RESUMEN
Glioblastoma (GB) is the most common and aggressive form of primary brain tumor, in which the presence of an inflammatory environment, composed mainly by tumor-associated macrophages (TAMs), is related to its progression and development of chemoresistance. Toll-Like Receptors (TLRs) are key components of the innate immune system and their expression in both tumor and immune-associated cells may impact the cell communication in the tumor microenvironment (TME), further modeling cancer growth and response to therapy. Here, we investigated the participation of TLR4-mediated signaling as a mechanism of induced-immune escape in GB. Initially, bioinformatics analysis of public datasets revealed that TLR4 expression is lower in GB tumors when compared to astrocytomas (AST), and in a subset of TAMs. Further, we confirmed that TLR4 expression is downregulated in chemoresistant GB, as well as in macrophages co-cultured with GB cells. Additionally, TLR4 function is impaired in those cells even following stimulation with LPS, an agonist of TLR4. Finally, experiments performed in a cohort of clinical primary and metastatic brain tumors indicated that the immunostaining of TLR4 and CD45 are inversely proportional, and confirmed the low TLR4 expression in GBs. Interestingly, the cytoplasmic/nuclear pattern of TLR4 staining in cancer tissues suggests additional roles of this receptor in carcinogenesis. Overall, our data suggest the downregulation of TLR4 expression and activity as a strategy for GB-associated immune escape. Additional studies are necessary to better understand TLR4 signaling in TME in order to improve the benefits of immunotherapy based on TLR signaling.
Asunto(s)
Neoplasias Encefálicas/inmunología , Regulación hacia Abajo/inmunología , Glioblastoma/inmunología , Glioblastoma/metabolismo , Evasión Inmune/inmunología , Receptor Toll-Like 4/inmunología , Macrófagos Asociados a Tumores/inmunología , Anciano , Animales , Neoplasias Encefálicas/metabolismo , Línea Celular , Línea Celular Tumoral , Proliferación Celular/fisiología , Femenino , Humanos , Masculino , Ratones , Ratones Endogámicos C57BL , Persona de Mediana Edad , Transducción de Señal/inmunología , Receptor Toll-Like 4/metabolismo , Microambiente Tumoral/inmunología , Macrófagos Asociados a Tumores/metabolismoRESUMEN
PURPOSE: Two cases of corneal crystal deposition are reported, both caused by a benign monoclonal gammopathy METHODS: Similar corneal pathology is identified in these two patients, both of whom presented with visual acuities of 6/6 or better Consideration of possible causes involved biochemical and haematological testing and assessment. RESULTS: Potential for malignant transformation of monoclonal gammopathy was recognized, hence the need for ongoing haematological follow-up. CONCLUSION: Corneal crystals may be the initial presentation in a patient with monoclonal gammopathy, a rare, but significant, clinical finding.
Asunto(s)
Córnea/patología , Enfermedades de la Córnea/diagnóstico , Inmunoglobulina G/análisis , Cadenas kappa de Inmunoglobulina/análisis , Paraproteinemias/diagnóstico , Sedimentación Sanguínea , Cromatografía Líquida de Alta Presión , Enfermedades de la Córnea/complicaciones , Cristalización , Electroforesis en Gel de Poliacrilamida , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Paraproteinemias/complicaciones , Agudeza VisualRESUMEN
BACKGROUND: Aeromonas sobria causes a rare Gram-negative bacterial water-borne infection. It has been found in waters of North Queensland and South-east Asia. Of all Aeromonas species, A. sobria is the most virulent and invasive and has been reported to cause soft tissue infection and corneal ulcer. METHODS: A 14-year-old Caucasian male from North Queensland presented following a penetrating eye injury in which a water bird (cormorant species) had pecked his eye while he was fishing. A fulminant endophthalmitis developed despite treatment with intravenous, intravitreal and topical antibiotics and initial wound repair. Enucleation was performed. RESULTS: Aeromonas sobria was isolated from the vitreous aspirate. CONCLUSION: Aeromonas sobria infection should be suspected in water-contaminated penetrating eye injuries. The prognosis in this case was poor.
Asunto(s)
Aeromonas/aislamiento & purificación , Endoftalmitis/microbiología , Infecciones Bacterianas del Ojo/etiología , Lesiones Oculares Penetrantes/microbiología , Infecciones por Bacterias Gramnegativas/etiología , Adolescente , Animales , Cámara Anterior/lesiones , Cámara Anterior/microbiología , Cámara Anterior/patología , Antibacterianos , Aves , Catarata/etiología , Córnea/patología , Lesiones de la Cornea , Vías de Administración de Medicamentos , Quimioterapia Combinada/administración & dosificación , Quimioterapia Combinada/uso terapéutico , Endoftalmitis/patología , Endoftalmitis/terapia , Enucleación del Ojo , Infecciones Bacterianas del Ojo/patología , Infecciones Bacterianas del Ojo/terapia , Lesiones Oculares Penetrantes/patología , Lesiones Oculares Penetrantes/terapia , Estudios de Seguimiento , Infecciones por Bacterias Gramnegativas/patología , Infecciones por Bacterias Gramnegativas/terapia , Humanos , Iris/lesiones , Iris/patología , Masculino , Cuerpo Vítreo/microbiologíaRESUMEN
BACKGROUND: Intraoperative cracking of foldable acrylic posterior chamber intraocular lenses has previously been documented. However, most cracks have resulted in no significant visual impairment. METHODS: A case report of an acrylic posterior chamber intraocular lens that cracked during folding. RESULTS: The crack in the lens resulted in significant optical disturbance and required explanation and insertion of another lens. CONCLUSIONS: Acrylic intraocular lenses must be folded carefully with appropriate forceps to prevent cracking of the optic.
Asunto(s)
Extracción de Catarata/efectos adversos , Lentes Intraoculares , Falla de Prótesis , Estudios de Seguimiento , Humanos , Complicaciones Intraoperatorias , Masculino , Metilmetacrilatos , Microscopía Electrónica de Rastreo , Persona de Mediana Edad , ReoperaciónRESUMEN
DVT is a very frequent complication of general surgery. Heparin and, more recently, LMWHs can successfully prevent post surgical thromboembolism. One thousand one hundred and twenty-two patients (533 males and 589 females; mean age 62.2 +/- 11.4 yrs) were enrolled in a multicentre controlled study, to evaluate the efficacy and safety of enoxaparin in comparison to calcium heparin in the prevention of deep venous thrombosis (DVT) following general surgery. Patients assigned to the enoxaparin and the calcium heparin groups received 1 daily dose of 20 mg (2000 I.U.) and 2 daily doses of 0.2 ml (5000 I.U.), respectively starting 2 hours before the operation. Both drugs were given by subcutaneous route. A Doppler or Duplex Scan diagnosis of DVT was made in 3 (0.5%) patients in the enoxaparin group (2 cases during treatment and 1 patient at the end of treatment) and in 6 (1.1%) patients in the calcium heparin group (5 cases during treatment and 1, bilateral, after the end of treatment). Pulmonary embolism (PE) was ascertained by angiography in 1 patient (0.18%) in the enoxaparin group and in 2 patients (0.36%) in the calcium heparin one. Hemorrhagic complications occurred in 29 patients (5.2%) in the enoxaparin group and in 34 (6.1%) in the calcium heparin group. Haematomas located in the injection site were reported in 16.1% and 25.3% in the enoxaparin and calcium heparin groups respectively (p = 0.0001). Local pain in the injection site at the 5th day of treatment was reported in 8.4% and 16.6% in the enoxaparin and calcium heparin groups respectively (p = 0.0001).(ABSTRACT TRUNCATED AT 250 WORDS)
Asunto(s)
Enoxaparina/uso terapéutico , Fibrinolíticos/uso terapéutico , Heparina/uso terapéutico , Complicaciones Posoperatorias/prevención & control , Embolia Pulmonar/prevención & control , Tromboflebitis/prevención & control , Anciano , Enoxaparina/efectos adversos , Femenino , Hemostasis Quirúrgica/métodos , Heparina/efectos adversos , Humanos , Incidencia , Inyecciones Subcutáneas , Italia , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Embolia Pulmonar/epidemiología , Embolia Pulmonar/etiología , Factores de Riesgo , Tromboflebitis/epidemiología , Tromboflebitis/etiologíaRESUMEN
Thirty patients presenting with painful shoulder syndrome were treated with i.m. ketoprofen 100 mg b.d. for 8 days to assess the efficacy and tolerance of the above treatment regime. The patients' condition was monitored by clinical, instrumental and laboratory examinations. Ketoprofen was found to be significantly effective in all cases of non calcific rotator cuff tendinitis while no improvement was noted in calcific tendinitis. The above data confirm the efficacy and tolerance of ketoprofen in the treatment of painful shoulder syndrome as an alternative to local steroid therapy.
Asunto(s)
Cetoprofeno/uso terapéutico , Dolor/tratamiento farmacológico , Articulación del Hombro , Adulto , Anciano , Evaluación de Medicamentos , Tolerancia a Medicamentos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Periartritis/tratamiento farmacológico , Manguito de los Rotadores , Tenosinovitis/tratamiento farmacológicoRESUMEN
Fifty patients suffering from prostatic adenoma with asymptomatic bacteriuria, were admitted to an open non comparative trial. Enoxacin was administered at the daily dosage of 300 mg every 12 hours for 10 days. Three cycles of treatment were performed during three consecutive months. Treatment efficacy was established by assessing patient symptoms related to the infection such as pollakiuria , nocturia, decreased flow rate, stranguria, daily temperature. Cultural tests were also performed. All observations were collected at baseline and at the end of each cycle of therapy. Cure was obtained in 43 patients (87, 75%), 1 patient (2,04%) relapsed, 5 patients (10.2%) withdrew because of inefficacy of treatment and 1 patient died of heart failure. No side effects were observed. These results suggest that enoxacin may be successfully used in the treatment of asymptomatic bacteriuria.
Asunto(s)
Bacteriuria/tratamiento farmacológico , Enoxacino/uso terapéutico , Hiperplasia Prostática/complicaciones , Anciano , Bacteriuria/etiología , Bacteriuria/microbiología , Evaluación de Medicamentos , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Twenty women with Chlamydia trachomatis genitourinary infection were treated with oral enoxacin 800 mg/day in two divided doses for 12 days starting on day 1 of the menstrual cycle. A physical examination was performed before the start and 28-30 days after the end of the treatment. At the final examination cultures of urethral and endocervical swabs and endometrial samples were negative in all cases, demonstrating that Chlamydia trachomatis infection had been eradicated. No significant results were obtained at serologic evaluation with the indirect immunofluorescence method to show specific IgM, IgG and IgA antibodies. In the four women with subjective symptomatology this was improved by the treatment with enoxacin. Only two patients presented mild side effects (headache, tachycardia, nausea). Enoxacin seems therefore a very effective and well tolerated drug in the treatment of Chlamydia trachomatis genitourinary infection.
Asunto(s)
Infecciones por Chlamydia/tratamiento farmacológico , Chlamydia trachomatis , Enoxacino/uso terapéutico , Enfermedades Urogenitales Femeninas/microbiología , Adulto , Anticuerpos Antibacterianos/sangre , Chlamydia trachomatis/inmunología , Endometrio/microbiología , Enoxacino/efectos adversos , Femenino , Enfermedades Urogenitales Femeninas/tratamiento farmacológico , Humanos , Enfermedades Uretrales/microbiología , Enfermedades del Cuello del Útero/microbiologíaRESUMEN
Forty-one patients suffering from postoperative pain were admitted to an open, noncomparative trial. A dose of 10 mg of Kerotolac was administered i.v. to patients complaining severe pain. The analgesic efficacy of the drug was evaluated at 5, 15, 30 minutes and at 1, 1.5, 2, 3, 4, 6 hours after injection; the patients were asked to score their pain relief on the VRS comparing the pre-injection evaluation to each post-injection period. A significant decrease of pain intensity (less than p 0.01) was observed at 45 minutes after injection. No side effects were observed. These results suggest that Ketorolac can be successfully used in the treatment of postoperative pain.
Asunto(s)
Analgésicos/administración & dosificación , Dolor Postoperatorio/tratamiento farmacológico , Tolmetina/análogos & derivados , Adolescente , Adulto , Anciano , Evaluación de Medicamentos , Tolerancia a Medicamentos , Femenino , Humanos , Ketorolaco , Masculino , Persona de Mediana Edad , Dimensión del Dolor , Factores de Tiempo , Tolmetina/administración & dosificaciónRESUMEN
Thirty-three patients suffering from acute, subacute or chronic prostatovesiculitis were admitted to an open, non comparative trial. Enoxacin was administered at the daily dosage of 400 mg every 12 hours for 10 days starting from the enrollment. A second cycle of treatment was performed if cure was not obtained with the first cycle. Treatment efficacy was established by assessing patient symptoms related to the infection, such as pollakiuria and dysuria, consistency and volume of prostate and spermatic vesicles (evaluated by rectal examination and transrectal ultra-sonography); bacterioscopical and bacteriological evaluations of prostate/vesicles secretion with sensitivity testing were also carried out. All observations were collected at baseline, 5 and 30 days after the end of the first cycle and 5 days after the end of the 2nd cycle of treatment. After the first cycle of treatment, cure was obtained in 22 subjects (67%) and clinical improvement in 24 (73%). All but one patients still infected at the end of the first treatment period, showed improvement (5; 45.5%) or cure (6; 54.5%). The end of the second cycle None of the 22 patients cured with one cycle of treatment relapsed within 30 days after the end of treatment, confirming they really achieved cure. Side effects were observed only in 1 case (mild vertigo); no drop outs were observed. These results suggest that enoxacin may be successfully used in the treatment of prostato-vesiculitis.
Asunto(s)
Infecciones Bacterianas/tratamiento farmacológico , Cistitis/tratamiento farmacológico , Enoxacino/uso terapéutico , Prostatitis/tratamiento farmacológico , Enfermedad Aguda , Adulto , Anciano , Enfermedad Crónica , Ensayos Clínicos como Asunto , Cistitis/etiología , Evaluación de Medicamentos , Humanos , Masculino , Persona de Mediana Edad , Prostatitis/etiologíaAsunto(s)
Enoxacino/uso terapéutico , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antiinfecciosos/efectos adversos , Antiinfecciosos/uso terapéutico , Bacterias/efectos de los fármacos , Bacterias/aislamiento & purificación , Infecciones Bacterianas/tratamiento farmacológico , Ensayos Clínicos como Asunto , Enoxacino/efectos adversos , Femenino , Humanos , Masculino , Persona de Mediana EdadAsunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Enfermedades de los Genitales Femeninos/tratamiento farmacológico , Sulfonamidas/uso terapéutico , Adolescente , Adulto , Ensayos Clínicos como Asunto , Método Doble Ciego , Endometritis/tratamiento farmacológico , Episiotomía/efectos adversos , Femenino , Humanos , Persona de Mediana Edad , Enfermedad Inflamatoria Pélvica/tratamiento farmacológico , Distribución Aleatoria , Sulfonamidas/efectos adversos , Cervicitis Uterina/tratamiento farmacológicoAsunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Enfermedades de los Genitales Femeninos/tratamiento farmacológico , Sulfonamidas/uso terapéutico , Adolescente , Adulto , Anciano , Ensayos Clínicos como Asunto , Método Doble Ciego , Tolerancia a Medicamentos , Endometritis/tratamiento farmacológico , Episiotomía/efectos adversos , Femenino , Humanos , Inflamación , Persona de Mediana Edad , Quistes Ováricos/tratamiento farmacológico , Enfermedad Inflamatoria Pélvica/tratamiento farmacológico , Cervicitis Uterina/tratamiento farmacológico , Enfermedades Uterinas/tratamiento farmacológicoAsunto(s)
Antiinflamatorios no Esteroideos/uso terapéutico , Artritis/tratamiento farmacológico , Osteoporosis/tratamiento farmacológico , Sulfonamidas/uso terapéutico , Factores de Edad , Anciano , Anciano de 80 o más Años , Evaluación de Medicamentos , Tolerancia a Medicamentos , Humanos , Persona de Mediana EdadAsunto(s)
Alginatos/uso terapéutico , Enfermedades del Esófago/tratamiento farmacológico , Várices Esofágicas y Gástricas/terapia , Soluciones Esclerosantes/efectos adversos , Adulto , Anciano , Enfermedades del Esófago/etiología , Femenino , Ácido Glucurónico , Ácidos Hexurónicos , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Úlcera/tratamiento farmacológico , Úlcera/etiologíaRESUMEN
After a brief examination of the recent literature on non-secretory multiple myeloma, the Authors describe the immunohistologic study (peroxidase-antiperoxidase method) of a case of truly non producing plasmacytoma, interesting because of the presence of a small polyclonal plasma cell population within the neoplastic clone. Several possible explanations are considered.
Asunto(s)
Mieloma Múltiple/patología , Anciano , Médula Ósea/patología , Citoplasma/patología , Humanos , Técnicas para Inmunoenzimas , Masculino , Mieloma Múltiple/inmunología , Osteólisis/patología , Células Plasmáticas/patología , Polimorfismo Genético , Cráneo/patologíaRESUMEN
A comparative study between nefopam (Acupan) and pentazocine was carried out in 90 patients for treatment of postoperative pain following gynaecological operations. The results show that nefopam has an analgesic activity comparable with that of pentazocine, but its duration of action seems to be longer-lasting, even if with a longer period of latency. At equieffective analgesic action, nefopam shows a lower interference with the respiratory function. As far as side-effects are concerned a significant increase in drowsiness was observed with both types of treatment; sweating was observed only in nefopam group.