1,721,063 research outputs found
La Modulazione dell’espressione del Tnf-Alfa e del suo recettore nella placca Psoriasica durante il trattamento con farmaci biologici
No full textPalmoplantar hyperkeratotic psoriasis with a combination of adalimumab and alitretinoin: Clinical and histologic finding
No full textBackground: Palm and sole psoriasis occours approximately in 15% of patients. Occupational manual workers are especially at risk and the isomorphic Koebner reaction may actually contribute to significant palmar hyperkeratosis even refractory to biologics. Oral alitretinoin (9-cis retinoic acid), which has been emerging as novel treatment for recalcitrant chronic hand eczema, is a vitamin A derivative with immunomodulatory and antiinflammatory activities. The specific alitretinoin mechanism of action which finally leads to skin inflammatory changes improvement is still far from being understood. We evaluated the therapeutic effect of alitretinoin plus adalimumab in patients with recalcitrant palmoplantar psoriasis thus investigating subsequent immunopathological alterations. Methods: Fifteen patients with palmoplantar psoriasis were treated with oral alitretinoin 30 mg once daily for 12 weeks plus adalimumab 40 mg once every 2 weeks. Efficacy was assessed by PASI, Palmoplantar Pustular Psoriasis Area and Severity Index (PPPASI), visual analogue scales (VAS) on intensity of pain and pruritus along with an overall patient assessment. Immunostaining for TNFα, p40 IL12-23, RAR, and RXR was performed from skin lesions biopsied before and after 12 weeks of treatment. Results: PASI, PPPASI and VAS for pruritus and pain decreased significantly after 12 weeks of treatment with adalimumab plus alitretinoin. The overall patient assessment ranged from 60 to 90% clinical improvement. A significant reduction of TNFα, p40 IL12-23, RAR and RXR at immunohistochemistry was also observed reflecting clinical improvement. Discussion: Our findings suggest how alitretinoin may be used effectively in combination with adalimumab in patients with refractory palmoplantar hyperkeratotic psoriasis. Future randomized trials are required to confirm the safety and efficacy of such therapeutic option
Rebuttal from Authors re: Vincenzo Ficarra, Antonio Galfano and Stefano Cavalleri. Is Simple Enucleation a Minimal Partial Nephrectomy Responding to the EAU Guidelines' Recommendations? Eur Urol 2009;55:1315-8
Full text linkRe: Anders Lidgren, Ylva Hedberg, Kjell Grankvist, Torgny Rasmuson, Anders Bergh and Börje Ljungberg. Hypoxia-Inducible Factor 1α Expression in Renal Cell Carcinoma Analyzed by Tissue Microarray. Eur Urol 2006;50:1272–7
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Early detection of acute lung injury uncoupled to hypoxemia in pigs using ultrasound lung comets.
No full textOBJECTIVE: Oleic acid-induced lung injury is an established experimental model of acute lung injury in pigs and is considered to reproduce the early exudative phase of acute respiratory distress syndrome. Ultrasound lung comets are an echographic sign of extravascular lung water, originating from thickened interlobular septa. The objective of this study was to evaluate the timing and relationship between the number of ultrasound lung comets, the Pao2/Fio2 ratio, and the static respiratory compliance in an experimental model of oleic acid-induced lung injury in pigs. DESIGN: Laboratory experiment. SETTING: Research institute. SUBJECTS: Ten anesthetized pigs. INTERVENTIONS: Acute lung injury was induced by injection of oleic acid (0.1 mL/kg, intravenously). Ultrasound lung comets, Pao2/Fio2, and static respiratory compliance were measured at baseline and at 15, 30, 60, and 90 mins after the injection of oleic acid. We evaluated ultrasound lung comets by transthoracic echography (7.5-MHz vascular probe), scanning on right and left hemithoraxes at 12 predefined scanning sites. MEASUREMENTS AND MAIN RESULTS: Acute lung injury/acute respiratory distress syndrome was present in all pigs at 90 mins. The number of ultrasound lung comets increased over time and was consistently earlier than the decrease in Pao2/Fio2. At 15 mins, ultrasound lung comets were markedly increased, but no significant changes in Pao2/Fio2 were observed. Accordingly, static respiratory compliance was dramatically reduced at 15 mins compared with baseline (17.04 +/- 1.82 vs. 34.84 +/- 2.62 mL/cm H2O, p < .05). CONCLUSIONS: Ultrasound lung comets, assessed by transthoracic echography, detected extravascular lung water accumulation very early in the course of the oleic acid lung injury in pigs, in the presence of a normal Pao2/Fio2. These results suggest that ultrasound lung comets could be a very early, noninvasive, and simple method to detect and quantify pulmonary edema in acute lung injury
Spontaneous umbilical endometriosis: a case report with one-year follow-up
No full textUmbilical endometriosis is a very rare disease. We report a case of spontaneous umbilical endometriosis in a 36-year old female. Endometriosis was suspected because of the presence of the typical cyclic bleeding and swelling. Abdominal CT excluded the presence of other endometriotic localizations. The umbilical mass was widely excised together with the umbilicus, fascia and peritoneum. The ensuing defect was primarily closed without using prosthetic mesh. Postoperative recovery was uneventful. Histological examination of the specimen showed the presence of endometrial glands with a stromal component, compatible with the diagnosis of endometriosis. At one-year follow-up the results Of Surgery were satisfactory with no sign of endometriosis recurrence and or parietal defect occurrence. We suggest that surgical excision should be wide in order to prevent local recurrence, and prosthetic materials should not be used to repair the ensuing umbilical defect
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