The cornea has unique features that make it a useful model for regenerative medicine studies. It is an avascular, transparent, densely innervated tissue and any pathological changes can be easily detected by slit lamp...The cornea has unique features that make it a useful model for regenerative medicine studies. It is an avascular, transparent, densely innervated tissue and any pathological changes can be easily detected by slit lamp examination. Corneal sensitivity is provided by the ophthalmic branch of the trigeminal nerve that elicits protective reflexes such as blinking and tearing and exerts trophic support by releasing neuromediators and growth factors. Corneal nerves are easily evaluated for both function and morphology using standard instruments such as corneal esthesiometer and in vivo confocal microscope. All local and systemic conditions that are associated with damage of the trigeminal nerve cause the development of neurotrophic keratitis, a rare degenerative disease. Neurotrophic keratitis is characterized by impairment of corneal sensitivity associated with development of persistent epithelial defects that may progress to corneal ulcer, melting and perforation. Current neurotrophic keratitis treatments aim at supporting corneal healing and preventing progression of corneal damage. Novel compounds able to stimulate corneal nerve recovery are in advanced development stage. Among them, nerve growth factor eye drops showed to be safe and effective in stimulating corneal healing and improving corneal sensitivity in patients with neurotrophic keratitis. Neurotrophic keratitis represents an useful model to evaluate in clinical practice novel neuro-regenerative drugs.展开更多
Restorative proctocolectomy with ileal pouch-anal anastomosis(RP-IPAA) is the gold standard surgical treatment for ulcerative colitis.However,despite the widespread use of RP-IPAA,many aspects of this treatment still ...Restorative proctocolectomy with ileal pouch-anal anastomosis(RP-IPAA) is the gold standard surgical treatment for ulcerative colitis.However,despite the widespread use of RP-IPAA,many aspects of this treatment still remain controversial,such as the approach(open or laparoscopic),number of stages in the surgery,type of pouch,and construction type(hand-sewn or stapled ileal pouch-anal anastomosis).The present narrative review aims to discuss current evidence on the short-,mid-,and long-term results of each of these technical alternatives as well as their benefits and disadvantages.A review of the MEDLINE,EMBASE,and Ovid databases was performed to identify studies published through March 2016.Few large,randomized,controlled studies have been conducted,which limits the conclusions that can be drawn regarding controversial issues.The available data from retrospective studies suggest that laparoscopic surgery has no clear advantages compared with open surgery and that one-stage RP-IPAA may be indicated in selected cases.Regarding 2- and 3-stage RP-IPAA,patients who underwent these surgeries differed significantly with respect to clinical and laboratory variables,making any comparisons extremely difficult.The long-term results regarding the pouch type show that the W- and J-reservoirs do not differ significantly,although the J pouch is generally preferred by surgeons.Hand-sewn and stapled ileal pouch-anal anastomoses have their own advantages,and there is no clear benefit of one technique over the other.展开更多
<strong>Background:</strong><span style="white-space:normal;font-family:;" "=""> Extracranial Carotid Artery Aneurysm is considered a thera</span><span style="w...<strong>Background:</strong><span style="white-space:normal;font-family:;" "=""> Extracranial Carotid Artery Aneurysm is considered a thera</span><span style="white-space:normal;font-family:;" "="">peutic and diagnostic challenge. In an unprecedented way in the literature, we describe an aneurysm originat</span><span style="white-space:normal;font-family:;" "="">ing</span><span style="white-space:normal;font-family:;" "=""> from the Catastrophic Antiphospholipid </span><span style="white-space:normal;font-family:;" "="">Syndrome. </span><b style="white-space:normal;"><span style="font-family:;" "="">Case Presentation: </span></b><span style="white-space:normal;font-family:;" "="">A 25-year-old male patient came to the</span><span style="white-space:normal;font-family:;" "=""> Emergency Room of the ABC University Hospital in Sao Bernardo do Campo referring </span><span style="white-space:normal;font-family:;" "="">to </span><span style="white-space:normal;font-family:;" "="">bilateral neck pain for 1 month, associated with carotid aneurysms. Due to the severity and urgency of the clinical condition, immediate surgical therapy was performed without a definitive etiological diagnosis. The initial morphological analysis of the carotid artery suggested a diagnosis of Polyarteritis Nodosa. After </span><span style="white-space:normal;font-family:;" "="">anamnesis, physical examination</span><span style="white-space:normal;font-family:;" "="">, the </span><span style="white-space:normal;font-family:;" "="">use of a specific primary vasculitis </span><span style="white-space:normal;font-family:;" "="">algori</span><span style="white-space:normal;font-family:;" "="">thm, </span><span style="white-space:normal;font-family:;" "="">and </span><span style="white-space:normal;font-family:;" "="">a review of the pathological anatomy was requested, which showed bila</span><span style="white-space:normal;font-family:;" "="">teral carotid aneurysms secondary to catastrophic antiphospholipid</span><span style="white-space:normal;展开更多
BACKGROUND: Postoperative hepatic failure is a dreadful complication after major hepatectomy and carries high morbidity and mortality rates. In this study, we assessed the accuracy of the 50/50 criteria (bilirubin >...BACKGROUND: Postoperative hepatic failure is a dreadful complication after major hepatectomy and carries high morbidity and mortality rates. In this study, we assessed the accuracy of the 50/50 criteria (bilirubin >2.9 mg/dL and international normalized ratio >1.7 on postoperative day 5) and the Mullen criteria (bilirubin peak >7 mg/dL on postoperative days 1-7) in predicting death from hepatic failure in patients undergoing right hepatectomy only. In addition, we identified prognostic factors linked to intra-hospital morbidity and mortality in these patients. METHODS: One hundred seventy consecutive patients underwent major right hepatectomy at a tertiary medical center from 2000 to 2008. Nineteen (11.2%) patients suffered from liver cirrhosis. Univariate and multivariate analyses were performed to identify predictors of intra-hospital mortality, morbidity and death from hepatic failure. RESULTS: The intra-hospital mortality was 6.5% (11/170). Of the six patients who died from hepatic failure, one was positive for the 50/50 criteria, but all six patients were positive for the Mullen criteria. Multivariate analysis showed that male gender, hepatitis C (HCV), hepatocellular carcinoma, postoperative bilirubin >7 mg/dL and ALT<188 U/L on postoperative day 1 were predictive of death from hepatic failure in the postoperative period. Age >65 years, HCV, reoperation, andrenal failure were significant predictors of overall intra-hospital mortality on multivariate analysis. CONCLUSIONS: The Mullen criteria were more accurate than the 50/50 criteria in predicting death from hepatic failure in patients undergoing right hepatectomy. A bilirubin peak >7 mg/dL in the postoperative period, HCV positivity, hepatocellular carcinoma, and an ALT level <188 U/L on postoperative day 1 were associated with death from hepatic failure in our patient population.展开更多
Objective:To characterize chemokine receptor CCR5 expression on the conjunctival epithelium in dry eye syndromes.Methods:Conjunctival impression cytology samples were obtained from normal subjects(n=15)and patients wi...Objective:To characterize chemokine receptor CCR5 expression on the conjunctival epithelium in dry eye syndromes.Methods:Conjunctival impression cytology samples were obtained from normal subjects(n=15)and patients with dry eye syndrome(n=45).Cells were harvested from impression cytology samples,and flow cytometry was performed to quantitatively analyze the cell surface expression of chemokine receptor CCR5.Characterization of CCR5-positive cells was done by 2-color flow cytometry using fluorescein-conjugated anti-CCR5 and phycoerythrin-conjugated anti-CD45 antibodies(whereCD45 is a marker for bone marrow-derivedcells).To study CCR5 messenger RNA transcripts,real-time polymerase chain reaction was done on RNA isolated from the impression cytology samples of normal subjects(n=5)and patients with dry eye syndrome(n=14).Results:We found significant upregulation in cell surface expression of CCR5 in patients with both aqueous tear-deficient and evaporative forms of dry eye syndrome(P <.001).The real-time polymerase chain reaction results(for messenger RNA)corroborated the flow cytometry data(for protein).The majority of the cells expressing CCR5 were non-bone marrow-derived resident epithelial cells of the conjunctiva.Conclusion:Our findings suggest that CCR5 up-regulation is significantly associated with dry eye syndrome-associated ocular surface disease.Clinical Relevance:Chemokine receptor CCR5 or its ligands may serve as useful targets for modulation of tissue immunoinflammatory responses in dry eye syndromes.展开更多
Investigations on microbial symbioses in Tephritidae have increased over the past 30 years owing to the potential use of these relationships in developing new control strategies for economically important fruit flies....Investigations on microbial symbioses in Tephritidae have increased over the past 30 years owing to the potential use of these relationships in developing new control strategies for economically important fruit flies.Bactrocera oleae(Rossi)—the olive fruit fly—is a monophagous species strictly associated with the olive tree,and among all the tephritids,its symbionts are the most investigated.The bacterium Candidatus Erwinia dacicola is the major persistent resident endosymbiont in wild B.oleae populations.Its relationship with B.oleae has been investigated since being identified in 2005.This endosymbiont is vertically transmitted through generations from the female to the egg.It exists at every developmental stage,although it is more abundant in larvae and ovipositing females,and is necessary for both larvae and adults.Studying B.oleae–Ca.E.dacicola,or other B.oleae–microbe interactions,will allow us to develop modern biological control systems for area-wide olive protection and set an example for similar programs in other important food crops.This review summarizes the information available on tephritid–microbe interactions and investigates relationships among fruit flies,bacteria and host plants;however,its focus is on B.oleae and its strict association with Ca.E.dacicola to promote environmentally friendly control strategies for area-wide pest management.展开更多
Aim: The aim of our study was to compare characteristics of stroke patients who presented Obstructive Sleep Apnea/Hypopnea (OSAH) to those of cases that presented Central Sleep Apnea/Hypopnea (CSAH) events at PSG, and...Aim: The aim of our study was to compare characteristics of stroke patients who presented Obstructive Sleep Apnea/Hypopnea (OSAH) to those of cases that presented Central Sleep Apnea/Hypopnea (CSAH) events at PSG, and to investigate relationships between the type of breathing disturb during sleep and the location of brain damage. Methods: Thirty four patients were submitted to clinical, neuroradiological and polisomnographyc study (PSG) after 4 months of stroke. A Sleep Disordered Breathing (SDB) was diagnosed in all cases with an AHI > 5. Patients were classified as affected by predominantly OSAH (pOSAH), or predominantly CSAH (pCSAH). Comparisons were made among the groups and correlation analyses were done in each group. Significance was set at p < 0.005. Results: Twenty six patients with ischemic strokes had a SDB during sleep (56% embolic, 31% lacunar, 8% large artery, 8% with undetermined cause). The 61% of them showed pOSAH. Except for age, no statistical differences were found between the two groups as to clinical findings, risk factors for stroke, PSG data, or location of brain lesion. Correlation analysis outlined that in pOSAH cases the time interval from stroke to PSG (Δt) was inversely related to both TST (p = 0.017) and TSP (p = 0.039);in pCSAHs it was inversely related to SE Index (p = 0.021) and directly related to both ODI (p = 0.016) and with the n. of arrhythmias/h sleep (p = 0.033). In pCSAH, AHI did not correlate with ODI. Conclusions: Our data suggest that among cases with post stroke SDB is included 3 different subgroups of cases: OSAHs who terminate the obstruction by arousal, OSAHs who do not arise and alternate obstructive to central events, and CSAHs due to the direct effect of stroke on the breathing network;in a forth subgroup of cases, the microstructure of sleep might be altered, with the consequent occurrence of sleep-related events. Further studies are needed to clarify these hypotheses as well as the role of poststroke depression on the nature and occurrence of SDB after stroke.展开更多
The process of oxidation, due to free radicals, is the cause of major concern for human health. In particular damages related to the skin have great relevance;therefore, many antioxidants based products are developed ...The process of oxidation, due to free radicals, is the cause of major concern for human health. In particular damages related to the skin have great relevance;therefore, many antioxidants based products are developed and marketed with the intention to counteract the action of free radicals. The seed of Araucaria angustifolia is a rich source of antioxidants due to the presence of bioflavonoids to counteract free radicals damages. In this study, two extracts, one from the seed external teguments (shell) and the other from the inner seed pulp (endosperm and embryo) were obtained in order to evaluate possible applications to the dermo-cosmetic field. In parallel the following different methods were employed to characterize both the extracts and to determine their antioxidant capacity: HPTLC, ABTS and DPPH, ORAC and PLC. The qualitative analysis showed that both extracts have the antioxidant activity, but the quantitative evaluation revealed a more promising bioactivity from the shell than from the pulp. Therefore, it was evaluated the potential skin application of different cosmetic formulations, based on the presence of seed shell extract (W/O emulsion, O/W emulsion and gel). The best result was achieved with the W/O emulsion.展开更多
文摘The cornea has unique features that make it a useful model for regenerative medicine studies. It is an avascular, transparent, densely innervated tissue and any pathological changes can be easily detected by slit lamp examination. Corneal sensitivity is provided by the ophthalmic branch of the trigeminal nerve that elicits protective reflexes such as blinking and tearing and exerts trophic support by releasing neuromediators and growth factors. Corneal nerves are easily evaluated for both function and morphology using standard instruments such as corneal esthesiometer and in vivo confocal microscope. All local and systemic conditions that are associated with damage of the trigeminal nerve cause the development of neurotrophic keratitis, a rare degenerative disease. Neurotrophic keratitis is characterized by impairment of corneal sensitivity associated with development of persistent epithelial defects that may progress to corneal ulcer, melting and perforation. Current neurotrophic keratitis treatments aim at supporting corneal healing and preventing progression of corneal damage. Novel compounds able to stimulate corneal nerve recovery are in advanced development stage. Among them, nerve growth factor eye drops showed to be safe and effective in stimulating corneal healing and improving corneal sensitivity in patients with neurotrophic keratitis. Neurotrophic keratitis represents an useful model to evaluate in clinical practice novel neuro-regenerative drugs.
文摘Restorative proctocolectomy with ileal pouch-anal anastomosis(RP-IPAA) is the gold standard surgical treatment for ulcerative colitis.However,despite the widespread use of RP-IPAA,many aspects of this treatment still remain controversial,such as the approach(open or laparoscopic),number of stages in the surgery,type of pouch,and construction type(hand-sewn or stapled ileal pouch-anal anastomosis).The present narrative review aims to discuss current evidence on the short-,mid-,and long-term results of each of these technical alternatives as well as their benefits and disadvantages.A review of the MEDLINE,EMBASE,and Ovid databases was performed to identify studies published through March 2016.Few large,randomized,controlled studies have been conducted,which limits the conclusions that can be drawn regarding controversial issues.The available data from retrospective studies suggest that laparoscopic surgery has no clear advantages compared with open surgery and that one-stage RP-IPAA may be indicated in selected cases.Regarding 2- and 3-stage RP-IPAA,patients who underwent these surgeries differed significantly with respect to clinical and laboratory variables,making any comparisons extremely difficult.The long-term results regarding the pouch type show that the W- and J-reservoirs do not differ significantly,although the J pouch is generally preferred by surgeons.Hand-sewn and stapled ileal pouch-anal anastomoses have their own advantages,and there is no clear benefit of one technique over the other.
文摘<strong>Background:</strong><span style="white-space:normal;font-family:;" "=""> Extracranial Carotid Artery Aneurysm is considered a thera</span><span style="white-space:normal;font-family:;" "="">peutic and diagnostic challenge. In an unprecedented way in the literature, we describe an aneurysm originat</span><span style="white-space:normal;font-family:;" "="">ing</span><span style="white-space:normal;font-family:;" "=""> from the Catastrophic Antiphospholipid </span><span style="white-space:normal;font-family:;" "="">Syndrome. </span><b style="white-space:normal;"><span style="font-family:;" "="">Case Presentation: </span></b><span style="white-space:normal;font-family:;" "="">A 25-year-old male patient came to the</span><span style="white-space:normal;font-family:;" "=""> Emergency Room of the ABC University Hospital in Sao Bernardo do Campo referring </span><span style="white-space:normal;font-family:;" "="">to </span><span style="white-space:normal;font-family:;" "="">bilateral neck pain for 1 month, associated with carotid aneurysms. Due to the severity and urgency of the clinical condition, immediate surgical therapy was performed without a definitive etiological diagnosis. The initial morphological analysis of the carotid artery suggested a diagnosis of Polyarteritis Nodosa. After </span><span style="white-space:normal;font-family:;" "="">anamnesis, physical examination</span><span style="white-space:normal;font-family:;" "="">, the </span><span style="white-space:normal;font-family:;" "="">use of a specific primary vasculitis </span><span style="white-space:normal;font-family:;" "="">algori</span><span style="white-space:normal;font-family:;" "="">thm, </span><span style="white-space:normal;font-family:;" "="">and </span><span style="white-space:normal;font-family:;" "="">a review of the pathological anatomy was requested, which showed bila</span><span style="white-space:normal;font-family:;" "="">teral carotid aneurysms secondary to catastrophic antiphospholipid</span><span style="white-space:normal;
文摘BACKGROUND: Postoperative hepatic failure is a dreadful complication after major hepatectomy and carries high morbidity and mortality rates. In this study, we assessed the accuracy of the 50/50 criteria (bilirubin >2.9 mg/dL and international normalized ratio >1.7 on postoperative day 5) and the Mullen criteria (bilirubin peak >7 mg/dL on postoperative days 1-7) in predicting death from hepatic failure in patients undergoing right hepatectomy only. In addition, we identified prognostic factors linked to intra-hospital morbidity and mortality in these patients. METHODS: One hundred seventy consecutive patients underwent major right hepatectomy at a tertiary medical center from 2000 to 2008. Nineteen (11.2%) patients suffered from liver cirrhosis. Univariate and multivariate analyses were performed to identify predictors of intra-hospital mortality, morbidity and death from hepatic failure. RESULTS: The intra-hospital mortality was 6.5% (11/170). Of the six patients who died from hepatic failure, one was positive for the 50/50 criteria, but all six patients were positive for the Mullen criteria. Multivariate analysis showed that male gender, hepatitis C (HCV), hepatocellular carcinoma, postoperative bilirubin >7 mg/dL and ALT<188 U/L on postoperative day 1 were predictive of death from hepatic failure in the postoperative period. Age >65 years, HCV, reoperation, andrenal failure were significant predictors of overall intra-hospital mortality on multivariate analysis. CONCLUSIONS: The Mullen criteria were more accurate than the 50/50 criteria in predicting death from hepatic failure in patients undergoing right hepatectomy. A bilirubin peak >7 mg/dL in the postoperative period, HCV positivity, hepatocellular carcinoma, and an ALT level <188 U/L on postoperative day 1 were associated with death from hepatic failure in our patient population.
文摘Objective:To characterize chemokine receptor CCR5 expression on the conjunctival epithelium in dry eye syndromes.Methods:Conjunctival impression cytology samples were obtained from normal subjects(n=15)and patients with dry eye syndrome(n=45).Cells were harvested from impression cytology samples,and flow cytometry was performed to quantitatively analyze the cell surface expression of chemokine receptor CCR5.Characterization of CCR5-positive cells was done by 2-color flow cytometry using fluorescein-conjugated anti-CCR5 and phycoerythrin-conjugated anti-CD45 antibodies(whereCD45 is a marker for bone marrow-derivedcells).To study CCR5 messenger RNA transcripts,real-time polymerase chain reaction was done on RNA isolated from the impression cytology samples of normal subjects(n=5)and patients with dry eye syndrome(n=14).Results:We found significant upregulation in cell surface expression of CCR5 in patients with both aqueous tear-deficient and evaporative forms of dry eye syndrome(P <.001).The real-time polymerase chain reaction results(for messenger RNA)corroborated the flow cytometry data(for protein).The majority of the cells expressing CCR5 were non-bone marrow-derived resident epithelial cells of the conjunctiva.Conclusion:Our findings suggest that CCR5 up-regulation is significantly associated with dry eye syndrome-associated ocular surface disease.Clinical Relevance:Chemokine receptor CCR5 or its ligands may serve as useful targets for modulation of tissue immunoinflammatory responses in dry eye syndromes.
文摘Investigations on microbial symbioses in Tephritidae have increased over the past 30 years owing to the potential use of these relationships in developing new control strategies for economically important fruit flies.Bactrocera oleae(Rossi)—the olive fruit fly—is a monophagous species strictly associated with the olive tree,and among all the tephritids,its symbionts are the most investigated.The bacterium Candidatus Erwinia dacicola is the major persistent resident endosymbiont in wild B.oleae populations.Its relationship with B.oleae has been investigated since being identified in 2005.This endosymbiont is vertically transmitted through generations from the female to the egg.It exists at every developmental stage,although it is more abundant in larvae and ovipositing females,and is necessary for both larvae and adults.Studying B.oleae–Ca.E.dacicola,or other B.oleae–microbe interactions,will allow us to develop modern biological control systems for area-wide olive protection and set an example for similar programs in other important food crops.This review summarizes the information available on tephritid–microbe interactions and investigates relationships among fruit flies,bacteria and host plants;however,its focus is on B.oleae and its strict association with Ca.E.dacicola to promote environmentally friendly control strategies for area-wide pest management.
文摘Aim: The aim of our study was to compare characteristics of stroke patients who presented Obstructive Sleep Apnea/Hypopnea (OSAH) to those of cases that presented Central Sleep Apnea/Hypopnea (CSAH) events at PSG, and to investigate relationships between the type of breathing disturb during sleep and the location of brain damage. Methods: Thirty four patients were submitted to clinical, neuroradiological and polisomnographyc study (PSG) after 4 months of stroke. A Sleep Disordered Breathing (SDB) was diagnosed in all cases with an AHI > 5. Patients were classified as affected by predominantly OSAH (pOSAH), or predominantly CSAH (pCSAH). Comparisons were made among the groups and correlation analyses were done in each group. Significance was set at p < 0.005. Results: Twenty six patients with ischemic strokes had a SDB during sleep (56% embolic, 31% lacunar, 8% large artery, 8% with undetermined cause). The 61% of them showed pOSAH. Except for age, no statistical differences were found between the two groups as to clinical findings, risk factors for stroke, PSG data, or location of brain lesion. Correlation analysis outlined that in pOSAH cases the time interval from stroke to PSG (Δt) was inversely related to both TST (p = 0.017) and TSP (p = 0.039);in pCSAHs it was inversely related to SE Index (p = 0.021) and directly related to both ODI (p = 0.016) and with the n. of arrhythmias/h sleep (p = 0.033). In pCSAH, AHI did not correlate with ODI. Conclusions: Our data suggest that among cases with post stroke SDB is included 3 different subgroups of cases: OSAHs who terminate the obstruction by arousal, OSAHs who do not arise and alternate obstructive to central events, and CSAHs due to the direct effect of stroke on the breathing network;in a forth subgroup of cases, the microstructure of sleep might be altered, with the consequent occurrence of sleep-related events. Further studies are needed to clarify these hypotheses as well as the role of poststroke depression on the nature and occurrence of SDB after stroke.
文摘The process of oxidation, due to free radicals, is the cause of major concern for human health. In particular damages related to the skin have great relevance;therefore, many antioxidants based products are developed and marketed with the intention to counteract the action of free radicals. The seed of Araucaria angustifolia is a rich source of antioxidants due to the presence of bioflavonoids to counteract free radicals damages. In this study, two extracts, one from the seed external teguments (shell) and the other from the inner seed pulp (endosperm and embryo) were obtained in order to evaluate possible applications to the dermo-cosmetic field. In parallel the following different methods were employed to characterize both the extracts and to determine their antioxidant capacity: HPTLC, ABTS and DPPH, ORAC and PLC. The qualitative analysis showed that both extracts have the antioxidant activity, but the quantitative evaluation revealed a more promising bioactivity from the shell than from the pulp. Therefore, it was evaluated the potential skin application of different cosmetic formulations, based on the presence of seed shell extract (W/O emulsion, O/W emulsion and gel). The best result was achieved with the W/O emulsion.
