848 research outputs found
Neuroprotective role of phosphoserine in primary open-angle glaucoma patients
OBJECTIVE: To evaluate the neuroprotective role of phosphoserine (P-Ser) in primary open-angle glaucoma (POAG) patients and to compare its therapeutic effectiveness to placebo treatment. PATIENTS AND METHODS: Fifty-one patients (24 males and 27 females) between 35 and 61 years (average 46 years ± 3.8 SD) affected by POAG were enrolled in this study. Patients were divided in two groups: group A included 28 subjects that received an oral P-Ser treatment for 12 months; and group B included 23 subjects that received an oral placebo treatment for 12 months. Complete ophthalmological examination, standard automated perimetric examination, analysis of ON fibers via scanning laser polarimetry and glaucoma staging was performed in all patients at enrolment and 1, 3, 6, and 12 months after. Statistical analysis was performed using STATA 14.0 (Collage Station, TX, USA). RESULTS: Mean deviation (MD) and pattern standard deviation (PSD) analysis by means of 30-2 full threshold of the visual fields (VFs), retinal nerve fiber layer (RNFL) thickness by means of GDx, and IOP were considered to evaluate P-Ser therapy effectiveness in both groups. A statistically significant improvement (p<0.05) in VF, RNFL thickness and IOP compared to pre-treatment was found in patients in group A. CONCLUSIONS: Our study shows a significant improvement in several variables in patients with glaucoma treated with P-Ser compared to placebo and suggests a potential neuroprotective effect of P-Ser in treating glaucoma patients in association with the traditional hypotonic topical therapy
Post-operative outcomes and predictors of mortality after colorectal cancer surgery in the very elderly patients
Background: The frailty of the very elderly patients who undergo surgery for colorectal cancer negatively influences postoperative mortality. This study aimed to identify risk factors for postoperative mortality in octogenarian and nonagenarian patients who underwent surgical treatment for colorectal cancer. Methods: This is a single institution retrospective study. The primary outcomes were risk factors for postoperative mortality. The variables of the octogenarians and nonagenarians were compared by using t-test, chi-square test, and Fisher exact test. A multivariate logistic regression analysis was carried out on the combined cohorts. Results: we identified 319 octogenarians and 43 nonagenarians (N = 362) who underwent surgery for colorectal cancer at the Sant'Orsola-Malpighi university hospital in Bologna between 2011 and 2015. The 30-day post-operative mortality was 6% (N = 18) among octogenarians and 21% (N = 9) for the nonagenarians. The groups significantly differed in the type of surgery (elective vs. urgent surgery, p < 0.0001), ASA score (p = 0.0003) and rates of 30-day postoperative mortality (6% vs. 21%, p = 0.0003). In the multivariate analysis ASA > III (OR 2.37, 95% CI [1.43\u20133.93], p < 0,001), and urgent surgery (OR 2.17, 95% CI [1.17\u20134.04], p = 0.014) were associated to post-operative mortality. On the contrary, pre-operative albumin 653.4 g/dL (OR 0.14, 95% CI [0.05\u20130.52], p = 0.001) was associated with a protective effect on postoperative mortality. Conclusions: In the very elderly affected by colorectal cancer, preoperative nutritional status and pre-existing comorbidities, rather than age itself, should be considered as selection criteria for surgery. Preoperative improvement of nutritional status and ASA risk assessment may be beneficial for stratification of patients and ultimately for optimizing outcomes
INPP4B overexpression and c-KIT downregulation in human achalasia.
BACKGROUND:
Achalasia is a rare motility disorder characterized by myenteric neuron and interstitial cells of Cajal (ICC) abnormalities leading to deranged/absent peristalsis and lack of relaxation of the lower esophageal sphincter. The mechanisms contributing to neuronal and ICC changes in achalasia are only partially understood. Our goal was to identify novel molecular features occurring in patients with primary achalasia.
METHODS:
Esophageal full-thickness biopsies from 42 (22 females; age range: 16-82 years) clinically, radiologically, and manometrically characterized patients with primary achalasia were examined and compared to those obtained from 10 subjects (controls) undergoing surgery for uncomplicated esophageal cancer (or upper stomach disorders). Tissue RNA extracted from biopsies of cases and controls was used for library preparation and sequencing. Data analysis was performed with the "edgeR" option of R-Bioconductor. Data were validated by real-time RT-PCR, western blotting and immunohistochemistry.
KEY RESULTS:
Quantitative transcriptome evaluation and cluster analysis revealed 111 differentially expressed genes, with a P 64 10-3 . Nine genes with a P 64 10-4 were further validated. CYR61, CTGF, c-KIT, DUSP5, EGR1 were downregulated, whereas AKAP6 and INPP4B were upregulated in patients vs controls. Compared to controls, immunohistochemical analysis revealed a clear increase in INPP4B, whereas c-KIT immunolabeling resulted downregulated. As INPP4B regulates Akt pathway, we used western blot to show that phospho-Akt was significantly reduced in achalasia patients vs controls.
CONCLUSIONS & INFERENCES:
The identification of altered gene expression, including INPP4B, a regulator of the Akt pathway, highlights novel signaling pathways involved in the neuronal and ICC changes underlying primary achalasia
An open-label, multicenter study to evaluate the safe and effective use of the single-use autoinjector with an Avonex® prefilled syringe in multiple sclerosis subjects
<p>Abstract</p> <p>Background</p> <p>The ability to self-inject in patients with multiple sclerosis (MS) has been associated with a reduced risk of missed injections and drug discontinuation, and a beneficial effect on patients' independence. However, injection anxiety, needle phobia and disease-related disability are major barriers to a patient's ability to self-administer treatment. Use of an autoinjector may improve patients' ability to self-inject. This study evaluated the safe and effective use of Avonex Pen™ (prefilled pen), a single use autoinjector, for intramuscular delivery of interferon beta-1a (IM IFNβ-1a, Avonex) in MS patients.</p> <p>Methods</p> <p>This was a Phase IIIb, open-label, single-country, multicenter trial in MS patients currently using IM IFNβ-1a prefilled syringes. Patients received weekly 30 mcg IM IFNβ-1a treatment over 4 weeks. On Day 1, patients self-administered IM IFNβ-1a using a prefilled syringe at the clinic. On Day 8, patients received training on the prefilled pen and self-administered IM IFNβ-1a using the device. On Day 15, patients self-administered IM IFNβ-1a at home using the prefilled pen. A final injection occurred at the clinic on Day 22 when patients self-administered IM IFNβ-1a using the prefilled pen while clinic staff observed and completed a detailed questionnaire documenting patients' ability to self-inject with the device. Serum neopterin levels were evaluated pre and post-injection on Days 1 and 8. Adverse events were monitored throughout.</p> <p>Results</p> <p>Seventy-one (96%) patients completed the study. The overall success rate in safely and effectively using the prefilled pen was 89%. No device malfunctions occurred. One unsuccessful administration occurred at Day 22 due to patient error; no patient injury resulted. Patients gave the prefilled pen high ratings (8.7-9.3) on a 10-point scale for ease of use (0 = extremely difficult, 10 = extremely easy). Ninety-four percent of patients preferred the prefilled pen over the prefilled syringe. Induction of serum neopterin levels, serving as a biomarker for type 1 interferon action, was similar to that of the prefilled syringe. The prefilled pen demonstrated a safety profile comparable to the prefilled syringe.</p> <p>Conclusions</p> <p>The prefilled pen is a safe and effective device for administration of IM IFNβ-1a and represents an alternative method for self-injection for MS patients using this therapy.</p> <p>Trial registration</p> <p>This study is registered at clinicaltrials.gov, identifier: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00828204">NCT00828204</a></p
Lymphomononuclear cells from multiple sclerosis patients spontaneously produce high levels of oncostatin M, tumor necrosis factors a
Proinflammatory cytokines are deemed to play a pivotal role in the pathogenesis of multiple sclerosis (MS). They provide signals for T-cell activatio
Atmospheric neutrino induced muons in the MACRO detector
A measurement of the flux of neutrino-induced muons using the MACRO detector
is presented. Different event topologies, corresponding to different neutrino
parent energies can be detected. The upward throughgoing muon sample is the
larger event sample. The observed upward-throughgoing muons are 26% fewer than
expected and the zenith angle distribution does not fit with the expected one.
Assuming neutrino oscillations, both measurements suggest maximum mixing and
Dm2 of a few times 10-3 eV2. The other samples are due to the internally
produced events and to upward-going stopping muons. These data show a regular
deficit of observed events in each angular bin, as expected assuming neutrino
oscillations with maximum mixing, in agreement with the analysis of the
upward-throughgoing muon sample.Comment: 7 pages 6 figures to appear in the proceedings of XVIII International
Conference on Neutrino Physics and Astrophysics (Neutrino'98), Takayama,
Japan 4-9 June, 199
Measurement of the atmospheric neutrino-induced upgoing muon flux using MACRO
We present a measurement of the flux of neutrino-induced upgoing muons
(~100 GeV) using the MACRO detector. The ratio of the number of observed
to expected events integrated over all zenith angles is 0.74 +/- 0.036 (stat)
+/- 0.046(systematic) +/- 0.13 (theoretical). The observed zenith distribution
for -1.0 < cos(theta) < -0.1 does not fit well with the no oscillation
expectation, giving a maximum probability for chi^2 of 0.1%. The acceptance of
the detector has been extensively studied using downgoing muons, independent
analyses and Monte-Carlo simulations. The other systematic uncertainties cannot
be the source of the discrepancies between the data and expectations. We have
investigated whether the observed number of events and the shape of the zenith
distribution can be explained by a neutrino oscillation hypothesis. Fitting
either the flux or zenith distribution independently yields mixing parameters
of sin^2 (2theta)=1.0 and delta m^2 of a few times 10^-3 eV^2. However, the
observed zenith distribution does not fit well with any expectations giving a
maximum probability for chi^2 of 5% for the best oscillation hypothesis, and
the combined probability for the shape and number of events is 17%. We conclude
that these data favor a neutrino oscillation hypothesis, but with unexplained
structure in the zenith distribution not easily explained by either the
statistics or systematics of the experiment.Comment: 7 pages (two-column) with 4 figure
Observation of the Shadowing of Cosmic Rays by the Moon using a Deep Underground Detector
Using data collected by the MACRO experiment during the years 1989-1996, we
show evidence for the shadow of the moon in the underground cosmic ray flux
with a significance of 3.6 sigma. This detection of the shadowing effect is the
first by an underground detector. A maximum-likelihood analysis is used to
determine that the angular resolution of the apparatus is 0.9+/-0.3 degrees.
These results demonstrate MACRO's capabilities as a muon telescope by
confirming its absolute pointing ability and quantifying its angular
resolution.Comment: 14 pages, 8 figures Submitted to Phys. Rev.
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