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1.
Melatonin reduces oxidative stress and improves vascular function in pulmonary hypertensive newborn sheep
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Flavio Torres Alejandro González‐Candia Camilo Montt Germán Ebensperger Magdalena Chubretovic María Serón‐Ferré Roberto V. Reyes Aníbal J. Llanos Emilio A. Herrera 《Journal of pineal research》2015,58(3):362-373
Pulmonary hypertension of the newborn (PHN) constitutes a critical condition with severe cardiovascular and neurological consequences. One of its main causes is hypoxia during gestation, and thus, it is a public health concern in populations living above 2500 m. Although some mechanisms are recognized, the pathophysiological facts that lead to PHN are not fully understood, which explains the lack of an effective treatment. Oxidative stress is one of the proposed mechanisms inducing pulmonary vascular dysfunction and PHN. Therefore, we assessed whether melatonin, a potent antioxidant, improves pulmonary vascular function. Twelve newborn sheep were gestated, born, and raised at 3600 meters. At 3 days old, lambs were catheterized and daily cardiovascular measurements were recorded. Lambs were divided into two groups, one received daily vehicle as control and another received daily melatonin (1 mg/kg/d), for 8 days. At 11 days old, lung tissue and small pulmonary arteries (SPA) were collected. Melatonin decreased pulmonary pressure and resistance for the first 3 days of treatment. Further, melatonin significantly improved the vasodilator function of SPA, enhancing the endothelial‐ and muscular‐dependent pathways. This was associated with an enhanced nitric oxide‐dependent and nitric oxide independent vasodilator components and with increased nitric oxide bioavailability in lung tissue. Further, melatonin reduced the pulmonary oxidative stress markers and increased enzymatic and nonenzymatic antioxidant capacity. Finally, these effects were associated with an increase of lumen diameter and a mild decrease in the wall of the pulmonary arteries. These outcomes support the use of melatonin as an adjuvant in the treatment for PHN. 相似文献
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Samira Marín-Romero Teresa Elías-Hernández María Isabel Asensio-Cruz Rocío Ortega-Rivera Raquel Morillo-Guerrero Javier Toral Emilio Montero Verónica Sánchez Elena Arellano José María Sánchez-Díaz Macarena Real-Domínguez Remedios Otero-Candelera Luis Jara-Palomares 《Archivos de bronconeumología》2019,55(12):619-626
IntroductionScales for predicting venous thromboembolism (VTE) recurrence are useful for deciding the duration of the anticoagulant treatment. Although there are several scales, the most appropriate for our setting has not been identified. For this reason, we aimed to validate the DASH prediction score and the Vienna nomogram at 12 months.MethodsThis was a retrospective study of unselected consecutive VTE patients seen between 2006 and 2014. We compared the ability of the DASH score and the Vienna nomogram to predict recurrences of VTE. The validation was performed by stratifying patients as low-risk or high-risk, according to each scale (discrimination) and comparing the observed recurrence with the expected rate (calibration).ResultsOf 353 patients evaluated, 195 were analyzed, with an average age of 53.5 ± 19 years. There were 21 recurrences in 1 year (10.8%, 95% CI: 6.8%-16%). According to the DASH score, 42% were classified as low risk, and the rate of VTE recurrence in this group was 4.9% (95% CI: 1.3%-12%) vs. the high-risk group that was 15% (95% CI: 9%-23%) (p <.05). According to the Vienna nomogram, 30% were classified as low risk, and the rate of VTE recurrence in the low risk group vs. the high risk group was 4.2% (95% CI:0.5%-14%) vs. 16.2% (95% CI: 9.9%-24.4%) (p <.05).ConclusionsOur study validates the DASH score and the Vienna nomogram in our population. The DASH prediction score may be the most advisable, both because of its simplicity and its ability to identify more low-risk patients than the Vienna nomogram (42% vs. 30%). 相似文献
4.
Lucio Posteraro Fabrizio Pezzoni Emilio Varalda Gloria Fugazza Anna Mazzucchi 《Journal of neurology》1991,238(6):337-339
Summary A patient who developed a unilateral opercular syndrome following a cerebrovascular accident is described. Computed tomography showed that the lesion did not affect the opercular cortex, but involved deep white matter and the head of the caudate nucleus of the left hemisphere. Persistent hypophonia and transient aphasia were associated. Comparison with previous cases is discussed. 相似文献
5.
This study presents the case of a patient with necrobiosis or necrosing fascitis of the inguinal region, secondary to a complicated
Amyand’s hernia with a concomitant ipsilateral Richter’s hernia. The patient was treated with open trans-abdominal surgery
and hernia repair through the pre-peritoneal approach, plus anti-microbians, and thrice-daily wound cleansing and dressings
to the inguinal region. Evolution was satisfactory. There are no reports in the literature of a case such as this. 相似文献
6.
Juli Busquets Jose Castellote Jaume Torras Juan Fabregat Emilio Ramos Laura Llado Antonio Rafecas Esmeralda de la Banda Juan Figueras 《Journal of gastrointestinal surgery》2007,11(4):458-463
Background Cold ischemia time and the presence of postoperative hepatic arterial thrombosis have been associated with biliary complications
(BC) after liver transplantation. An ABO-incompatible blood group has also been suggested as a factor for predisposal towards
BC. However, the influence of Rh nonidentity has not been studied previously.
Materials Three hundred fifty six liver transplants were performed from 1995 to 2000 at our hospital. BC incidence and risk factors
were studied in 345 patients.
Results Seventy patients (20%) presented BC after liver transplantation. Bile leakage (24/45%) and stenotic anastomosis (21/30%) were
the most frequent complications. Presence of BC in Rh-nonidentical graft–host cases (23/76, 30%) was higher than in Rh-identical
grafts (47/269, 17%) (P = 0.01). BC was also more frequent in grafts with arterial thrombosis (9/25, 36% vs 60/319, 19%; P = 0.03) and grafts with cold ischemia time longer than 430 min (26/174, 15% vs 44/171, 26%; P = 0.01). Multivariate logistic regression confirmed that Rh graft–host nonidentical blood groups [RR = 2(1.1–3.6); P = 0.02], arterial thrombosis [RR = 2.6(1.1–6.4); P = 0.02] and cold ischemia time longer than 430 min [RR = 1.8(1–3.2); P = 0.02] were risk factors for presenting BC.
Conclusion Liver transplantation using Rh graft–host nonidentical blood groups leads to a greater incidence of BC. 相似文献
7.
Nephrotic syndrome in a mother and her infant: relationship with cytomegalovirus infection 总被引:1,自引:0,他引:1
Marisa Giani Alberto Edefonti Beatrice Damiani Giuseppina Marra Daniela Colombo Giovanni Banfi Emilio Rivolta Erich H. Strøm Michael Mihatsch 《Pediatric nephrology (Berlin, Germany)》1996,10(1):73-75
This case report describes infantile nephrotic syndrome (NS) in a baby girl with a clinically severe cytomegalovirus (CMV) infection. Culture of the baby's urine was positive for CMV and IgM anti-CMV antibodies were detected. After an unsuccessful course of corticosteroids, gancyclovir treatment was started and a remission of cutaneous, pulmonary, and renal symptoms was achieved. As the mother also developed NS at the end of pregnancy, a common etiology could be postulated, although there were no signs of recent CMV infection in the mother, only anti-CMV IgG. The relationship between CMV infection and glomerular disease is still unclear: NS may represent another manifestation of CMV disease. 相似文献
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9.
Emilio Bombardieri Antonia Martinetti Rosalba Miceli Luigi Mariani Maria Rita Castellani Ettore Seregni 《European journal of nuclear medicine and molecular imaging》1997,24(11):1349-1355
Bone scintigraphy plays a major role in the diagnosis of bone metastases. The clinical utility of new biochemical markers
of bone metabolism has recently been investigated in various bone diseases. This study evaluated the role of some bone metabolism
markers in comparison with bone scan in the follow-up of breast cancer patients. We studied 149 patients with breast cancer,
33 (22%) of whom had bone metastases. IRMAs were used for the evaluation of blood levels of osteocalcin, bone alkaline phosphatase
(BAP), the C-terminal propeptide of type I procollagen and the C-terminal cross-linked telopeptide of type I collagen (ICTP).
Multivariate regression analysis showed that menopausal status (P=0.007) and metastatic bone lesions (P=0.001) affected bone marker levels. When considering post-menopausal women, the only subset in which bone metabolism marker
behaviour could be reliably investigated, we found a high degree of overlap in marker distribution for scan-positive and scan-negative
patients. Discrimination between scan-negative and scan-positive patients based on the above markers, taken singly or jointly,
was assessed by means of logistic discriminant analysis. The best discrimination was achieved with BAP, closely followed by
ICTP. BAP and ICTP together gave a slight improvement over the use of the two markers separately. However, even in this case
the degree of discrimination was poor and its clinical utility was limited. In fact, to achieve a specificity of 95%, the
sensitivity of the test was about 20%; conversely, with a sensitivity of 95%, the specificity was below 10%. In conclusion,
based on our findings, we believe that blood levels of the investigated markers cannot replace bone scintigraphy in the follow-up
of breast cancer patients for the early detection of bone metastases.
Received 14 April and in revised form 5 July 1997 相似文献
10.
Treatment of Status Epilepticus in Adults: Guidelines of the Italian League Against Epilepsy 总被引:2,自引:1,他引:1
Fabio Minicucci †Giancarlo Muscas ‡Emilio Perucca §Giuseppe Capovilla Federico Vigevano ¶Paolo Tinuper 《Epilepsia》2006,47(S5):9-15
Summary: Status epilepticus (SE) is a medical emergency which can lead to significant morbidity and mortality and requires prompt diagnosis and treatment. SE is differentiated into generalized or partial SE on the basis of its electro-clinical manifestations. The guidelines for the management of SE produced by the Italian League against Epilepsy also distinguish three different stages of SE (initial, established and refractory), based on time elapsed since the onset of the condition and responsiveness to previously administered drugs. Treatment should be started as soon as possible, particularly in generalized convulsive SE, and should include general support measures, drugs to suppress epileptic activity and, whenever possible, treatments aimed at relieving the underlying (causative) condition. Benzodiazepines are the first line antiepileptic agents, and i.v. lorazepam is generally preferred because it is associated with a lower risk of early relapses. If benzodiazepines fail to control seizures, i.v. phenytoin is usually indicated, though i.v. phenobarbital or i.v. valproate may also be considered. Refractory SE requires admission to an intensive care unit (ICU) to allow adequate monitoring and support of respiratory, metabolic and hemodynamic functions and cerebral electrical activity. In refractory SE, general anesthesia may be required. Propofol and thiopental represent first line agents in this setting, after careful assessment of potential risks and benefits. 相似文献