181 research outputs found
Iron overload and hepcidin overexpression could play a key role in COVID infection, and may explain vulnerability in elderly, diabetics, and obese patients
Background: The COVID epidemic hit like a tsunami worldwide. At the time of its arrival in Italy, available literary data were meager, and most of them concerned its epidemiology. World Health Organization proposed guidelines in march 2020, a strategy of treatment has been developed, and a significant number of subsequent articles have been published to understand, prevent, and cure COVID patients. Methods: From the observation of two patients, we performed a careful analysis of scientific literature to unearth the relation between COVID infection, clinical manifestations as pneumonia and thrombosis, and to find out why it frequently affects obese, diabetics, and elderly patients. Results: The analysis shows that hepcidin could repre-sent one of such correlating factors. Hepcidin is most elevated in older age, in non-insulin diabetics patients and in obese people. It is the final target therapy of many medicaments frequently used. Viral disease, and in particular SARS-CoV19, could induce activation of the hepcidin pathway, which in turn is responsible for an increase in the iron load. Excess of iron can lead to cell death by ferroptosis and release into the bloodstream, such as free iron, which in turn has toxic and pro-coagulative effects. Conclusions: Overexpression of hepcidin and iron overload might play a crucial role in COVID infection, becoming potential targets for treatment. Hepcidin could also be considered as a biomarker to measure the effectiveness of our treatments and the res-toration of iron homeostasis the final intent. (www.actabiomedica.it)
Meningeal involvement in multiple myeloma: report of a case with cytologic and immunocytochemical diagnosis.
Multiple myeloma (MM) with meningeal involvement is a very rare phenomenon. Only 37 cases of plasma cell neoplasia (MM and plasma cell leukemia) with meningeal involvement have been reported.A 60-year-old male with stage IIIA light lambda chain MM returned nine months after the diagnosis with back pain, lower right extremity paresthesias and gait disturbance. A lumbar puncture revealed atypical plasma cells in the cerebrospinal fluid (CSF), and immunocytochemical studies showed a cytoplasmic monoclonal light lambda chain. A diagnosis of myelomatous meningitis was made, and the patient received intrathecal chemotherapy and craniospinal irradiation. He died six months after the diagnosis of meningeal disease.The present case and a review of the literature show that clinical manifestations of meningeal myeloma are non-specific. MM with meningeal involvement is accompanied frequently by circulating atypical plasma cells or plasma cell leukemia. Atypical plasma cells in the CSF are an important finding for the diagnosis of meningeal myeloma, and their neoplastic nature can be best identified by immunocytochemical analyses. Patients with meningeal myelomatosis can have a good response to treatment initially, but their prognosis is poor
Tipizzazione sierologica e tipizzazione in biologia molecolare (PCR-SSP E PCR-SSO) a confronto nella riqualifica dei donatori di midollo osseo
Composizione elettrolitica ed aminoacidica plasmatica e muscolare in corso di rabdomiolisi da deplezione potassica
Role of blood pressure in the natriuretic response to acute calcium channel blockade in humans
Clinical efficacy of ultrasound guided percutaneous drainage of abscesses in patients with leukaemia and lymphoma
Abstract: Ultrasound guided percutaneous drainage (US-PD), a minimally invasive technique, has been reported as highly effective for the treatment of deeply located abscesses, particularly in immunocompromised patients. Therefore, we retrospectively studied its therapeutic efficacy and safety in a series of 14 patients with leukaemia and lymphoma. We collected the clinical and sonographic data of 14 patients with various types of leukaemia and lymphoma. These patients were consecutively observed in four clinical centres with long-term experience with ultrasound guided therapeutic techniques. The cases were analysed according to underlying disease, clinical features, location of the abscess, drainage technique, microbiological data and both short-and long-term outcome. In our series, 11 patients were treated with repeated ultrasound guided needle aspirations (US-NA) and 3 underwent catheter drainage (US-PCD). In 12/14 cases the procedure was successful (86%): the mortality rate was 14%. 5 patients died during the follow-up period because of the underlying disease, without abscess recurrence. No complications were reported. Our data suggest that ultrasound guided percutaneous drainage should be considered the first choice, minimally invasive procedure for the treatment of deeply located abscesses in patients with leukaemia and lymphom
ALK positive lymphohistiocytic variant of anaplastic large cell lymphoma in an adult.
The lymphohistiocytic (LH) variant of anaplastic large cell lymphoma (ALCL) has, for a long time, been considered typical of children and adolescents. The aim of this study is a detailed characterization of a case of this peculiar ALCL subtype affecting an adult patient. DESIGN AND METHODS: A 36-year old male presented with diffuse adenopathy and systemic symptoms (high fever, anorexia, asthenia); a diagnosis of CD30+/ALK+ ALCL, LH variant, was morphologically suspected and corroborated by immunohistochemistry that was crucial for the definitive diagnosis and subtyping. RESULTS: The neoplastic population consisted of cells highly variable in size and shape but more often isolated and largely obscured by a predominant reactive cellular infiltrate of histiocytes and plasma cells. The lymphoma cells exhibited a null non-B non-T antigenic profile, but reacted strongly for the Ber-H2/CD30, EMA, ALKc anti-TIA-1 monoclonal antibodies. The patient underwent chemotherapy plus bone marrow transplantation and, one year after diagnosis, he is well and in complete remission. INTERPRETATION AND CONCLUSIONS: Our findings provide additional evidence that: a) ALK+ lymphoma represents a single disease with a broad spectrum of morphology; b) clinicians and pathologists should be aware of the possible occurrence of LH variant of ALK+ ALCL also in adults in whom a favorable response to therapy may be expected despite systemic disease and an aggressive clinical presentation
Human herpesvirus 8-associated primary effusion lymphoma in human immunodeficiency virus-negative patients: a clinico-epidemiologic variant resembling classic Kaposi's sarcoma
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