74 research outputs found
Effect of Cl-Substitution on Rooting- or Cytokinin-like Activity of Diphenylurea Derivatives
No full textTwenty-eight Cl-substituted diphenylurea derivatives differing in either the number and the position of the substituents, or in the type of substitution, that is, symmetric or asymmetric, were synthesized. Their hypothetical enhancement of rooting activity was assayed using the mung bean shoot bioassay; their possible cytokinin-like activity was assesed using the betacyanin (so-called “amaranthin”) accumulation test and the tomato regeneration test. Seven Cl-substituted diphenylurea derivatives (2E, 4A, 4B, 4E, 4G, 6A, 6B) having two substituted phenyl rings showed the capacity to enhance adventitious root formation in mung bean shoots. Furthermore the presence of a halogen substituent was not sufficient to reach the adventitious rooting activaties shown by the N,N′-bis-(2,3-methylenedioxyphenylurea) and the N,N′-bis-(3,4-methylenedioxyphenylurea), two diphenylurea derivatives for which an interaction with auxin was the first reported in enhancing adventitious root formation. Seven compounds (1B, 3E, 3D, 4B, 4E, 4F, 6B) showed cytokinin-like activity and three of them (4B, 4E, 6B) also evidenced rooting activity, once more demonstrating the wide action spectrum of diphenylurea derivatives
A multi-allergen ELISA screening method. Comparison with Pharmacia CAP system and Phazet skin prick test.
No full textCarotid Artery Diameters, Carotid Endarterectomy Techniques and Restenosis
No full textBackground: Restenosis of the carotid artery is a major complication of carotid endarterectomy (CEA). The
purpose of this study was to examine the role of CEA techniques on carotid dimensions variation, postoperative
versus preoperative multi-segmental diameters and its impact on the development of restenosis at 12 months follow
up.
Methods: 175 consecutive patients eligible for carotid surgery were included in the study. 75 underwent CEA
by patch reconstruction (PR), 53 by eversion (EV) and 47 by primary closure (PC). Before the procedures and
at discharge, carotid diameters were measured at four reference points (common carotid, CC; carotid bulb, CB;
proximal internal carotid artery, PICA; distal internal carotid artery, DICA) by ultrasonography. The rate of minor (<
50%) and major (≥ 50%) restenosis was evaluated at 12 months follow up.
Results: PR produced an increase in all carotid diameters while PC and EV produced a decrease in carotid
diameters, having PC affected all diameters while EV affected CB and PICA diameter. However, postoperative
diameters had comparable dimension independently of the surgical technique used. The rate of overall and major
restenosis did not differ significantly between the three types of surgery. Logistic regression analysis showed
that female gender was associated with major restenosis (OR 6.9, 95% CI 1, 23 – 38, 49) irrespective of surgical
technique.
Conclusion: This study shows that carotid diameters and restenosis rate after CEA are comparable whatever is
the surgical technique adopted, and that women are at high risk of major restenosis.Background: Restenosis of the carotid artery is a major complication of carotid endarterectomy (CEA). The
purpose of this study was to examine the role of CEA techniques on carotid dimensions variation, postoperative
versus preoperative multi-segmental diameters and its impact on the development of restenosis at 12 months follow
up.
Methods: 175 consecutive patients eligible for carotid surgery were included in the study. 75 underwent CEA
by patch reconstruction (PR), 53 by eversion (EV) and 47 by primary closure (PC). Before the procedures and
at discharge, carotid diameters were measured at four reference points (common carotid, CC; carotid bulb, CB;
proximal internal carotid artery, PICA; distal internal carotid artery, DICA) by ultrasonography. The rate of minor (<
50%) and major (≥ 50%) restenosis was evaluated at 12 months follow up.
Results: PR produced an increase in all carotid diameters while PC and EV produced a decrease in carotid
diameters, having PC affected all diameter
Multiple thromboembolism with multiple causes in a 69-year-old woman: a case report
No full textAbstract Introduction Aggressive, recurrent embolisms require accurate etiologic diagnosis. We describe the case of a 69-year-old Italian Caucasian woman with recurrent arterial embolisms in whom several sources and triggers of thrombosis were detected. Case presentation The patient, a 69-year-old Italian Caucasian woman, presented with a systemic embolism that was initially attributed to atrial fibrillation. The recurrence of embolisms despite anti-thrombotic therapy prompted a re-evaluation of the clinical presentation. New potential causes of thrombosis emerged in this patient, including thrombocytosis associated with the JAK2 V617F mutation and the very rare mural thrombosis of the descending aorta. A mural thrombus in the pulmonary artery was detected contiguous with the aortic mural thrombosis, raising the possibility of a clinically silent ductus Botalli as the initiating event. The patient was treated with warfarin, aspirin, hydroxyurea, and surgery. Conclusions The diagnosis was achieved via systematic use of imaging procedures and reconsideration of blood tests performed to explore the diagnosis of thrombosis. This allowed a deeper and more detailed analysis of the case beyond the conventional approach, which would have aimed to identify one cause for the condition at hand, in this case, atrial fibrillation. The broader approach that we used resulted in the diagnosis of multiple embolisms from multiple sites and multiple causes.</p
Identification of a potential proinflammatory genetic profile influencing carotid plaque vulnerability.
No full textOBJECTIVE:
Atherosclerosis and vascular remodeling after injury are driven by inflammation and mononuclear cell infiltration. Unstable atherosclerotic plaques are characterized by a large necrotic core. In this study we investigated the distribution and interaction between gene polymorphisms encoding proinflammatory molecules in an Italian population with internal carotid artery stenosis (ICAS). We also evaluated whether reciprocal interaction between these gene polymorphisms increased the risk of plaque vulnerability.
METHODS:
In this genetic association study, 11 proinflammatory gene polymorphisms were analyzed in 933 individuals comprising 344 patients with ICAS who underwent carotid endarterectomy and 589 controls without ultrasound evidence of atherosclerosis or intimal thickening.
RESULTS:
We found that interleukin (IL) 6 (IL-6), IL-1β, monocyte chemoattractant protein-1 (CCL2) macrophage inflammatory protein-1α (CCL3), E-selectin (SELE), intercellular adhesion molecule 1 (ICAM1), and matrix metalloproteinase-3 (MMP-3), and 9 (MMP-9) gene variants were independently and significantly associated with ICAS. The association remained significant even after the Bonferroni correction. We also found a genetic profile associated with different risks for ICAS, depending on the number of high-risk genotypes simultaneously present in an individual. Furthermore, proinflammatory genetic profiles are significantly more common in individuals with unstable carotid plaque.
CONCLUSIONS:
Our study shows, for the first time, a reciprocal interaction between proinflammatory genotypes for the development and progression of ICAS
Outcomes in the emergency endovascular repair of blunt thoracic aortic injuries
No full textAbstract
Thoracic aorta blunt injury (BAI) is a highly lethal lesion. A large number of victims die before obtaining emergency care. Thoracic endovascular aneurysm repair (TEVAR) is a less invasive method compared with open surgery and may change protocols for BAI treatment. This retrospective study was developed to evaluate the potential issues about thoracic endografting in the management of these patients. Twenty-seven patients with a BAI underwent aortic stent grafting. Intervention was preceded by the treatment of more urgent associated lesions in nine cases. In-hospital mortality was 7.4%. No paraplegia or ischemic complications developed because of the coverage of the left subclavian artery. In one case (3.2%), a type I endoleak was detected, proximal endograft infolding in two cases (7.4%) and endograft distal migration in further two cases were detected during follow-up (6-110 months). Thoracic endovascular aneurysm repair of BAI showed encouraging results in terms of perioperative mortality and morbidity. Concerns still remain about the potential mid- and long-term complications in younger patients
Surgical treatment of thoracic outlet syndrome: immediate and mid-term results
No full textIntroduction: We report the results from a consecutive series of patients treated by
scalenectomy or cervical rib resection for clearly symptomatic or paucisymptomatic
thoracic outlet syndrome (TOS) over a 6-year period.
Material and methods: From September 1999 to August 2005, 14 surgical
decompressions were performed in 12 patients with unremitting signs and
symptoms of nerve or vascular compression at the thoracic outlet. The symptoms
of TOS were due to involvement of the brachial plexus in 8 cases (57.1%). A sign
of vascular obstruction could be detected in 10 cases (71.4%): in 6 cases (42.8%)
the presentation was predominantly arterial (arm claudication, coldness, Raynaud’s
phenomenon and distal embolisation) and in 4 cases (28.5%) was related to vein
compression with congestion and swelling of the affected arm or vein thrombosis.
Two patients presented as emergencies with critical upper limb ischaemia or distal
vessel embolisation.
Results: The median follow-up period was 28.2 months (range 8-78 months).
Results were evaluated in terms of technical success, lack of complications
(temporary or permanent plexus injury, temporary or permanent phrenic palsy),
relief of symptoms. Outcome data were divided into immediate/perioperative
and mid-term results. Perioperative results: There was no operative mortality.
Technical success was achieved in all patients in excision of the fibrous band
with scalenectomy and in cervical rib excision. Mid-term results: In 4 patients
with venous symptoms complete relief was achieved in 75%. In all patients who
experienced arterial complications we registered complete relief. In patients with
neurological presentation we detected complete relief in 5 (62.5%), relief of some
symptoms in 2 (25%) and no improvement in 1 (12.5%).
Conclusions: Scalenectomy performed by a standard supraclavicular approach seems
to allow relief in the majority of patients with symptoms of neurological, arterial or
venous compression at the thoracic outlet. Nevertheless, we emphasize the importance
of an objective method of evaluation and the necessity of a prolonged follow-up.
Key words: thoracic outlet syndrome, scalenectomy, cervical rib resection
Echocardiography in telemedicine: a possible solution for containing waiting lists in cardiology [L’ecocardiografia in telemedicina: una possibile soluzione per il contenimento delle liste d’attesa in cardiologia]
No full textBackground: The length of waiting lists in Italy for outpatient cardiology investigations provided by the National Health System is a serious dysfunction. The shortage of physicians in hospitals makes it difficult to solve this problem by drawing on internal resources. The waiting list at Valduce Hospital in Como for outpatient echocardiographic examinations was 12 months at the beginning of 2018. Therefore, we experimented a new way to deal with this inefficiency. Methods: Starting in February 2018, we have undertaken in Valduce Hospital a partnership between the Department of Cardiology and an external startup (Ecocardioservice LLC) which guarantees for outpatients on-site performance by sonographers of echocardiographic examinations that are subsequently reported remotely via telemedicine by experienced cardiologists. Results: From February 12, 2018 to July 7, 2022, 20 782 examinations were carried out by this mode. The waiting list was reduced from 12 months to 15-20 days. A new diagnosis or a significant change in pre-existing pathology were detected in 3466 patients well in advance of previous timelines. In 5640 patients we found a known stable pathology. Of the 8926 patients with pathologic examination, 3706 patients were taken over by the Cardiology Department for subsequent investigations, possible hospitalization and, when necessary, interventional or cardiac surgical procedures on an elective basis in 2636 cases (71%) and on an urgent basis in 1070 cases (29%). Conclusions: In our experience, a system in which echocardiograms are performed on-site by sonographers and then reported in telecardiology by cardiologists outside the facility makes it possible to meet the demands of the local area and free up internal resources. This organization allowed to bring outpatients waiting lists for echocardiography back within acceptable limits and to intercept early a significant proportion of patients with need for further investigations or procedures
Vitamin K Antagonists after 6 Months of Low-Molecular-Weight Heparin in Cancer Patients with Venous Thromboembolism
No full textLow-molecular-weight heparin (LMWH) is the treatment of choice in cancer patients with venous thromboembolism. However, data on continuing LMWH treatment beyond 6 months remain scanty
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