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  • 1
    Electronic Resource
    Electronic Resource
    Relationships between allergic inflammation and nasal airflow in children with persistent allergic rhinitis due to mite sensitization (2005)
    Oxford, UK : Munksgaard International Publishers
    Allergy 60 (2005), S. 0 
    Details
    ISSN: 1398-9995
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background:  Allergic rhinitis is associated with Th2-dependent inflammation. Nasal obstruction is the most typical symptom in children with mite allergy.Objectives:  The aim of this study was to evaluate the possible relationships among nasal symptoms, allergic inflammation, including inflammatory cells and cytokine pattern, and nasal airflow in children with persistent allergic rhinitis because of mite sensitization.Methods:  Twenty children (13 males and seven females, mean age 13.4 ± 1.6 years) with persistent rhinitis because of mite allergy were evaluated. All of them had moderate–severe grade of nasal obstruction. Total symptom score (TSS), rhinomanometry, nasal lavage, and nasal scraping were obtained in all subjects. Inflammatory cells were counted by conventional staining; interleukin (IL)-5, and IL-8 were measured by immunoassay on fluids recovered from nasal lavage.Results:  Eosinophils were significantly associated with TSS (R = 74.4%, P = 0.0002), with IL-5 (R = 90.6%, P 〈 0.0001) and with nasal flow (R = −69%, P = 0.0007), but not with IL-8 (R = 0.1%, P = 0.995). Eosinophil levels were shown to independently predict nasal flow (P 〈 0.001), with flow decreasing linearly for increasing eosinophils, together with a significant effect of neutrophils (P = 0.016, linear increase in flow) and a borderline effect of IL-8 (P = 0.063, linear increase in flow).Conclusions:  This study demonstrates the close association between IL-5 concentration and eosinophil infiltration. In addition, there is clear evidence concerning the relationship between eosinophil infiltration and nasal airflow. Thus, nasal eosinophils can be regarded as the most important predictor of upper airway function. These findings constitute first evidence of the relationship between nasal airflow impairment and Th2-related eosinophilic inflammation in children with persistent allergic rhinitis because of mite sensitization.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1398-9995.2005.00664.x
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  • 2
    Electronic Resource
    Electronic Resource
    Prognostic criteria in nonfunctioning pancreatic endocrine tumours (1996)
    Springer
    Virchows Archiv 429 (1996), S. 323-333 
    Details
    ISSN: 1432-2307
    Keywords: Nonfunctioning pancreatic endocrine tumours ; Prognostic factors ; Ki67 proliferative index ; Immunohistochemical profile
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract To identify prognostic subgroups among nonfunctioning (nonsyndromic) pancreatic endocrine tumours, a series of 61 tumours were analysed systematically for macroscopic, histopathological and immunohistochemical variables potentially predictive of malignancy. High-grade nuclear atypia, elevated mitotic rate and multifocal necrosis allowed us to separate 5 poorly differentiated carcinomas from 56 well differentiated tumours. Among the latter, 29 well-differentiated carcinomas showing gross local invasion or metastases were identified. Vascular or perineural microinvasion, Ki67 proliferative index 〉2%, mitotic rate ≥2, size ≥4 cm, capsular penetration, nuclear atypia, lack of progesterone receptors and presence of calcitonin were among the variables correlated with malignancy. The first two were the most sensitive and specific. Their presence or absence was used in the 27 tumours lacking evidence of malignancy at the time of surgery to separate 11 cases with increased risk of malignancy (in 2 of which metastases developed during follow-up) from 16 cases with limited risk. The resulting four prognostic groups of nonfunctioning pancreatic endocrine tumours (limited- and increased-risk tumours, well-differentiated carcinomas and poorly differentiated carcinomas) showed distinct survival curves, which were significantly affected by vascular microinvasion, Ki67 proliferative index and metastases.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00198436
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  • 3
    Electronic Resource
    Electronic Resource
    Assessment of renal function in patients with multiple myeloma: the role of urinary proteins (1999)
    Springer
    Annals of hematology 78 (1999), S. 371-375 
    Details
    ISSN: 1432-0584
    Keywords: Key words Myeloma ; Renal failure ; Urinary proteins ; Bence Jones proteinuria ; Tubular function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  Renal failure (RF) in multiple myeloma (MM) is considered an ominous complication even though, when timely therapy is started in patients with minimal damage, a high percentage of cases can achieve a regression. The evaluation of renal involvement usually relies on serum creatinine or its clearance, but these parameters have proved to be inadequate to identify initial damage. The aim of this study was to assess the role of the following urinary proteins in diagnosing renal impairment at an early stage: high-molecular-mass proteins (transferrin, IgG, albumin) as markers of glomerular damage, and low-molecular-weight proteins and parenchymal enzymes [α1-acid glycoprotein (AGP), α1-microglobulin (α1M), retinol-binding protein (RBP), β2-microglobulin (β2M), lysozyme (LZ), and N-acetyl-β-d-glucosaminidase (NAG)] as indicators of tubular disorder. Thirty MM patients (nine at disease onset and 21 previously treated) were included in the study. No correlation was found between the urinary proteins and the phase or the stage of the disease. By the Spearman test, Bence Jones proteinuria correlated significantly with the 24 h proteinuria (p=0.01) and β2M (p=0.02), and weakly with the α1M. Serum creatinine concentrations and urea correlated with most of the analytes evaluated: RBP correlated well with urea (p=0.004) and creatinine (p=0.004); IgG (p=0.006) albumin (p=0.009), AGP (p=0.04), and NAG (p=0.02) correlated with serum creatinine. Significant statistical correlation was found between all the analytes except LZ and the creatinine clearance. Twelve of the 30 MM patients (40%) showed abnormal values of urinary proteins. Four of these patients showed overt renal failure with significant modification of the serum parameters and of creatinine clearance, three showed an isolated decrease of creatinine clearance, and five did not present any alteration of serum or urinary parameters. This testifies to the utility of urinary proteins in highlighting renal damage even in cases where the customary serum indicators of renal disorder are normal. In conclusion, our results demonstrate that AGP, RBP, NAG, transferrin, and IgG are good indicators of renal damage. They do not correlate with the severity of the disease, but they seem to be helpful in identifying a subset of patients with initial renal dysfunction.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050531
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  • 4
    Electronic Resource
    Electronic Resource
    Multiple myeloma in younger patients: the role of age as prognostic factor (1998)
    Springer
    Annals of hematology 76 (1998), S. 67-72 
    Details
    ISSN: 1432-0584
    Keywords: Key words Multiple myeloma ; Prognostic factors ; Age
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract  The presenting features of 356 previously untreated multiple myeloma (MM) patients grouped according to age were analyzed in order (a) to elucidate the possible differences in initial clinical and laboratory features between patients younger than 50 years and the older ones and (b) to statistically assess the prognostic value of the parameters considered, with particular emphasis on the prognostic impact of age. Patients were divided into two groups: group I included 61 patients aged less than 50, group II comprised 295 patients aged 50 or more. No significant differences were found between the two groups in terms of either clinical or laboratory initial characteristics. The treatments adopted and the response to therapy did not differ in the two groups. The prognostic value of presenting features was evaluated for the whole cohort by univariate and multivariate analysis, considering both the observed survival rates and survival rates corrected for the effect of other independent causes of death, using a Poisson model. In both models, calcium level (RR 2.33), performance status (RR 1.83), and creatinine (RR 1.69) maintained their independent negative prognostic value. In contrast, the impact of age was different in the two models. In fact, patients younger than 50 seem to have a better prognosis when the observed survival rates are considered, but they show an increased risk of death when the model takes into account the expected mortality of the underlying population. In conclusion, this study shows that the younger cohort of MM patients has no distinctive initial characteristics with respect to older patients. In multivariate analysis, creatinine levels, calcemia, and performance status show a relevant negative independent prognostic value. Regarding the prognostic impact of age, survival seems to be better among patients younger than 50 than in older patients when the observed survival rates are considered but is significantly worse when the mortality of the corresponding general population. is taken into account.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002770050365
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  • 5
    Electronic Resource
    Electronic Resource
    Long-term pulmonary sequelae after treatment of childhood Hodgkin's disease (1997)
    Springer
    Annals of oncology 8 (1997), S. 19-24 
    Details
    ISSN: 1569-8041
    Keywords: childhood ; Hodgkin's disease ; late effects ; lung function
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Pulmonary sequelae have been reported in patients treatedfor Hodgkin's disease (HD). Few data are available about patients treated forchildhood HD followed over several years. Patients and methods: In a cross-sectional study carried out for 76months (median time) after treatment completion, we evaluated the lungfunction abnormalities and respiratory symptoms in 27 patients (16 males and11 females) with HD diagnosed betweeen 1983 and 1994 (median age at diagnosis11 years, range 2–16 years). They had been treated with chemotherapy andradiotherapy according to current protocol AIEOP-MH 83 (n = 14) orAIEOP-MH 89 (n = 13). At the time of the study, 26 patients were infirst complete remission and one in second remission. Of the 27 patients, 19had had mediastinal irradiation at a dose of 20 Gy (n = 5) or20.8–44 Gy (n = 14). Forced vital capacity (FVC), functionalresidual capacity (FRC), forced expiratory volume in one second(FEV1), FEV1/FVC ratio, and maximal expiratoryflow at 25% of FVC were registered; diffusion capacity for carbonmonoxide (DLCO) was determined. Data were expressed asstandard deviation (SD) score. Four patterns of respiratory functionabnormalities were defined: restrictive, obstructive, isolated bronchiolarimpairment, isolated diffusing impairment. Results: Twelve patients (44%) were asymptomatic and showedcompletely normal pulmonary function tests. Three patients reported dyspneaon exertion, and one of them also cough and phlegm: out of these symptomaticsubjects, only 1 had functional abnormality (isolated DLCOimpairment). A restrictive pattern was found in 5 patients (18%),including 2 who also had a pathological DLCO SD score. Eightadditional patients (30%) had isolated diffusing impairment. Oxygensaturation was normal in all patients. Forty-seven percent of patients withnormal DLCO had had lower dose irradiation (20 Gy) comparedto 10% of patients with impaired DLCO (P =0.054). Similarly, patients with normal DLCO had hadsignificantly less chemotherapy as compared to patients with abnormalDLCO (P = 0.003). Occurrence of lung abnormalities wasnot significantly associated with sex, age at treatment, mediastinalirradiation, and time elapsed from treatment completion. Conclusion: Adolescents and young adults treated for childhood HD areat risk for lung function abnormalities, significantly more frequent inpatients who received more intense treatment, as mediastinal irradiation ata higher dose (〉20 Gy) and more chemotherapy blocks. Long-term follow-upshould be offered to these patients because of their possible limitedpotential for pulmonary function and possible lesser resistance toadverse agents such as smoke, pollution, infections, and aging.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1023/A:1008281213703
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