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GST Primary GST Primary Best Strategies for Health Care Quality Im... Best Strategies for Health Care Quality Improvement - Diabetes Quality Improvement Strategies for Antibio... Kathryn McDonald, Stanford-UCSF Evidence-b... Systematic review assessing the effect of ... Quality Improvement Strategies for Antibiotics Management Kathryn McDonald, Stanford-UCSF Evidence-based Practice Center, 117 Encina Commons, Stanford, CA 94305-6019, Kathy.mcdonald@stanford.edu Systematic review assessing the effect of quality improvement strategies on appropriate prescribing of antibiotics and appropriate choice of antibiotics. Adherence Adherence Assistive Devices Assistive Devices Childhood Burn Hanson MacMillan Childhood Burn Hanson MacMillan CLSA_9 CLSA_9 Cyberabuse Cyberabuse Cognitive Behavioural Therapy for Violent ... This review included randomized trials abo... Cognitive Behavioural Therapy for Violent Men who Batter Their Partners This review included randomized trials about the effects of cognitive behavioral therapy on domestic violence. The intervention included programs based on the Duluth Model. The violence had to be committed by a male toward his female partner. The violence also had to be physical. The primary outcomes were new arrests and convictions, and new reports of violence. CABG vs PCI CABG vs PCI Quality Improvement Strategies for Prevent... Quality Improvement Strategies for Preventing Nosocomial Infections (Created 17-Feb-06) Quality Improvement Strategies for Asthma ... Quality Improvement Strategies for Asthma Control Erectile Dysfunction (Created 30-Jan-06) Erectile Dysfunction (Created 30-Jan-06) Inequality - Smoking Cessation to Reduce S... This review was the first part of a projec... Inequality - Smoking Cessation to Reduce Socio-Economic Differences This review was the first part of a project about inequality. It included randomized trials about the effect of smoking cessation interventions on reducing socio-economic differences. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Diet and Physical Activity to Reduce Socio... This review was the second part in a proje... Diet and Physical Activity to Reduce Socio-Economic Differences This review was the second part in a project about inequality. It included randomized trials about the effect of interventions on reducing socio-economic differences in diet and physical activity. The studies had to report data either on persons with low socio-economic groups status or, preferably, on both low and high socio-economic groups. Workfare The data in SRS are not identical to the d... Workfare The data in SRS are not identical to the data in the published report. We used SRS only for an updated search. The review included randomized trials about the effect of welfare-to-work programs. Participants were welfare recipients. There were basically two types of programs. The educational type tried to build knowledge and skills in order to help the welfare recipients acquire jobs that could support them economically. The "work first" approach was more aimed at getting the participants quickly into a job. Exercise interventions for the management ... The objective of this systematic review wa... Exercise interventions for the management of frailty The objective of this systematic review was to examine the effectiveness of current exercise interventions on the management of frailty. A comprehensive search of Medline, Embase, Psycinfo, Cinahl, Scopus, Ageline, Eric, and SportDiscus databases was conducted and produced 1808 citations. So far we have completed 2 levels of “title and abstract” screening and we ended up with 262 articles. We have just started the full text screening. Eligibility criteria included original studies whose participants were identified as frail or prefrail with specific criteria and in which structured physical activity was included as at least one component of the intervention. Create a free account, build a dictionary with saved terms to re-use later! Public Domestic Violence - Using Cognitive Behavior Therapy Smoking Cessation to Reduce Socio-Economic Differences Diet and Physical Activity to Reduce Socio-Economic Differences Workfare Exercise Interventions for the Management of Frailty Search     Simple Advanced Refine (4 coded questions)  Any of these:   Exact Phrase: All of these: None of these: Author: Periodical: Projects: No restrictions   Libraries: Public   Select SRS Projects Show Saved Terms Select Library Show articles that do not have abstracts  Language English French German Italian Japanese Russian Spanish Afrikaans Albanian Unknown Arabic Armenian Azerbaijani Bosnian Bulgarian Catalan Chinese Croatian Czech Danish Dutch Esperanto Estonian Finnish Georgian Greek, Modern Hebrew Hindi Hungarian Icelandic Indonesian Kinyarwanda Korean Latin Latvian Lithuanian Macedonian Malay Malayalam Maori Multiple Languages Norwegian Persian Polish Portuguese Pushto Romanian Sanskrit Scottish gaelic Serbian Slovak Slovenian Swedish Thai Turkish Ukrainian Vietnamese Not English Not French Humans or Animals Humans Animals Ages All Infant: birth-23 months All Child: 0-18 years All Adult: 19+ years Newborn: birth-1 month Infant: 1-23 months Preschool Child: 2-5 years Child: 6-12 years Adolescent: 13-18 years Adult: 19-44 years Middle Aged: 45-64 years Middle Aged + Aged: 45+ years Aged: 65+ years 80 and over: 80+ years Undetermined Type of Article Clinical Trial Editorial Letter Meta-Analysis Practice Guideline Randomized Controlled Trial Review Addresses Bibliography Biography Case Reports Classical Article Clinical Conference Clinical Trial, Phase I Clinical Trial, Phase II Clinical Trial, Phase III Clinical Trial, Phase IV Comment Comparative Study Consensus Development Conference Consensus Development Conference, NIH Controlled Clinical Trial Corrected and Republished Article Dictionary Directory Duplicate Publication English Abstract Evaluation Studies Festschrift Government Publications Guideline Historical Article Interview In Vitro Journal Article Lectures Legal Cases Legislation Multicenter Study News Newspaper Article Overall Patient Education Handout Periodical Index Published Erratum Retracted Publication Research Support, N.I.H., Extramural Research Support, N.I.H., Intramural Research Support, Non-U.S. Gov't Research Support, U.S. Gov't, Non-P.H.S. 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Retraction of Publication Scientific Integrity Review Support of Research Technical Report Twin Study Validation Studies Not a Primary Study or Review Unknown Primary Study Case Series Case Control Cohort Study Observational Study Qualitative Research CBA or ITS Registry Double Blind Controlled before after study Quasi-randomized trial Simple before after study Cluster-RCT Non-Randomized Study Report Book Book chapter Dissertation Conference procedings Secondary Research Not RCT Results(1-25 of 13,233) Sort By: Publication Date Relevance Took: 1.701 seconds to search 17,750,454  Action: Copy Results to new Clipboard Build Search Link Page 1 of 530 1 2 3 4 > Last >> (13233 articles found) [Implementation of transanal endoscopic microsurgery (TEM) in Italy: a multicentre investigation] 2007 Sep-Oct Roberto Puglisi,Mario Guerrieri,Emanuele Lezoche,Marco Ettore Allaix,Francesco Stipa,Mario Ferri,Mario Trompetto,Giuseppe Clerico,Renzo Zaffarano,Francesco Quaglia,Mario Morino Transanal endoscopic microsurgery (TEM), which was first introduced several years ago, allows the excision of rectal tumours not susceptible to a more traditional endoscopic approach or as an alternative to highly invasive or debilitating procedures. We surveyed the effective implementation of TEM ... ( view more )in Italy, the indications adopted by each surgical department and the technical results achieved. We contacted 34 surgical departments and analysed the answers given by 17 centres (those actually using the technique = 50%). Most of these are situated in Northern Italy. A total of 1208 procedures were declared (84% of them performed in 6 centres). The most frequent declared indications were adenomas and T1 and T2 carcinomas (741 cases). The contraindications have to do with the staging, localisation and size of the neoplasms. The mean operative time reported by most of the centres ranged from 60 to 90 minutes. The most frequent complication in 13 departments was haemorrhage. The conclusions reported by some of the surgeons contacted are useful. The implementation of TEM is confined to only a few centres with a large number of treated cases. Overall analysis of the data raised many questions needing to be answered, especially with regard to the proper use of a surgical technique that is difficult but not impossible to implement. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Continuous quality improvement in intensive care medicine. The GiViTI Margherita Project - Report 2005. Jun 2006 S Boffelli,C Rossi,A Anghileri,M Giardino,L Carnevale,M Messina,M Neri,M Langer,G Bertolini,Italian Group for the Evaluation of Interventions in Intensive Care Medicine ,Abastanotti Marco,Alberti Arnaldo,Alborghetti Armando,Angiolini Patrizia,Anticoli Borza Stefani,Archi Davide,Arditi Enrico,Badii Flavio,Andrea Balata,Barattini Massimo,Barbagli Remo,Bartoccini Arcangelo,Bartoli Teresa,Bassi Francesco,Beck Eduardo,Belloni Umberto Giuseppe,Berardino Maurizio,Berasconi Mara Olga,Bianchin Andre,Blasetti Angelo,Boccalatte-Rosa Daniela,Bonaccorso Giuseppina,Bonfà Andrea,Monica Bonfiglio,Bonizzoli Manuela,Bottari Valter,Breschi Cesare,Bressan Silvia,Brunori Emaunuela,Burgio Gaetano,Buzzetti Virginio,Cabano Gian Virgilio,Calicchio Giuseppe,Caracciolo Massimo,Casagli Sergio,Casagrande Lucia,Casciani Massimo,Caracciolo Giacomo,Renata Cavallo,Chiarello Marco,Chieregato Arturo,Chinelli Elena,Chini Giuseppe,Clementi Stefano,Coaloa Maddalena,Colombo Riccardo,Colonna Salvatore silvio,Cominotti Silvano,Corsini Walter,Costanzo Eleonora,Crema Luciano,Crestan Ezio,Dal Cero Paolo,Dal Ferro Marino,Dal Poggetto Luigi,Dal Pos Lucia,David Antonio,De Blasio Roberto Alberto,De Luca Alessandra,De Negri Pasquale,Dei Poli Marco,Del Sarto Paolo,Di Masi Pierfrancesco,Di Pasquale Dino,Elvio De Blasio,Fabbri Emilio,Fabbri Lea,Fabbri Pier Giorgio,Fabi Maria Critina,Faccio Luciana,Falconio Anotnio,Fasiolo Simonetta,Febbrari Paolo,Ferrante Marco,Ferraro Fausto,Fiore Gilberto,Fontaneto Carlotta,Gabini Rita,Galeotti Elsa,Gamberini Emiliano,Garelli Alberto,Garofalo Giuseppe,Giacopuzzi Luigi,Gianni Massimo,Giannoni Stefano,Girardis Massimo,Giudici Daniela,Giugiaro Pier Mario,Gorietti Adonella,Grassi Paolo,Greco Maurizio,Guadagnucci Alberto,Guagliardi Clementina,Isetta Michele,Lampati Laura,Lapolla Antonio,Lazzaro Francesco,Livigni Sergio,Madona Roberto,Magatti Maria Federica,Maitan Stefano,Malacarne Paolo,Mangani Valerio,Mantovani Giorgio,Marchesi Gianmariano,Mastroianni Alessandro,Mastropierro Rosa,Mediani Teresa Sabina,Meloni Alessandra,Miglioranzi Renzo,Montani Cinza,Morigi Aristide,Mosca Carlo,Murru Salvatore,Nardi Giuseppe,Nascimben Ennio,Natalina Giuseppe,Negri Giovanni,Negro Giancarlo,Nicolini Andrea,Nuovo Domineco,Odetto Lorenzo,Olivieri Carlo,Ortoleva Antonino,Paganini Giorgio,Paganoni Guido,Palmer Maurizio,Panella Luigi,Papiri Silvano,Parlanti Garbe Massimiliano,Parma Alberto,Pastorelli Mauro,Pegoraro Maurizio,Pelosi Giuseppe,Pezza Brunello,Pezzi Angelo,Piccinini Paolo,Pinciroli Donatella,Piredda Giuseppe,Pisu Marina,Pizzaballa Marialuisa,Poole Daniele,Possamai Clemente,Postiglione Maurizio,Pulici Marco,Quattrocchi Pasqualino,Raffaeli Massimo,Righini Erminio,Riva Alberto,Rizzi Maurizio,Romitti Mario,Rossi Giancarlo,Rossi Maurizio,Rossi Nicola,Rossi Simona,Roticiani Valeria,Rottoli Federica,Salcuni Rosa,Schellino Maria Maddalena,Segala Vicenzo,Sicignano Alberto,Spadini Elisabetta,Staccioli Paola,Stefano Maurizio,Tavola Mario,Tetamo Romano,Tinacci Silvia,Todesco Livio,Tomasoni Gabriele,Tosi Luigi,Vaj Monica,Vespignani Maria Giovanna,Visconti Maria Grazia,Vivaldi Nicoletta,Vulcano Giuseppe Angelo,Zamperetti Nereo,Zampieri Giovanni,Zappa Sergio,Zava Raffaele,Zocaro Rosamaria AIM: The assessment of the quality of intensive care medicine is mandatory in the modern healthcare system. In Italy, the GiViTI (Gruppo Italiano per la Valutazione degli Interventi in Terapia Intensiva) network is working in this field since 1991 and it now involves 295 out of the about 450 Italia... ( view more )n intensive care units (ICU). In 2002 GiViTI launched a project for the continuous quality assessment and improvement that is now joined by 180 ICUs. Data collected in 2005 are analyzed and presented. METHODS: All admitted patients were entered in a validated software, which performs a multitude of validity checks during the data entry. Data were further reviewed by the co-ordinating center; patients admitted in months with more than 10% of incomplete or inconsistent records in each ICU were excluded from the analysis. Each year, a multivariate logistic regression model is fitted to identify predictors of hospital mortality. Starting from the SAPS 2 and the 2004 GiViTI model predictions of hospital mortality, two calibration tables and curves are presented. RESULTS: In 2005, 180 Italian ICUs collected data on 55 246 patients. After excluding those admitted in months with an unjustified lower recruitment rate or with less than 90% of complete and consistent data, we had 52 816 (95.6%) valid cases. Although the rough hospital mortality in 2005 was 1% higher than in 2004 (22.6% vs 21.5%), the adjusted mortality shows a statistically significant 4% reduction (obser-ved-to-expected ratio: 0.96; 95% CI: 0.94-0.97). CONCLUSIONS: Italian ICUs in 2005 performed better than in 2004, at a parity of patient severity. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Analgesia after thoracotomy: epidural fentanyl/bupivacaine compared with intercostal nerve block plus intravenous morphine. Jun 2004 Mario Concha,Jorge Dagnino,Mario Cariaga,Jorge Aguilera,Rodrigo Aparicio,Mario Guerrero OBJECTIVES: Intercostal nerve blockade plus intravenous (IV) patient-controlled analgesia (PCA) could be an easier and safer alternative to epidural analgesia for postthoracotomy pain, but information about the efficacy of this technique is scarce. The objective of this randomized study was to comp... ( view more )are the quality of analgesia and lung function in 2 groups of patients undergoing pulmonary surgery through a posterolateral thoracotomy. METHODS: Two groups were studied: G1 (n = 16) patients received a 5-segment intercostal block plus IV PCA morphine, and G2 (n = 15) patients received a bupivacaine and fentanyl PCA infusion through a thoracic epidural catheter. Resting and dynamic visual analog pain scale (VAS) measurements, forced vital capacity, and forced expiratory volume in 1 second were measured basally, on arrival in the recovery room, then hourly up to 4 hours and then 12, 24 and 48 hours later. Results were analyzed with a 2-way analysis of variance, chi-square, or Fisher exact test. A p value < or =0.05 was considered significant. RESULTS: Resting and dynamic VAS scores were slightly lower in G2 patients, although only resting scores were significant. After the first hour, mean scores were below 4 in both groups. No significant difference was observed between groups in relation to respiratory parameters or side effects. CONCLUSION: The fact that the difference in pain scores is probably not clinically significant shows that an intercostal block with bupivacaine plus IV morphine PCA is a good alternative for postthoracotomy pain management. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles [Results of intraventricular resynchronization in patients with severe cardiac failure] Oct 2003 René Asenjo,Mario Zapata,Ivonne Aramburú,Raimundo Morris,Mauricio Cereceda,Solange Brugere,Rubén Aguayo,Jhonny Ríos,Carlos Toro,Mario Hassi,Patricio González,José Cannessa,Rodulfo Oyarzún,Mario Ortiz,Viviana Avalos,Patricia Morales,Martín Nicola,Miguel Oyonarte,Alejandro Abufhele BACKGROUND: Intraventricular resynchronization with pacemakers is a promising therapy for patients with refractory cardiac failure and intraventricular conductions delay. However its long term effects are not well known. AIM: To report the results of this therapy in patients with cardiac failure. P... ( view more )ATIENTS AND METHODS: Fourteen patients (11 male), whose mean age was 68 years, with a severe and refractory cardiac failure, have been treated in our unit using intraventricular resynchronization with pacemakers. Eight had a coronary heart disease and six a dilated myocardiopathy. The pacemaker was implanted transvenously, with conventional stimulation in atrium and right ventricle. The left ventricle was stimulated through an epicardial vein, accessed through the coronary sinus. RESULTS: In one patient the high thresholds did not allow a left ventricular stimulation. In the other 13 patients, a clinical improvement was observed in 11 (85%), that has been sustained for a mean of 8.2 months. The ejection fraction improved form 23.5 to 32.4% (p < 0.001), the 6 min walking test improved from 347 to 437 m (p = 0.003) and the functional capacity changes from 3.3 to 2.7 (p < 0.001). Three patients died during follow up. One was the patient in whom the stimulation failed and two had a sudden death. No complications of the procedure were observed. CONCLUSIONS: In this series, intraventricular resynchronization with pacemakers was effective in 11 of 13 patients, improving functional capacity and ejection fraction. Sudden death could be avoided adding a defibrillator to the pacemaker system. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles A new essential hypertension susceptibility locus on chromosome 2p24-p25, detected by genomewide search. Oct 2002 Andrea Angius,Enrico Petretto,Giovanni Battista Maestrale,Paola Forabosco,Giuseppina Casu,Daniela Piras,Manuela Fanciulli,Mario Falchi,Paola Maria Melis,Mario Palermo,Mario Pirastu Essential hypertension (EH) is a complex disorder that results from the interaction of a number of susceptibility genes and environmental factors. We studied an isolated Sardinian village (Talana) in which the prevalence of hypertension is comparable to that in most Western populations. Talana exhi... ( view more )bits features, such as slow demographic growth, high inbreeding, a low number of founders, stable lifestyle and culture, and accurate genealogical records, that make it suitable for the study of complex disorders. Clinical assessment of the entire adult population (N= approximately 1,000) identified approximately 100 hypertensive subjects. For our study, we selected the individuals with the most-severe EH (i.e., diastolic blood pressure >100 mm Hg), belonging to a single deep-rooted pedigree (12 generations), whose common ancestors lived in the 17th century. We performed a three-stage genomewide search using 36 affected individuals, by means of parametric linkage and allele-sharing approaches. LOD scores >1 were observed on chromosomes 1, 2, 13, 15, 17, and 19 (stage I). The most striking result was found in a 7.57-cM region on chromosome 2p24-p25. All five nonparametric linkage statistics estimated by the SimWalk2 program lie above the significance threshold of P<.008 for the whole region. Similar significance was obtained for 2p24-25 when parametric linkage (LOD score 1.99) and linkage disequilibrium mapping (P=.00006) were used, suggesting that a hypertension-susceptibility locus is located between D2S2278 and D2S168. This finding is strengthened by a recent report of linkage with marker D2S168 in a hypertensive sib-pair sample from China. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Fatty acid composition and volatile compounds of caviar from farmed white sturgeon (Acipenser transmontanus). Jun 9, 2008 Fabio Caprino,Vittorio Maria Moretti,Federica Bellagamba,Giovanni Mario Turchini,Maria Letizia Busetto,Ivan Giani,Maria Antonietta Paleari,Mario Pazzaglia The present study was conducted to characterize caviar obtained from farmed white sturgeons (Acipenser transmontanus) subjected to different dietary treatments. Twenty caviar samples from fish fed two experimental diets containing different dietary lipid sources have been analysed for chemical comp... ( view more )osition, fatty acids and flavour volatile compounds. Fatty acid make up of caviar was only minimally influenced by dietary fatty acid composition. Irrespective of dietary treatments, palmitic acid (16:0) and oleic acid (OA, 18:1 n-9) were the most abundant fatty acid followed by docosahexaenoic acid (DHA, 22:6 n-3) and eicopentaenoic (EPA, 20:5 n-3). Thirty-three volatile compounds were isolated using simultaneous distillation-extraction (SDE) and identified by GC-MS. The largest group of volatiles were represented by aldehydes with 20 compounds, representing the 60% of the total volatiles. n-Alkanals, 2-alkenals and 2,4-alkadienals are largely the main responsible for a wide range of flavours in caviar from farmed white surgeon. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Inverse relationship between scores on the quality of life questionnaire SF-12 and on the Aging Males' Symptoms scale in Italian men. Jun 2008 Giorgio Valenti,Massimo Capone,Gianni Forti,Marco Grasso,Vicenzo Mirone,Francesca Chiaffarino,Elena Ricci,Gianluca Appiani,Emilio Corti,Davide Fabbrica,Enzo Ferrario,Sergio Ghezzi,Marco Grendele,Paolo Maroni,Gianbattista Mazzoleni,Mario Nicolussi,Antonio Pinnavaria,Alberto Rossi,Vittorino Sala,Silvana Santoro,Gaetano Autore,Giovanni Avvento,Roberto Barra,Dario Brunetti,Aurelio Catalano,Vincenzo Girardi,Giuseppe Iovane,Federico Lettieri,Sergio Marescotti,Nicola Pelaggi,Gennaro Sica,Stefano Delcanale,Beatrice M Gorreri,Carlo Maini,Fabrizio Peri,Emilio Sani,Mario Sisto,Anita Sullam,Giovanni Zanardi,Giuseppe Burgio,Alessandro Bussotti,Lucia Caldini,Lucia Gianelli,Nadia Gianni,Massimo Giuntoli,Massimo Guarducci,Alessio Nastruzzi,Rachele Pacileo,Riccardo Pirozzi,Lorenzo Pisani,Maurizio Puliti,Paola Rafanelli,Paolo Baron,Filippo Cocomazzi,Giovanni Cominetti,Gianfranco Matera,Gianfranco Panizzo,Denis Podrecca,Ivana Rupalti,Paolo Spagnul,Laura Ivana Tonelli,Onorino Venturini,Claudio Nardo,Fabio Parazzini,Aging Male Italian Epidemiological Study Group OBJECTIVES: To analyse the relation between results of the Aging Males' Symptoms (AMS) questionnaire for aging males, and of quality of life (QOL) questionnaire SF-12 and cardiovascular risk factors. METHODS: 1,927 men aged 55-85 years were interviewed by 56 general practitioners. During the interv... ( view more )iew the men were asked to fill in the AMS scale and the QOL questionnaire SF-12. RESULTS: Of 1,927 men 1,806 men filled correctly the AMS questionnaire. The mean SF-12 mental index was respectively 55.9 in men with a total AMS score indicating no impairment, 50.9 mild, 42.8 moderate, and 32.8 severe impairment. The corresponding values for the physical index were 51.2, 46.7, 40.8 and 32.3. A history of diabetes was associated with an increased risk of reporting moderate/severe impairment: in relation to the total AMS score the odds ratio, (OR), of moderate/severe impairment in comparison with no impairment was 1.6 (95%CI 1.2-2.1). A history of myocardial infarction and hypertension increased the risk (respectively OR 1.4 (95%CI 1.1-18) and 1.7 (95%CI 1.2-2.4)). CONCLUSIONS: This study shows that higher AMS scores are associated with lower SF-12 indices and suggests that elevated values of the AMS score are associated with cardiovascular risk factors or diseases. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles A dynamic prognostic model to predict survival in post-polycythemia vera myelofibrosis. Apr 1, 2008 Francesco Passamonti,Elisa Rumi,Marianna Caramella,Chiara Elena,Luca Arcaini,Emanuela Boveri,Cecilia Del Curto,Daniela Pietra,Laura Vanelli,Paolo Bernasconi,Cristiana Pascutto,Mario Cazzola,Enrica Morra,Mario Lazzarino Post-polycythemia vera myelofibrosis (post-PV MF) is a late evolution of PV. In 647 patients with PV, we found that leukocytosis leukocyte count>(15x10(9)/L) at diagnosis is a risk factor for the evolution of post-PV MF. In a series of 68 patients who developed post-PV MF, median survival was 5.7 y... ( view more )ears. Hemoglobin level less than 100 g/L (10 g/dL) at diagnosis of post-PV MF was an independent risk factor for survival. The course of post-PV MF, however, is a dynamic process that implies a progressive worsening of clinical parameters. Using a multivariate Cox proportional hazard regression with time-dependent covariates, we found that a dynamic score based on hemoglobin level less than 100 g/L (10 g/dL), platelet count less than 100x10(9)/L, and leukocyte count more than 30x10(9)/L is useful to predict survival at any time from diagnosis of post-PV MF. The resulting hazard ratio of the score was 4.2 (95% CI: 2.4-7.7; P<.001), meaning a 4.2-fold worsening of survival for each risk factor acquired during follow up. In conclusion, leukocytosis at diagnosis of PV is a risk factor for evolution in post-PV MF. A dynamic score based on hemoglobin level, and platelet and leukocyte count predicts survival at any time from diagnosis of post-PV MF. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles A new mechanism involving ERK contributes to rosiglitazone inhibition of tumor necrosis factor-alpha and interferon-gamma inflammatory effects in human endothelial cells. Apr 2008 Adriana Lombardi,Giulia Cantini,Elisabetta Piscitelli,Stefania Gelmini,Michela Francalanci,Tommaso Mello,Elisabetta Ceni,Gabriele Varano,Gianni Forti,Mario Rotondi,Andrea Galli,Mario Serio,Michaela Luconi OBJECTIVE: Microvascular endothelium is one of the main targets of the inflammatory response. On specific activation, endothelial cells recruit Th1-lymphocytes at the inflammatory site. We investigated the intracellular signaling mediating tumor necrosis factor (TNF)-alpha and interferon (IFN)-gamm... ( view more )a inflammatory response in human microvascular endothelial cells (HMEC-1) and the interfering effects of the peroxisome-proliferator-activated-receptor (PPARgamma) agonist, rosiglitazone (RGZ). METHODS AND RESULTS: TNFalpha and IFNgamma, mainly when combined, stimulate IFNgamma-inducible protein of 10 kDa (IP10) and fractalkine production evaluated by ELISA and TaqMan analyses. This effect is not only mediated by activation of the NFkB and Stat1 classic pathways, but also involves a rapid increase in phosphorylation and activation of extracellular signal-regulated kinases (ERK1/2) as measured by Western blot. RGZ interferes with TNFalpha and IFNgamma stimulation of IP10, fractalkine, and adhesion molecule through a novel rapid mechanism which involves the blocking of ERK activation. CONCLUSIONS: Our findings shed new light on the mechanisms underlying the inflammatory response of microvascular endothelium and on the possible therapeutic use of RGZ in vasculopathies involving Th1-responses. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Adjuvant chemotherapy in completely resected gastric cancer: a randomized phase III trial conducted by GOIRC. Mar 19, 2008 Francesco Di Costanzo,Silvia Gasperoni,Luigi Manzione,Giancarlo Bisagni,Roberto Labianca,Stefano Bravi,Enrico Cortesi,Paolo Carlini,Raffaella Bracci,Silverio Tomao,Luca Messerini,Annarosa Arcangeli,Valter Torri,Domenico Bilancia,Irene Floriani,Maurizio Tonato,Italian Oncology Group for Cancer Research ,Angelo Dinota,Gennaro Strafiuso,Enrichetta Corgna,Stella Porrozzi,Corrado Boni,Ermanno Rondini,Alessandro Giunta,Barbara Monzio Compagnoni,Franco Biagioni,Maurizio Cesari,Giuseppe Fornarini,Fabrizio Nelli,Manlio Carboni,Francesco Cognetti,Maria Ruggeri Enzo,Andrea Piga,Adriana Romiti,Alessandra Olivetti,Luigi Masoni,Marinella De Stefanis,Angelo Dalla Mola,Salvatore Camera,Francesco Recchia,Sandro De Filippis,Loreto Scipioni,Sandra Zironi,Gabriele Luppi,Maurizio Italia,Stefano Banducci,Andrea Pisani Leretti,Bruno Massidda,Maria Teresa Ionta,Angelo Nicolosi,Rodolfo Canaletti,Bruno Biscottini,Fausto Grigniani,Federica Di Costanzo,Rossella Rovei,Enrico Croce,Rosalia Carroccio,Germana Gilli,Carla Cavalli,Angelo Olgiati,Umberto Pandolfi,Riccardo Rossetti,Giovanni Natalini,Paolo Foa,Sabina Oldani,Lorenzo Bruno,Stefano Cascinu,Giuseppina Catalano,Vincenzo Catalano,Ferdinando Lungarotti,Antonio Farris,Maria Giuseppina Sarobba,Mario Trignano,Antonio Muscogiuri,Fontana Francavilla,Franco Figoli,Maurizio Leoni,Giorgio Papiani,Gianfranco Orselli,Mauro Antimi,Vincenzo Bellini,Alessandro Cabassi,Antonio Contu,Antonio Pazzola,Mario Frignano,Elena Lastraioli,Matilde Saggese,Diletta Bianchini,Lorenzo Antonuzzo,Micol Mela,Roberta Camisa BACKGROUND: Complete surgical resection of gastric cancer is potentially curative, but long-term survival is poor. METHODS: Patients with histologically proven adenocarcinoma of the stomach of stages IB, II, IIIA and B, or IV (T4N2M0) and treated with potentially curative surgery were randomly assi... ( view more )gned to follow-up alone or to intravenous treatment with four cycles (repeated every 21 days) of PELF (cisplatin [40 mg/m(2), on days 1 and 5], epirubicin [30 mg/m(2), days 1 and 5], L-leucovorin [100 mg/m(2), days 1-4], and 5-fluorouracil [300 mg/m(2), days 1-4] in a hospital setting. Frequencies and severity of adverse events were determined. Overall survival (OS) and disease-free survival (DFS) were compared between the treatment arms using Kaplan-Meier analysis and a Cox proportional hazards regression model. All statistical tests were two-sided. RESULTS: From January 1995 through September 2000, 258 patients were randomly assigned to chemotherapy (n = 130) or surgery alone (n = 128). Patient characteristics were well balanced between the two arms. Among those who received chemotherapy, grade 3 or 4 toxic effects including vomiting, mucositis, and diarrhea were experienced by 21.1%, 8.4%, and 11.8% of patients, respectively. Leucopenia, anemia, and thrombocytopenia of grade 3 or 4 were experienced by 20.3%, 3.3%, and 4.2% of patients, respectively. After a median follow-up of 72.8 months, 128 patients (49.6%) experienced recurrence and 139 (53.9%) deaths were observed, one toxicity-related. Relative to treatment with surgery alone, adjuvant chemotherapy did not increase disease-free survival (hazard ratio [HR] of recurrence = 0.92; 95% confidence interval [CI] = 0.66 to 1.27) or overall survival (HR of death = 0.90; 95% CI = 0.64 to 1.26). CONCLUSIONS: Our results failed to provide proof of an effect of adjuvant chemotherapy with PELF on overall survival or disease-free survival. The estimated effect of chemotherapy (10% reduction in the hazard of death or relapse) is modest and consistent with the results of meta-analyses of adjuvant chemotherapy without platinum agents. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Patterns of structural MRI abnormalities in deficit and nondeficit schizophrenia. Mar 2008 Silvana Galderisi,Mario Quarantelli,Umberto Volpe,Armida Mucci,Giovanni Battista Cassano,Giordano Invernizzi,Alessandro Rossi,Antonio Vita,Stefano Pini,Paolo Cassano,Enrico Daneluzzo,Luca De Peri,Paolo Stratta,Arturo Brunetti,Mario Maj Negative symptoms of schizophrenia have generally been found in association with ventricular enlargement and prefrontal abnormalities. These relationships, however, have not been observed consistently, most probably because negative symptoms are heterogeneous and result from different pathophysiolo... ( view more )gical mechanisms. The concept of deficit schizophrenia (DS) was introduced by Carpenter et al to identify a clinically homogeneous subgroup of patients characterized by the presence of primary and enduring negative symptoms. Findings of brain structural abnormalities reported by magnetic resonance imaging (MRI) studies focusing on DS have been mixed. The present study included 34 patients with DS, 32 with nondeficit schizophrenia (NDS), and 31 healthy comparison subjects, providing the largest set of MRI findings in DS published so far. The Schedule for the Deficit Syndrome was used to categorize patients as DS or NDS patients. The 2 patient groups were matched on age and gender and did not differ on clinical variables, except for higher scores on the negative dimension and more impaired interpersonal relationships in DS than in NDS subjects. Lateral ventricles were larger in NDS than in control subjects but were not enlarged in patients with DS. The cingulate gyri volume was smaller in NDS but not in DS patients as compared with healthy subjects. Both groups had smaller dorsolateral prefrontal cortex and temporal lobes than healthy subjects, but DS patients had significantly less right temporal lobe volume as compared with NDS patients. These findings do not support the hypothesis that DS is the extreme end of a severity continuum within schizophrenia. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Essential but differential role for CXCR4 and CXCR7 in the therapeutic homing of human renal progenitor cells. Feb 18, 2008 Benedetta Mazzinghi,Elisa Ronconi,Elena Lazzeri,Costanza Sagrinati,Lara Ballerini,Maria Lucia Angelotti,Eliana Parente,Rosa Mancina,Giuseppe Stefano Netti,Francesca Becherucci,Mauro Gacci,Marco Carini,Loreto Gesualdo,Mario Rotondi,Enrico Maggi,Laura Lasagni,Mario Serio,Sergio Romagnani,Paola Romagnani Recently, we have identified a population of renal progenitor cells in human kidneys showing regenerative potential for injured renal tissue of SCID mice. We demonstrate here that among all known chemokine receptors, human renal progenitor cells exhibit high expression of both stromal-derived facto... ( view more )r-1 (SDF-1) receptors, CXCR4 and CXCR7. In SCID mice with acute renal failure (ARF), SDF-1 was strongly up-regulated in resident cells surrounding necrotic areas. In the same mice, intravenously injected renal stem/progenitor cells engrafted into injured renal tissue decreased the severity of ARF and prevented renal fibrosis. These beneficial effects were abolished by blocking either CXCR4 or CXCR7, which dramatically reduced the number of engrafting renal progenitor cells. However, although SDF-1-induced migration of renal progenitor cells was only abolished by an anti-CXCR4 antibody, transendothelial migration required the activity of both CXCR4 and CXCR7, with CXCR7 being essential for renal progenitor cell adhesion to endothelial cells. Moreover, CXCR7 but not CXCR4 was responsible for the SDF-1-induced renal progenitor cell survival. Collectively, these findings suggest that CXCR4 and CXCR7 play an essential, but differential, role in the therapeutic homing of human renal progenitor cells in ARF, with important implications for the development of stem cell-based therapies. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Pretransplant serum FT3 levels in kidney graft recipients are useful for identifying patients with higher risk for graft failure. Feb 2008 Mario Rotondi,Giuseppe Stefano Netti,Alberto Rosati,Benedetta Mazzinghi,Flavia Magri,Elisa Ronconi,Francesca Becherucci,Fabio Pradella,Maurizio Salvadori,Mario Serio,Paola Romagnani,Luca Chiovato OBJECTIVE: End-stage renal disease (ESRD) is a condition associated with thyroid disturbances both in function and morphology. Recent studies demonstrated that serum free triiodothyronine 3 (FT3) levels are negatively correlated with serum markers of inflammation and endothelial activation in patie... ( view more )nts with ESRD. However, no previous research evaluated serum thyroid function parameters in relation to kidney graft outcome, as we aim to do so in this study. DESIGN: Serum FT3, free thyroxine 4 (FT4) and TSH levels were measured before transplantation in 196 kidney graft recipients. RESULTS: The graft survival rate at 5 years for all patients was 92.3%. Kidney graft recipients with normally functioning grafts showed serum pretransplant thyroid parameters similar to patients who experienced graft failure. Life-time analysis was performed after stratification of patients according to pretransplant serum FT3 levels < 3.1 pmol/l or > 3.1 pmol/l. A significantly different 5-year death-censored graft survival rate (93.9%vs. 76.5% for patients with normal or low FT3 levels, respectively; P < 0.01) and similar survival rate (death of patients with functioning grafts) (21.1%vs. 5.9%; P = 0.288) were observed. No similar feature was found for FT4 or TSH, suggesting that the effect is not related to hypothyroidism but rather dependent upon inappropriately low FT3 levels. Pretransplant serum FT3 levels were similar in patients who experienced early acute rejections as compared with nonrejector patients. CONCLUSIONS: The results of this study demonstrate that among patients with ESRD undergoing kidney transplantation, those displaying lower pretransplant serum FT3 levels are at higher risk for subsequent graft failure. The demonstration of a predictive value of serum FT3 levels for graft survival suggests that measurement of pretransplant serum FT3 levels might represent a clinically useful parameter to identify patients with increased risk for graft failure. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Cardiovascular risk factors in centenarians. Feb 2008 Antonio Galioto,Ligia J Dominguez,Antonella Pineo,Anna Ferlisi,Ernesto Putignano,Mario Belvedere,Giuseppe Costanza,Mario Barbagallo Several studies have shown that centenarians have better cardiovascular risk profiles compared to younger old people. Some reports have revealed that cardiovascular diseases (i.e. hypertension, diabetes, angina and/or myocardial infarction) are less common in centenarians respect to 70 and 80 years... ( view more ) old persons. In order to explain this evidence, there is a growing number of hypothesis that consider a combination of genetic factors and lifestyle aspects to elucidate the exceptional longevity of centenarians, able to overcome the most frequent mortality cause, which is a cardiovascular event. It has been suggested that a role on this better cardiovascular risk profile may be played by the increasing use of pharmacologic treatments in the elderly population (specially for hypertension and dyslipidemia), but the contribution of drug treatments to promote extreme longevity is not confirmed. Furthermore, centenarians in general have needed fewer drugs at younger ages due to a healthy lifestyle. The importance of the genetic contribution is demonstrated by the inheritance of low-risk cardiovascular profiles in centenarian offspring and lower prevalence of cardiovascular diseases in this population as compared with their spouses or with age-matched subjects without centenarian parents. Another advantage in centenarians' offspring seems to be a delay in the onset for cardiovascular diseases, respect to age- and sex-matched controls. Cardiovascular risk factors mirror the factors that contribute to longevity. Hence, it is not surprising that these risk factors are less prevalent in centenarians when compared to younger old individuals. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles A prospective randomized study with a 5-year minimum follow-up evaluation of transanal endoscopic microsurgery versus laparoscopic total mesorectal excision after neoadjuvant therapy. Feb 2008 G Lezoche,M Baldarelli,Mario Guerrieri, Mario,A M Paganini,A De Sanctis,S Bartolacci,E Lezoche BACKGROUND: This study aimed to compare the oncologic results for local excision via transanal endoscopic microsurgery (TEM) and those for laparoscopic resection (LR) via total mesorectal excision in the treatment of T(2) N(0), G(1-2 )rectal cancer after neoadjuvant therapy with both treatments, in... ( view more )corporating a 5-year minimum follow-up period. METHODS: The study enrolled 70 patients whose malignancy was staged at admission as T(2) N(0), G(1-2 )rectal cancer located within 6 cm of the anal verge with a tumor diameter less than 3 cm. Of these patients, 35 were randomized to TEM and 35 to LR. The patients in both groups previously had undergone high-dose radiotherapy (5,040 cGy in 28 fractions over 5 weeks) combined with continuous infusion of 5-flurouracil (200 mg/m(2)/day). RESULTS: The median follow-up period was 84 months (range, 72-96 months). Two local recurrences (5.7%) were observed after TEM and 1 (2.8%) after LR. Distant metastases (2.8%) occurred in one case each after TEM and LR. The probability of survival for rectal cancer was 94% for TEM and 94% for LR. CONCLUSIONS: The study shows similar results between the two treatments in terms of local recurrences, distant metastases, and probability of survival for rectal cancer. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Morphological and functional features of hepatic cyst epithelium in autosomal dominant polycystic kidney disease. Feb 2008 Domenico Alvaro,Paolo Onori,Gianfranco Alpini,Antonio Franchitto,Douglas M Jefferson,Alessia Torrice,Vincenzo Cardinale,Fabrizio Stefanelli,Maria Grazia Mancino,Mario Strazzabosco,Mario Angelico,Adolfo Attili,Eugenio Gaudio We evaluated the morphological and functional features of hepatic cyst epithelium in adult autosomal dominant polycystic kidney disease (ADPKD). In six ADPKD patients, we investigated the morphology of cyst epithelium apical surface by scanning electron microscopy and the expression of estrogen rec... ( view more )eptors (ERs), insulin-like growth factor 1 (IGF1), IGF1 receptors (IGF1-R), growth hormone receptor, the proliferation marker proliferating cell nuclear antigen, and pAKT by immunohistochemistry and immunofluorescence. Proliferation of liver cyst-derived epithelial cells was evaluated by both MTS proliferation assay and [(3)H]thymidine incorporation into DNA. The hepatic cyst epithelium displayed heterogeneous features, being normal in small cysts (<1 cm), characterized by rare or shortened cilia in 1- to 3-cm cysts, and exhibiting the absence of both primary cilia and microvilli in large cysts (>3 cm). Cyst epithelium showed marked immunohistochemical expression of ER, growth hormone receptor, IGF1, IGF1-R, proliferating cell nuclear antigen, and pAKT. IGF1 was 10-fold more enriched in the hepatic cyst fluid than in serum. Serum-deprived liver cyst-derived epithelial cells proliferated when exposed to 17beta-estradiol and IGF1 and when exposed to human cyst fluid. ER or IGF1-R antagonists inhibited the proliferative effect of serum readmission, cyst fluid, 17beta-estradiol, and IGF1. Our findings could explain the role of estrogens in accelerating the progression of ADPKD and may suggest a potential benefit of therapeutic strategies based on estrogen antagonism. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Results, outcome predictors, and complications after stapled transanal rectal resection for obstructed defecation. Feb 2008 Giuseppe Gagliardi,Mario Pescatori,Donato F Altomare,Gian Andrea Binda,Corrado Bottini,Giuseppe Dodi,Vincenzino Filingeri,Giovanni Milito,Marcella Rinaldi,Giovanni Romano,Liana Spazzafumo,Mario Trompetto,Italian Society of Colo-Rectal Surgery (SICCR) PURPOSE: Obstructed defecation may be treated by stapled transanal rectal resection, but different complications and recurrence rates have been reported. The present study was designed to evaluate stapled transanal rectal resection results, outcome predictive factors, and nature of complications. M... ( view more )ETHODS: Clinical and functional data of 123 patients were retrospectively analyzed. All patients had symptoms of obstructed defecation before surgery and had rectocele and/or intussusception. Of them, 85 were operated on by the authors and 38 were referred after stapled transanal rectal resection had been performed elsewhere. RESULTS: At a median follow-up of 17 (range, 3-44) months, 65 percent of the patients operated on by the authors had subjective improvement. Recurrent rectocele was present in 29 percent and recurrent intussusception was present in 28 percent of patients. At univariate analysis, results were worse in those with preoperative digitation (P<0.01), puborectalis dyssynergia (P<0.05), enterocele (P<0.05), larger size rectocele (P<0.05), lower bowel frequency (P<0.05), and sense of incomplete evacuation (P<0.05). Bleeding was the most common perioperative complication occurring in 12 percent of cases. Reoperations were needed in 16 patients (19 percent): 9 for recurrent disease. In the 38 patients referred after stapled transanal rectal resection, the most common problems were perineal pain (53 percent), constipation with recurrent rectocele and/or intussusception (50 percent), and incontinence (28 percent). Of these patients, 14 (37 percent) underwent reoperations: 7 for recurrence. Three patients presented with a rectovaginal fistula. One other patient died for necrotizing pelvic fasciitis. CONCLUSIONS: Stapled transanal rectal resection achieved acceptable results at the cost of a high reoperation rate. Patients with puborectalis dyssynergia and lower bowel frequency may do worse because surgery does not address the causes of their constipation. Patients with large rectoceles, enteroceles, digitation, and a sense of incomplete evacuation may have more advanced pelvic floor disease for which stapled transanal rectal resection, which simply removes redundant tissue, may not be adequate. This, together with the complications observed in patients referred after stapled transanal rectal resection, suggests that this procedure should be performed by colorectal surgeons and in carefully selected patients. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Calmodulin-dependent kinase IV links Toll-like receptor 4 signaling with survival pathway of activated dendritic cells. Jan 15, 2008 Maddalena Illario,Maria L Giardino-Torchia,Uma Sankar,Thomas J Ribar,Mario Galgani,Laura Vitiello,Anna Maria Masci,Francesca R Bertani,Elena Ciaglia,Dalila Astone,Giuseppe Maulucci,Anna Cavallo,Mario Vitale,Vincenzo Cimini,Lucio Pastore,Anthony R Means,Guido Rossi,Luigi Racioppi Microbial products, including lipopolysaccharide (LPS), an agonist of Toll-like receptor 4 (TLR4), regulate the lifespan of dendritic cells (DCs) by largely undefined mechanisms. Here, we identify a role for calcium-calmodulin-dependent kinase IV (CaMKIV) in this survival program. The pharmacologic... ( view more ) inhibition of CaMKs as well as ectopic expression of kinase-inactive CaMKIV decrease the viability of monocyte-derived DCs exposed to bacterial LPS. The defect in TLR4 signaling includes a failure to accumulate the phosphorylated form of the cAMP response element-binding protein (pCREB), Bcl-2, and Bcl-xL. CaMKIV null mice have a decreased number of DCs in lymphoid tissues and fail to accumulate mature DCs in spleen on in vivo exposure to LPS. Although isolated Camk4-/- DCs are able to acquire the phenotype typical of mature cells and release normal amounts of cytokines in response to LPS, they fail to accumulate pCREB, Bcl-2, and Bcl-xL and therefore do not survive. The transgenic expression of Bcl-2 in CaMKIV null mice results in full recovery of DC survival in response to LPS. These results reveal a novel link between TLR4 and a calcium-dependent signaling cascade comprising CaMKIV-CREB-Bcl-2 that is essential for DC survival. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Postsplenectomy type-1 hypersensitivity response: a correlation between IL-4 and IgE serum levels. 2008 Stefano Miniello,Graziana Cristallo,Mario Testini,Mario Giosuè Balzanelli,Rinaldo Marzaioli,Pietro Venezia,Germana Lissidini,Dino Petrozza,Michele Nacchiero Authors demonstrated the presence of allergic manifestations in splenectomized patients following traumatic rupture of this organ. In particular, allergic diathesis, as supported by serum IgE increase, was exclusively found in patients with preserved T helper (h)-2 lymphocyte function. Th-2 functio... ( view more )n was monitored by measuring serum levels of interleukin (IL)-4, a cytokine involved in IgE synthesis. On the opposite, in splenectomized individuals with a reduced Th-2 function as supported by lower IL-4 serum levels, no IgE increase and allergic manifestations were detectable. On these grounds, authors hypothesize that allergic manifestations may be correlated to splenectomy since its exeresis may favor the persistence of antigens in the blood. Consequentially, in patients with a preserved Th-2 function, antigenic overload may lead to IgE increase and allergy onset. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Management of obstetrical brachial plexus palsy with early plexus microreconstruction and late muscle transfers. 2008 Marios D Vekris,Marios G Lykissas,Alexandros E Beris,Grigorios Manoudis,Anastasios D Vekris,Panayiotis N Soucacos Birth brachial plexus injury usually affects the upper roots. In most cases, spontaneous reinnervation occurs in a variable degree. This aberrant reinnervation leaves characteristic deformities of the shoulder, elbow, forearm, wrist, and hand. Common sequelae are the internal rotation and adduction... ( view more ) deformity of the shoulder, elbow flexion contractures, forearm supination deformity, and lack of wrist extension and finger flexion. Nowadays, the strategy in the management of obstetrical brachial plexus palsy focuses in close follow-up of the baby up to 3-6 months and if there are no signs of recovery, microsurgical repair is indicated. Nonetheless, palliative surgery consisting of an ensemble of secondary procedures is used to further improve the overall function of the upper extremity in patients who present late or fail to improve after primary management. These secondary procedures include transfers of free vascularized and neurotized muscles. We present and discuss our experience in treating early and/or late obstetrical palsies utilizing the above-mentioned microsurgical strategy and review the literature on the management of brachial plexus birth palsy. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Profiling tumor-associated markers for early detection of malignant mesothelioma: an epidemiologic study. Jan 2008 Monica Amati,Marco Tomasetti,Mario Scartozzi,Laura Mariotti,Renata Alleva,Elettra Pignotti,Battista Borghi,Matteo Valentino,Mario Governa,Jiri Neuzil,Lory Santarelli Improved detection methods for diagnosis of asymptomatic malignant mesothelioma (MM) are essential for an early and reliable detection and treatment of this type of neoplastic disease. Thus, focus has been on finding tumor markers in the blood that can be used for noninvasive detection of MM. Ninet... ( view more )y-four asbestos-exposed subjects defined at high risk, 22 patients with MM, and 54 healthy subjects were recruited for evaluation of the clinical significance of 8-hydroxy-2'-deoxyguanosine (8OHdG) in WBCs and plasma concentrations of soluble mesothelin-related peptides (SMRPs), angiogenic factors [platelet-derived growth factor beta, hepatocyte growth factor, basic fibroblast growth factor, and vascular endothelial growth factor beta (VEGFbeta)], and matrix proteases [matrix metalloproteinase (MMP) 2, MMP9, tissue inhibitor of metalloproteinase (TIMP) 1, and TIMP2] for potential early detection of MM. The area under receiver operating characteristic (ROC) curves indicate that 8OHdG levels can discriminate asbestos-exposed subjects from healthy controls but not from MM patients. Significant area under ROC curve values were found for SMRPs, discriminating asbestos-exposed subjects from MM patients but not from healthy controls. Except for platelet-derived growth factor beta, the hepatocyte growth factor, basic fibroblast growth factor, and VEGFbeta can significantly differentiate high-risk individuals from healthy control and cancer groups. No diagnostic value was observed for MMP2, MMP9, TIMP1, and TIMP2. In addition to the diagnostic performance defined by the ROC analysis, the sensitivity and specificity results of markers with clinical significance were calculated at defined cutoffs. The combination of 8OHdG, VEGFbeta, and SMRPs best distinguished the individual groups, suggesting a potential indicator of early and advanced MM cancers. The combination of blood biomarkers and radiographic findings could be used to stratify the risk of mesothelioma in asbestos-exposed populations. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Structure, function, and mechanism of cytosolic quinone reductases. 2008 Mario A Bianchet,Sabri Bora Erdemli,L Mario Amzel Quinone reductases type 1 (QR1) are FAD-containing enzymes that catalyze the reduction of many quinones, including menadione (Vit K3), to hydroquinones using reducing equivalents provided by NAD(P)H. The reaction proceeds with a ping-pong mechanism in which the NAD(P)H and the substrate occupy alte... ( view more )rnatively overlapping regions of the same binding site and participate in a double hydride transfer: one from NAD(P)H to the FAD of the enzyme, and one from the FADH(2) of the enzyme to the quinone substrate. The main function of QR1 is probably the detoxification of dietary quinones but it may also contribute to the reduction of vitamin K for its involvement in blood coagulation. In addition, the same reaction that QR1 uses in the detoxification of quinones, activates some compounds making them cytotoxic. Since QR1 is elevated in many tumors, this property has encouraged the development of chemotherapeutic compounds that become cytotoxic after reduction by QR1. The structures of QR1 alone, and in complexes with substrates, inhibitors, and chemotherapeutic prodrugs, combined with biochemical and mechanistic studies have provided invaluable insight into the mechanism of the enzyme as well as suggestions for the improvements of the chemotherapeutic prodrugs. Similar information is beginning to accumulate about another related enzyme, QR2. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Incidence of primary liver cancer in Italy between 1988 and 2002: an age-period-cohort analysis. Jan 2008 Luigino Dal Maso,Mauro Lise,Paola Zambon,Emanuele Crocetti,Diego Serraino,Fulvio Ricceri,Marina Vercelli,Vincenzo De Lisi,Giovanna Tagliabue,Massimo Federico,Fabio Falcini,Tiziana Cassetti,Andrea Donato,Mario Fusco,Mario Budroni,Stefano Ferretti,Rosario Tumino,Silvano Piffer,Francesco Bellù,Lucia Mangone,Adriano Giacomin,Susanna Vitarelli,Silvia Franceschi We conducted in Italy a study to evaluate trends of primary liver cancer (PLC) and to disentangle the period from birth-cohort effects on PLC incidence. Cases aged<80 years and diagnosed between 1988 and 2002 in 20 areas covered by population-based Cancer Registries were included. Age-standardised ... ( view more )incidence rates and age-period-cohort effects were estimated. In 1998-2002, incidence rates of PLC were 21.1/100,000 men and 6.0/100,000 women. In both genders, incidence rates increased slightly between 1988-1992 and 1993-1997 but did not rise thereafter. Amongst men, PLC risk increased in every cohort born after 1913 and the rise became steeper for cohorts born in 1948. In women, an upward trend appeared only in the cohorts born after 1953. Incidence of PLC over the last two decades in Italy did not substantially change but huge geographical variability emerged, mainly due to different times and modalities of spread of hepatitis C virus. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Bone marrow microvessel density in chronic myeloproliferative disorders: a study of 115 patients with clinicopathological and molecular correlations. Jan 2008 Emanuela Boveri,Francesco Passamonti,Elisa Rumi,Daniela Pietra,Chiara Elena,Luca Arcaini,Cristiana Pascutto,Alessandro Castello,Mario Cazzola,Umberto Magrini,Mario Lazzarino Philadelphia-negative chronic myeloproliferative disorders (CMD) include polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF). Angiogenesis is critical in the pathogenesis of PMF. We studied angiogenesis in 115 patients with CMD (23 PV, 24 ET, 46 PMF, 12 post-PV an... ( view more )d 10 post-ET myelofibrosis) by assessment of microvessel density (MVD) in bone marrow (BM). Kruskall-Wallis analysis of variance showed that patients with PMF had significantly higher values of MVD than those with PV (P < 0.001), ET (P < 0.001) and controls (P < 0.001). Mann-Whitney U-test demonstrated that patients with PMF at the prefibrotic stage had significantly higher MVD values than those with ET (P = 0.02). Patients with post-PV myelofibrosis showed significantly higher MVD values than those with PV (P < 0.001), as did patients with post-ET myelofibrosis compared with ET (P < 0.001). In patients with CMD, the multivariate generalized linear regression model showed that the JAK2 (V617F) mutational burden (P = 0.01), serum lactate dehydrogenase level (P = 0.003), and anaemia (P < 0.001) independently correlated with MVD. In summary, this study indicates that assessment of BM angiogenesis, as measured by MVD, may be a useful additional tool in the histopathological definition of CMD. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Familial chronic myeloproliferative disorders: clinical phenotype and evidence of disease anticipation. Dec 10, 2007 Elisa Rumi,Francesco Passamonti,Matteo G Della Porta,Chiara Elena,Luca Arcaini,Laura Vanelli,Cecilia Del Curto,Daniela Pietra,Emanuela Boveri,Cristiana Pascutto,Mario Cazzola,Mario Lazzarino PURPOSE: Chronic myeloproliferative disorders (CMDs) have sporadic occurrence. However, familial clustering is reported. The purpose of this study was to assess the prevalence and the clinical phenotype of familial CMDs, and to study the anticipation of disease onset in successive generations. PATI... ( view more )ENTS AND METHODS: Among 458 patients with apparently sporadic CMDs, an interview-based investigation of family history was performed to identify familial cases. The clinical phenotype of familial CMDs was compared with that of sporadic CMDs. Anticipation was studied evaluating age at diagnosis and telomere length in successive generations. RESULTS: Among 458 patients with apparently sporadic CMDs, the prevalence of familial cases was 7.6% (35 pedigrees; 75 patients). Kolmogorov-Smirnov and two-tailed Fisher's exact tests did not demonstrate significant differences in clinical presentation between patients with familial and sporadic CMDs. Within 544 person-years of follow-up, patients with familial CMDs developed similar complications and disease evolutions as those with sporadic CMDs. The comparison of second-generation and first-generation patients showed a significantly younger age at diagnosis (Wilcoxon matched-pair test, P = .001) and a significantly higher age-dependent hazard of CMD onset (Nelson-Aalen method, P < .001) in patients of the second generation. A significant shortening of telomere length was highlighted in offspring compared with parent (P = .043). CONCLUSION: This study indicates that a thorough investigation of family history should be part of the initial work-up of patients with CMDs. Patients with familial CMDs show the same clinical features and suffer the same complications as patients with sporadic disease. Age distribution between parent and offspring and telomere length shortening provide evidence of disease anticipation. ( view less ) View Full Abstract View Article Details View Coded Data Related Articles Page 1 of 530 1 2 3 4 > Last >> (13233 articles found)

      
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