term treatment of neuronal cultures with reboxetine reduced kinase activation in a concentration-dependent manner. The short-term inhibitory effect of reboxetine suggests that kinase up-regulation during antidepressant drug treatment is an adaptive response compensating for initial functional down-regulation. 相似文献
99.
Epileptic seizures are a common complication of several clinical conditions affecting the CNS. In these cases, the occurrence of seizures and epilepsy may increase the functional damage provoked by the underlying epileptogenic condition and affect the patient's quality of life to a significant extent. Therefore, the search of effective means for primary prevention of seizures and epilepsy is necessary in these cases. However, the use of antiepileptic drugs for the primary prevention of seizures and epilepsy can be considered only if the ratio between efficacy, safety and tolerability of treatment is favorable, in that the advantages, in terms of seizure prevention, outweigh the disadvantages in terms of adverse effects and overall costs of treatment. In this article, the efficacy, safety and tolerability of antiepileptic drugs for the primary prevention of seizures and epilepsy are reviewed. The areas covered include: the definition of early (provoked) and late (unprovoked) seizures; knowledge of the overall risk of seizures and epilepsy in CNS disorders for which primary prevention of seizures can be attempted; rationale for the use of antiepileptic drugs for the primary prevention of epilepsy; experimental data on the antiepileptogenic properties of antiepileptic drugs; available literature findings on the prevention of early and late seizures, with specific emphasis on randomized clinical trials; and the main problems with experimental trials for the primary prevention of epileptic seizures. On this basis, practice recommendations for the primary prevention of epilepsy will be offered where indicated. Suggestions for future research are also made as concluding remarks, by indicating the areas of investigation and the design of future studies. 相似文献
100.
PURPOSE: To investigate the risk of illnesses in a cohort of patients with epilepsy and in matched nonepilepsy controls, by type and complications. METHODS: A total of 951 children and adults with idiopathic, cryptogenic, or remote symptomatic epilepsy and 904 matched controls seen in secondary and tertiary centers in eight European countries (England, Estonia, Germany, Italy, the Netherlands, Portugal, Russia, Slovenia) were followed prospectively for 17,484 and 17,206 person-months and asked to report any spontaneous complaint requiring medical attention (illness), its type and complications (hospitalization, absence from work or school, medical action). Risk assessment was done by actuarial methods, relative risks (RR), and 95% confidence intervals (CIs). RESULTS: During the study period 644 patients (68%) and 504 controls (56%) reported an illness (p < 0.0001); 30% were seizure related. The cumulative probability of illness at 12 and 24 months was 49 and 86% in the cases and 39 and 75% in the controls (p < 0.0001). The largest differences regarded disorders affecting the nervous system (NS) (RR, 3.3; 95% CI, 2.3-4.2) and ear, nose, and throat (ENT) (RR, 1.3; 95% CI, 1.0-1.6). In patients with epilepsy, an NS illness was more likely to be followed by hospital admission, work absence, or medical intervention. All risks were significantly reduced after excluding seizure-related events. CONCLUSIONS: Patients with epilepsy are at higher risk of NS and ENT illnesses and complications than the general population. However, the risk of illness is significantly reduced when seizure-related events are excluded. 相似文献