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Citriniti G, Soriano A, Bertolini E, Sandri G, Bertani A, Tinazzi I, Martinis F, Girolimetto N, Salvarani C, Beltrami M, Macchioni P. POS0265 CLINICAL AND ULTRASONOGRAPHIC ENTHESITIS IN INFLAMMATORY BOWEL DISEASE WITH AND WITHOUT PSORIASIS. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.4162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:Previous studies have reported an association between psoriasis (PsO) and inflammatory bowel disease (IBD). Coexistence of IBD and PsO has been associated with significant higher prevalence of enthesitis and dactylitis1.Objectives:To compare the prevalence of clinical and ultrasonographic peripheral enthesis abnormalities in a consecutive series of patients with IBD and psoriasis (PsO) as compared to a group of IBD patients without psoriasis (IBD).Methods:One-hundred seventy-four IBD consecutive patients [36 PsO and 138 IBD, M/F 91/83, mean age 42.6±14.7 years, mean disease duration 110 ±12.3 months] entered the study. A complete clinical examination, including rheumatological history, 66/68 peripheral joint count, MASES and LEI scores, BASDAI, and dactylitis count, was performed at study entry. Laboratory test (ESR, CRP, Hb, fecal calprotectin) were collected. Axial or peripheral SpA diagnosis was made using ASAS criteria 2.US examination was executed by a rheumatologist blind to clinical data, using an Esaote MyLabClass, 18-6MHz linear multifrequence transducer both in B-mode and PD-mode. The following sites were examined bilaterally: lateral epicondyle of the humerus, distal quadriceps femoris insertion into the patella, inferior pole of the patella, tibial distal insertion of the patellar tendon, calcaneal insertion of the Achilles tendon, and plantar aponeurosis insertion. Knee and ankle joints were evaluated for synovial hypertrophy, PD signal and fluid effusion. Enthesitis was defined according to OMERACT 3 and scored as 0-36 for GUESS and 0-136 for MASEI.Results:PsO patients had later IBD onset (mean age 39±14.7 vs 33 ± 13.2 in IBD group, p=0.02). There weren’t observed any significant differences in IBD duration and Crohn/UC prevalence.No significant difference between the two groups in rheumatological history and clinical examination was detected, except for familiar history of psoriasis (PsO 44% vs IBD 16%, p <0.001). Prevalence of SpA was 33,3% in PsO group and 37% in IBD group (p = 0.687).146 patients (83.4%) showed structural damage at ≥ 1 enthesis, 44 patients (25%) had at least 1 active enthesitis, with no significant difference between the two groups. PsO group showcased a significantly increased prevalence of patients having ≥ 1 thickened enthesis (86.1% vs 63.9%, p=0.009) and of PD signal at knee examination (11.1% vs 2.2%, p= 0.034). Higher values of GUESS score were observed in PsO (8.1±5.1 vs 5.8±3.9, p=0.017). Enthesis hypoechogenicity was more prevalent in IBD group (27.5% vs 11.1%, p=0.049).Enthesis thickness was significantly increased in PsO, in every examined site. Enthesophyte length was significantly increased in PsO group at quadriceps tendon, patellar distal insertion and Achilles tendon.Conclusion:No differences in clinical manifestation and rheumatological history between IBD and PsO patients were observed. Subclinical (US) abnormalities were significantly increased in IBD patients with associated PsO, as compared to patients affected by IBD.References:[1]Cantini, F. et al. J. Rheumatol.44, 1341–1346 (2017).[2]Rudwaleit, M. et al. Ann. Rheum. Dis.68, 777–783 (2009).[3]Balint, P. V. et al. Ann. Rheum. Dis.77, 1730–1735 (2018).Acknowledgements:Abbvie provided funding for medical writingDisclosure of Interests:Giorgia Citriniti: None declared, Alessandra Soriano: None declared, Elena Bertolini: None declared, Gilda Sandri: None declared, Angela Bertani: None declared, Ilaria Tinazzi: None declared, Federica Martinis: None declared, Nicolò Girolimetto: None declared, Carlo Salvarani: None declared, Marina Beltrami Grant/research support from: Abbvie provided funding for medical writing, Pierluigi Macchioni: None declared
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Trabelsi M, Romand X, Gilson M, Vaillant M, Guerne PA, Hayem G, Bertolini E, Baillet A, Gaudin P. Rheumatoid Meningitis a Rare Extra-Articular Manifestation of Rheumatoid Arthritis: Report of 6 Cases and Literature Review. J Clin Med 2020; 9:jcm9061625. [PMID: 32471260 PMCID: PMC7356493 DOI: 10.3390/jcm9061625] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/15/2020] [Accepted: 05/22/2020] [Indexed: 12/13/2022] Open
Abstract
Objectives. Central neurological manifestations of rheumatoid arthritis (RA) like rheumatoid meningitis (RM) are rare, little known and have a high rate of morbi-mortality. METHODS. We described six cases of RM that were directly related to RA activity after exhaustive assessment. RESULTS. They were mainly women, aged of 50 to 69. All were positive for anti-cyclic citrullinated peptide antibodies and half for rheumatoid factors. RA activity, duration, and treatments were heterogeneous including oral steroids, conventional synthetic disease modifying anti-rheumatic drugs (DMARDs) and biologic DMARDs. Symptoms were various, with acute or progressive beginning; main were: generalized or focal seizure (4/6), fever (3/6), headaches (3/6), and frontal syndrome (2/6). Imaging lesions were four leptomeningitis, one pachymeningitis, and one association of both. MRI usually showed hypersignal in various territories in T2-FLAIR (fluid attenuated inversion recovery) mode, and enhancement in T1-weighted mode after gadolinium injection. All patients had lumbar puncture that found sterile cerebrospinal fluid, no neoplasic cell, elevated cell count in 5/6 cases and elevated proteins concentration in 3/6 cases. Cerebral biopsy was possible for three patients, and definitively confirmed the diagnosis of aseptic lepto- or pachymenintis, excluding vasculitis and lymphoma. Different treatments were used like intravenous high dose steroids, immunoglobulins or biologic DMARDs, with variable clinical and imaging outcome: one death, one complete recovery, and four recoveries with sequelae. Conclusions. Clinical symptoms, imaging, lumbar puncture, and serological studies are often nonspecific, only histologic examination can confirm the diagnosis of RM. Any central neurological manifestation in RA patients, even in quiescent and ancient RA, should warn the physician.
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Affiliation(s)
- Mélanie Trabelsi
- Rheumatology Department, CHU Grenoble Alpes, Hôpital Sud, 38130 Echirolles, France; (X.R.); (M.G.); (A.B.); (P.G.)
- Correspondence:
| | - Xavier Romand
- Rheumatology Department, CHU Grenoble Alpes, Hôpital Sud, 38130 Echirolles, France; (X.R.); (M.G.); (A.B.); (P.G.)
- GREPI TIMC, CNRS UMR 5525, Université Grenoble Alpes, 38000 Grenoble, France
| | - Mélanie Gilson
- Rheumatology Department, CHU Grenoble Alpes, Hôpital Sud, 38130 Echirolles, France; (X.R.); (M.G.); (A.B.); (P.G.)
| | - Mathieu Vaillant
- Neurology Department, CHU Grenoble Alpes, Hôpital Nord, 38000 Grenoble, France;
| | | | - Gilles Hayem
- Rheumatology Department, Groupe Hospitalier Paris Saint Joseph, 75014 Paris, France;
| | - Ewa Bertolini
- Rheumatology Department, CH Annecy, 74370 Annecy, France;
| | - Athan Baillet
- Rheumatology Department, CHU Grenoble Alpes, Hôpital Sud, 38130 Echirolles, France; (X.R.); (M.G.); (A.B.); (P.G.)
- GREPI TIMC, CNRS UMR 5525, Université Grenoble Alpes, 38000 Grenoble, France
| | - Philippe Gaudin
- Rheumatology Department, CHU Grenoble Alpes, Hôpital Sud, 38130 Echirolles, France; (X.R.); (M.G.); (A.B.); (P.G.)
- GREPI TIMC, CNRS UMR 5525, Université Grenoble Alpes, 38000 Grenoble, France
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Affiliation(s)
| | | | - Ewa Bertolini
- Centre hospitalier Annecy Genevois, Metz-Tessy, France
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Affiliation(s)
- E. Bertolini
- JET Joint UndertakingAbingdon, Oxfordshire OX14 3EA, United Kingdom
| | - P. L. Mondino
- JET Joint UndertakingAbingdon, Oxfordshire OX14 3EA, United Kingdom
| | - P. Noll
- JET Joint UndertakingAbingdon, Oxfordshire OX14 3EA, United Kingdom
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Bertolini E, Macchioni P, Beltrami M, Bassi F, Marani B, Salvarani C, Catanoso M. FRI0411 A Cross Sectional Study of The Clinical and Ultrasound Entheseal Involvement in Patients with IBD. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Moset V, Cerisuelo A, Ferrer P, Jimenez A, Bertolini E, Cambra-López M. Microbial examination of anaerobic sludge adaptation to animal slurry. Environ Technol 2014; 35:749-758. [PMID: 24645456 DOI: 10.1080/09593330.2013.848940] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The objective of this study was to evaluate changes in the microbial population of anaerobic sludge digesters during the adaptation to pig slurry (PS) using quantitative real-time polymerase chain reaction (qPCR) and qualitative scanning electron microscopy (SEM). Additionally, the relationship between microbial parameters and sludge physicochemical composition and methane yield was examined. Results showed that the addition of PS to an unadapted thermophilic anaerobic digester caused an increase in volatile fatty acids (VFA) concentration, a decrease in removal efficiency and CH4 yield. Additionally, increases in total bacteria and total archaea were observed using qPCR. Scanning electron micrographs provided a general overview of the sludge's cell morphology, morphological diversity and degree of organic matter degradation. A change in microbial morphotypes from homogeneous cell morphologies to a higher morphological diversity, similar to that observed in PS, was observed with the addition of PS by SEM. Therefore, the combination of qPCR and SEM allowed expanding the knowledge about the microbial adaptation to animal slurry in thermophilic anaerobic digesters.
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Toussirot E, Abbas W, Khan KA, Tissot M, Jeudy A, Baud L, Bertolini E, Wendling D, Herbein G. Imbalance between HAT and HDAC activities in the PBMCs of patients with ankylosing spondylitis or rheumatoid arthritis and influence of HDAC inhibitors on TNF alpha production. PLoS One 2013; 8:e70939. [PMID: 24039666 PMCID: PMC3748901 DOI: 10.1371/journal.pone.0070939] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2013] [Accepted: 06/24/2013] [Indexed: 11/18/2022] Open
Abstract
Objective Acetylation or deacetylation of histone proteins may modulate cytokine gene transcription such as TNF alpha (TNF). We evaluated the balance between histone deacetytlase (HDAC) and histone acetyltransferase (HAT) in patients with rheumatoid arthritis (RA) or ankylosing spondylitis (AS) compared to healthy controls (HC) and determined the influence of HDAC inhibitors (trichostatin A -TSA- or Sirtinol -Sirt-) on these enzymatic activities and on the PBMC production of TNF. Methods 52 patients with RA, 21 with AS and 38 HC were evaluated. HAT and HDAC activities were measured on nuclear extracts from PBMC using colorimetric assays. Enzymatic activities were determined prior to and after ex vivo treatment of PBMC by TSA or Sirt. TNF levels were evaluated in PBMC culture supernatants in the absence or presence of TSA or Sirt. Results HAT and HDAC activities were significantly reduced in AS, while these activities reached similar levels in RA and HC. Ex vivo treatment of PBMC by HDACi tended to decrease HDAC expression in HC, but Sirt significantly reduced HAT in RA. TNF production by PBMC was significantly down-regulated by Sirt in HC and AS patients. Conclusion HAT and HDAC were disturbed in AS while no major changes were found in RA. HDACi may modulate HDAC and HAT PBMC expression, especially Sirt in RA. Sirtinol was able to down regulate TNF production by PBMC in HC and AS. An imbalance between HAT and HDAC activities might provide the rationale for the development of HDACi in the therapeutic approach to inflammatory rheumatic diseases.
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Affiliation(s)
- Eric Toussirot
- Clinical Investigation Center Biotherapy CBT-506, University Hospital of Besançon, Besançon, France
- Department of Rheumatology, University Hospital of Besançon, Besançon, France
- Department of Therapeutics, University of Franche Comté, Besançon, France
- UPRES EA 4266, Pathogens and Inflammation Laboratory, SFR FED 4234, University of Franche Comté, Besançon, France
- * E-mail :
| | - Wasim Abbas
- UPRES EA 4266, Pathogens and Inflammation Laboratory, SFR FED 4234, University of Franche Comté, Besançon, France
- Department of Virology, University Hospital of Besançon, Besançon, France
| | - Kashif Aziz Khan
- UPRES EA 4266, Pathogens and Inflammation Laboratory, SFR FED 4234, University of Franche Comté, Besançon, France
- Department of Virology, University Hospital of Besançon, Besançon, France
| | - Marion Tissot
- Department of Virology, University Hospital of Besançon, Besançon, France
| | - Alicia Jeudy
- Department of Virology, University Hospital of Besançon, Besançon, France
| | - Lucile Baud
- Department of Virology, University Hospital of Besançon, Besançon, France
| | - Ewa Bertolini
- Department of Rheumatology, University Hospital of Besançon, Besançon, France
| | - Daniel Wendling
- Department of Rheumatology, University Hospital of Besançon, Besançon, France
- UPRES EA 4266, Pathogens and Inflammation Laboratory, SFR FED 4234, University of Franche Comté, Besançon, France
| | - Georges Herbein
- UPRES EA 4266, Pathogens and Inflammation Laboratory, SFR FED 4234, University of Franche Comté, Besançon, France
- Department of Virology, University Hospital of Besançon, Besançon, France
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Gaugler B, Laheurte C, Bertolini E, Wendling D, Saas P, Toussirot E. OP0008 Peripheral Blood B Cell Subsets and BAFF/April Receptor Expression, Together with Circulating BAFF and April Levels, are Disturbed in Rheumatoid Arthritis but not in Ankylosing Spondylitis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Toussirot E, Abbas W, Khan KA, Tissot M, Jeudy A, Baud L, Bertolini E, Wendling D, Herbein G. FRI0012 Imbalance between histone acetyl transferase and histone deacteylase activities and modulation of hdac activity and tnfa production by hdac inhibitors in patients with ankylosing spondylitis or rheumatoid arthritis. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2013-eular.1140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Christille JM, Bernagozzi A, Bertolini E, Calcidese P, Carbognani A, Cenadelli D, Damasso M, Giacobbe P, Lanteri L, Lattanzi M, Sozzetti A, Smart R. The APACHE survey hardware and software design: Tools for an automatic search of small-size transiting exoplanets. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20134717001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Sozzetti A, Bernagozzi A, Bertolini E, Calcidese P, Carbognani A, Cenadelli D, Christille JM, Damasso M, Giacobbe P, Lanteri L, Lattanzi M, Smart R. The APACHE Project. EPJ Web of Conferences 2013. [DOI: 10.1051/epjconf/20134703006] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Vidal E, Yokomi RK, Moreno A, Bertolini E, Cambra M. Calculation of diagnostic parameters of advanced serological and molecular tissue-print methods for detection of Citrus tristeza virus: a model for other plant pathogens. Phytopathology 2012; 102:114-121. [PMID: 21879789 DOI: 10.1094/phyto-05-11-0139] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Citrus tristeza virus (CTV) is one of the most important virus diseases that affect citrus. Control of CTV is achieved by grafting selected virus-free citrus scions onto CTV-tolerant or -resistant rootstocks. Quarantine and certification programs are essential for avoiding the entry and propagation of severe strains of CTV. Citrus nurseries in Spain and central California (United States) maintain zero-tolerance policies for CTV that require sensitive, specific, and reliable pathogen-detection methods. Tissue-print (TP) real-time reverse-transcriptase polymerase chain reaction (RT-PCR) assay was compared with the validated TP enzyme-linked immunosorbent assay (ELISA), using the CTV-specific monoclonal antibodies 3DF1 and 3CA5, for CTV detection. In total, 1,395 samples from healthy and CTV-infected nursery and mature tree plants were analyzed with both methods. The total agreement between both detection methods was substantial (Cohen's kappa index of 0.77 ± 0.03). The diagnostic parameters of each technique (i.e., the sensitivity, specificity, and likelihood ratios) were evaluated in a second test involving 658 Citrus macrophylla nursery plants. Mexican lime indexing was used to evaluate samples with discrepant results in the analysis. For TP-ELISA, a sensitivity of 0.8015, a specificity of 0.9963, and a positive and negative likelihood ratio of 216.42 and 0.199, respectively, were estimated. For TP real-time RT-PCR, a sensitivity of 0.9820, a specificity of 0.8519, and a positive and negative likelihood ratio of 6.63 and 0.021, respectively, were estimated. These diagnostic parameters show that TP real-time RT-PCR was the most sensitive technique, whereas TP-ELISA showed the highest specificity, validating the use of the molecular technique for routine CTV-detection purposes. In addition, our results show that the combination of both techniques can accurately substitute for the conventional biological Mexican lime index for the detection of CTV. The calculation of diagnostic parameters is discussed, as a necessary tool, to validate detection or diagnostic methods in plant pathology. Furthermore, assessment of the post-test probability of disease after a diagnostic result and CTV prevalence allows selection of the best method for accurate and reliable diagnosis.
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Affiliation(s)
- E Vidal
- Instituto Valemciano de Investigaciones Agrarias, Valencia, Spain
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Santambrogio R, Costa M, Strada D, Barabino M, Conti M, Bertolini E, Zuin M, Opocher E. Intraoperative ultrasound patterns predict recurrences after surgical treatments for hepatocellular carcinoma(). J Ultrasound 2010; 13:150-7. [PMID: 23396628 DOI: 10.1016/j.jus.2010.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Hepatocellular carcinoma (HCC) is associated with a high incidence of postoperative recurrence, despite high rates of complete necrosis with radiofrequency ablation (RFA) and curative hepatic resections (HR). The aim of this study was to identify intraoperative ultrasound patterns observed during HR or RFA that predicting intrahepatic HCC recurrence. MATERIALS AND METHODS From January 1997 through August 2008, we treated 377 patients with HCC (158 with HR and 219 with surgical RFA). All patients underwent intraoperative ultrasound (IOUS) examination. Primary HCCs was classified according to diameter, HCC pattern (nodular or infiltrative), echogenicity (hyper- or hypo-), echotexture (homogeneous or inhomogeneous), capsular invasion, mosaic pattern, nodule-in-nodule appearance, and infiltration of portal vessels. Number of HCC nodules was also considered. Comparisons between the groups of possible factors for intrahepatic recurrence of treated tumors were performed using the Kaplan-Meier method and compared using the log-rank test. RESULTS Patients were followed for 9-127 months (median: 18.6 months), and intrahepatic recurrence was observed in 198 (52.5%). In 138 patients (36.5%), recurrences were located in different segments with respect to the primary tumor. In 60 HCC tumors (16%), local recurrences were found in the same segment as the primary tumor. At univariate analysis, primary HCC echogenicity and mosaic pattern were the only factors not significant associated with intrahepatic recurrences. CONCLUSION IOUS is an accurate staging tool for use during "surgical" resection or RFA. This study shows that IOUS patterns can also be used to estimate the risk of post-treatment HCC recurrence. In patients at high risk for this outcome, closer follow-up and use of adjuvant therapies could be useful.
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Abelleira A, Mansilla JP, Padilla V, Hita I, Cabaleiro C, Bertolini E, Olmos A, Legorburu FJ. First Report of Arabis mosaic virus on Grapevine in Spain. Plant Dis 2010; 94:635. [PMID: 30754448 DOI: 10.1094/pdis-94-5-0635a] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Arabis mosaic virus (ArMV; genus Nepovirus, family Comoviridae) is one of several nepoviruses responsible for infectious degeneration disease of grapevines in Europe (3). The first occurrence in Spain, in the summer of 2007, was found in Val de Salnés, Rias Baixas appellation, Galice on 25-year-old vines of the Albariño variety grafted onto an unidentified rootstock and showing leaf yellowing. The second finding was in the spring of 2008 in Barriobusto, Rioja appellation, Basque Country on 30-year-old vines of Tempranillo variety grafted onto 41B rootstock. In this case, no obvious foliar symptoms were observed but fruit set was very poor. Positive ELISA results were obtained at two different laboratories using antibodies to ArMV obtained from two companies (BIOREBA, Reinach, Switzerland and Sediag, Longvic, France). At a third lab, the presence of ArMV was further confirmed by reverse transcription (RT)-nested PCR using the primers described by Bertolini et al. (1). External primers ArMV 1 and ArMV 2 amplified a fragment of 340 bp from the coat protein region of the virus and internal primers ArMV i1 and ArMV i2 amplified a fragment of 203 bp. The specificity of the amplicons was subsequently confirmed by sequencing and comparison with other ArMV isolates available in the GenBank, EMBL, and DDBJ databases. Alignment performed using Blastn showed 85% nucleotide sequence identity with ArMV isolate NW (Accession No. AY017339). ELISA revealed co-infection with GLRaV-1 in Galice, GLRaV-3 in Rioja, and GFkV at both sites; these other viruses being common in their respective appellations. ArMV could be mechanically transmitted from rooted cuttings onto Chenopodium amaranticolor with an average of a 46% success rate (1:10 tissue/buffer ratio; [2]), but the range was very wide (0 to 100%) and dependent on the individual source vine. No statistical differences were found between nicotine or phosphate buffer for extraction or when using shoot tips or root tips as a source of virus (Fisher's exact test). Infection in C. amaranticolor was symptomless, but detectable by ELISA, and systemic. The Galician grapevine was an isolated plant, replanted on the spot of a dead one. Xiphinema diversicaudatum, the nematode vector of ArMV, was found in the vineyard soil. Only two ArMV-positive vines were found among 1,993 plants analyzed in Galice from 2005 to 2007 (no field data available for the second finding). In Rioja, one positive vine was found in a random sample of 74 vines from two different vineyards. Further testing of the neighboring vines indicated that one of the adjacent plants was also infected. This minimal spread since the vineyard was planted is suggestive of a lack of vectored transmission. In Spain as a whole, the virus seems to be rare and associated with the Atlantic biogeographic region. Both vineyards were planted before certified material became widely available. Currently, statutory testing of grapevine propagation material should prevent further spread. References: (1) E. Bertolini et al. Phytopathology 93:286, 2003. (2) G. P. Martelli, ed. Graft-Transmissible Diseases of Grapevines. Handbook for Detection and Diagnosis, FAO, Rome, 1993. (3) G. P. Martelli and E. Boudon-Padieu. Directory of Infectious Diseases of Grapevines and Viruses and Virus-like Diseases of the Grapevine. Bibliographic Report 1998-2004, CIHEAM, Paris, 2006.
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Affiliation(s)
- A Abelleira
- Estación Fitopatolóxica do Areeiro, Deputación de Pontevedra, E-36153 Pontevedra, Spain
| | - J P Mansilla
- Estación Fitopatolóxica do Areeiro, Deputación de Pontevedra, E-36153 Pontevedra, Spain
| | - V Padilla
- Instituto Murciano de Investigación y Desarrollo Agrario, E-30150 La Alberca, Spain
| | - I Hita
- Instituto Murciano de Investigación y Desarrollo Agrario, E-30150 La Alberca, Spain
| | - C Cabaleiro
- Escola Politécnica Superior, Universidade de Santiago de Compostela, E-27002, Lugo, Spain
| | - E Bertolini
- Instituto Valenciano de Investigaciones Agrarias, E-46113 Moncada, Spain
| | - A Olmos
- Instituto Valenciano de Investigaciones Agrarias, E-46113 Moncada, Spain
| | - F J Legorburu
- NEIKER-Basque Institute for Agricultural Research and Development, E-01080 Vitoria/Gasteiz, Spain. Research funded by projects RTA2008-00064 and RTA2008-00078-C03 from INIA
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Abstract
Vertebroplasty and vertebral kyphoplasty are increasingly performed to treat vertebral fractures, most notably those related to osteoporosis. Adverse effects are uncommon and consist chiefly of cement leakage out of the vertebral body and of vertebral fractures adjacent to the treatment site. We report two cases of vertebral osteitis adjacent to vertebroplasty sites, in a 60-year-old woman and a 79-year-old man. Kyphoplasty to treat an osteoporotic vertebral fracture was followed by acute pain with an inflammatory time pattern and laboratory evidence of inflammation. Time to symptom onset was 10 days and 45 days, respectively. Magnetic resonance imaging showed changes consistent with inflammation in an adjacent vertebra (low signal on T1 images, gadolinium enhancement, and high signal on T2 images). A biopsy of the lesion disclosed moderate nonspecific inflammation, with no microorganisms or evidence of malignancy. Both patients recovered slowly. The male patient experienced a fracture at the site of the lesion. Few cases of osteitis adjacent to kyphoplasty have been reported. The underlying pathophysiology may involve changes in vertebral loading and cement leakage into the intervertebral disk.
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Affiliation(s)
- Daniel Wendling
- Service de rhumatologie, CHU Minjoz, 25030 Besançon, France.
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Toussirot E, Chataigner H, Pépin L, Bertolini E, Kantelip B. Spinal cord compression complicating aseptic spondylodiscitis in ankylosing spondylitis. Clin Exp Rheumatol 2009; 27:654-657. [PMID: 19772801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Aseptic spondylodiscitis is a well recognized complication of ankylosing spondylitis. Neurological complications of such discovertebral lesions are uncommon. We report a new case with a diagnosis of T12-L1 spondylodiscitis which developed ten years after a spinal cord compression. Such neurological complications of aseptic spondylodiscitis may be explained by proliferative epidural tissue without predominant inflammatory infiltrates and also the development of new bone reaction, suggesting the contribution of mechanical factors.
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Affiliation(s)
- E Toussirot
- Department of Rheumatology, University Hospital Jean Minjoz, Besançon, France.
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Toussirot É, Bertolini E, Wendling D. Management of ankylosing spondylitis with infliximab. Open Access Rheumatol 2009; 1:69-82. [PMID: 27789982 PMCID: PMC5074714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Ankylosing spondylitis (AS) is a systemic inflammatory rheumatic disease responsible for back pain, stiffness and progressive loss of functional capacity with limited therapeutic options. Regular physical exercises together with the use of nonsteroidal antiinflammatory drugs are the two recognized treatment options in AS. Infliximab is a chimeric anti-tumor necrosis factor-α monoclonal antibody that has been demonstrated to be highly effective in the treatment of AS, providing clinical amelioration at both axial and peripheral skeleton. Infliximab also improves quality of life, function, biological parameters (acute phase reactants) and inflammatory lesions of the spine as detected by magnetic resonance imaging. It is given at a 5 mg/kg dosage, as an infusion at weeks 0, 2, 6, and every 6 to 8 weeks after. Open-label and placebo-controlled trials have well demonstrated its high level of efficacy, with an improvement of the disease activity of at least 50% in 60%-80% of patients. In a large placebo-controlled trial, Assessment in Ankylosing Spondylitis Response Criteria (ASAS20) responders were observed in 61.2% of patients receiving infliximab compared to 19.2% of patients under placebo. Long-term efficacy is maintained when infliximab is administered every 6-8 weeks. Consensus international guidelines for the initiation and the use of this expensive treatment are available. Some questions remain, including the long-term safety, in particular the risk of lymphoma, and the potential influence of infliximab on radiological progression which is not currently demonstrated. Despite these concerns, infliximab has revolutionized the management of AS and represents a considerable therapeutic advancement in this disabling disease.
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Affiliation(s)
- Éric Toussirot
- Rheumatology, University Hospital Jean Minjoz, Besançon, France
- Equipe d’Accueil 3186 “Agents pathogènes et Inflammation” University of Franche-Comté, Besançon, France
- CIC – Biotherapy, St-Jacques Hospital, Besançon, France
| | - Ewa Bertolini
- Rheumatology, University Hospital Jean Minjoz, Besançon, France
| | - Daniel Wendling
- Rheumatology, University Hospital Jean Minjoz, Besançon, France
- Equipe d’Accueil 3186 “Agents pathogènes et Inflammation” University of Franche-Comté, Besançon, France
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Lopes SA, Frare GF, Bertolini E, Cambra M, Fernandes NG, Ayres AJ, Marin DR, Bové JM. Liberibacters Associated with Citrus Huanglongbing in Brazil: 'Candidatus Liberibacter asiaticus' Is Heat Tolerant, 'Ca. L. americanus' Is Heat Sensitive. Plant Dis 2009; 93:257-262. [PMID: 30764183 DOI: 10.1094/pdis-93-3-0257] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In São Paulo State, Brazil, 'Candidatus Liberibacter americanus' and 'Candidatus Liberibacter asiaticus' are associated with huanglongbing (HLB). Affected municipalities occur mainly in the central and southern regions, where the annual number of hours above 30°C is two to five times lower than that in the extreme northern and western regions. The influence of temperature on sweet orange trees infected with 'Ca. L. asiaticus' or 'Ca. L. americanus' was studied in temperature-controlled growth chambers. Symptom progression on new shoots of naturally infected and experimentally graft-inoculated symptomatic sweet orange trees was assessed. Mottled leaves developed on all infected trees at 22 to 24°C, but not on any 'Ca. L. americanus'-infected trees at 27 to 32°C. Quantitative, real time-PCR was used to determine the liberibacter titers in the trees. After 90 days, 'Ca. L. asiaticus'-infected trees had high titers at 32 and 35°C, but not at 38°C, while 'Ca. L. americanus'-infected trees had high titers at 24°C, but at 32°C the titers were very low or the liberibacters could not be detected. Thus, the multiplication of 'Ca. L. asiaticus' is not yet affected at 35°C, while a temperature of 32°C is detrimental to 'Ca. L. americanus'. Thus, 'Ca. L. americanus' is less heat tolerant than 'Ca. L. asiaticus'. The uneven distribution of these two liberibacters in São Paulo State might be in relation with these results.
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Affiliation(s)
- S A Lopes
- Fundecitrus, Av. Adhemar de Barros, 201, Araraquara, SP, CEP 14807-040, Brazil
| | - G F Frare
- Fundecitrus, Av. Adhemar de Barros, 201, Araraquara, SP, CEP 14807-040, Brazil
| | - E Bertolini
- Instituto Valenciano de Investigaciones Agrárias, Carretera Moncada Náquera, km 4.5, Moncada, Spain
| | - M Cambra
- Instituto Valenciano de Investigaciones Agrárias, Carretera Moncada Náquera, km 4.5, Moncada, Spain
| | | | | | | | - J M Bové
- University of Bordeaux 2 and INRA, 71, Av. E. Bourlaux, 33883 Villenave d'Ornon, France
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Lopes SA, Bertolini E, Frare GF, Martins EC, Wulff NA, Teixeira DC, Fernandes NG, Cambra M. Graft transmission efficiencies and multiplication of 'Candidatus Liberibacter americanus' and 'ca. Liberibacter asiaticus' in citrus plants. Phytopathology 2009; 99:301-306. [PMID: 19203283 DOI: 10.1094/phyto-99-3-0301] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In Brazil 'Candidatus Liberibacter asiaticus' and 'Ca. L. americanus' cause huanglongbing (also known as greening), the most destructive citrus disease. A shift in pathogen prevalence was observed over time, with a disproportional increase in 'Ca. L. asiaticus' occurrence. Graft transmission experiments were used for a comparative study of both species using budsticks from symptomatic branches of field-affected trees as inoculum. The plants were inoculated with 'Ca. L. asiaticus' or 'Ca. L. americanus' alone, or simultaneously with both species. Symptom manifestation and conventional and quantitative real-time polymerase chain reaction were used for plant evaluations. 'Ca. L. americanus' was detected mainly in symptomatic plants and 'Ca. L. asiaticus' was detected in symptomatic plants as well as in infected plants prior to symptom manifestation. Transmission percentages varied from 54.7 to 88.0% for 'Ca. L. asiaticus' and 10.0 to 45.2% for 'Ca. L. americanus' in two experiments. In co-inoculated plants, 12.9% contained 'Ca. L. americanus' only, 40.3% contained 'Ca. L. asiaticus' only, and 19.3% contained both species. Average bacterial titers for 'Ca. L. asiaticus' and 'Ca. L. americanus', in log cells per gram of leaf midrib, were 6.42 and 4.87 for the experimental plants and 6.67 and 5.74 for the field trees used as the source of inoculum. The higher bacterial populations of the 'Ca. L. asiaticus'-infected plants provided an explanation for the disproportional increase in field prevalence of this species over time, based on the greater likelihood for pathogen transmission by the insect vector.
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Affiliation(s)
- S A Lopes
- Fundecitrus, Araraquara, São Paulo, 14807-040, Brazil. slopes.fundecitrus.com.br
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Marco-Noales E, Bertolini E, Morente C, López MM. Integrated approach for detection of nonculturable cells of Ralstonia solanacearum in asymptomatic Pelargonium spp. cuttings. Phytopathology 2008; 98:949-955. [PMID: 18943214 DOI: 10.1094/phyto-98-8-0949] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Ralstonia solanacearum (biovar 2, race 3) is a soil and water-borne pathogen that causes serious diseases in several solanaceous hosts. It can also infect geranium plants, posing an important threat to their culture when latently infected cuttings are imported from countries where the pathogen is endemic. R. solanacearum can be present in very low numbers in asymptomatic geranium cuttings, and/or in a particular stressed physiological state that escapes direct isolation on the solid media usually employed. Consequently, an integrated protocol has been developed to analyze asymptomatic geranium cuttings routinely. The first screening tests include isolation and co-operational-polymerase chain reaction (Co-PCR), based on the simultaneous and co-operational action of three primers from 16S rRNA of R. solanacearum. This method was selected as the most sensitive one, able to detect only 1 cell/ml including nonculturable cells. When isolation is negative but Co-PCR is positive, the bioassay in tomato plants is proposed, since stressed bacterial cells or those present in low numbers that do not grow on solid media can be recovered from inoculated tomato plants and retain pathogenicity. This methodology has been demonstrated to be useful and has allowed us to assess the relevance of the physiological status of bacterial cells and its implications in detection. It also reveals the risk of introducing R. solanacearum through asymptomatic geranium material when relying only on bacterial isolation.
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Affiliation(s)
- E Marco-Noales
- Centro de Protección Vegetal y Biotecnología, Instituto Valenciano de Investigaciones Agrarias (IVIA), Valencia, Spain
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Wendling D, Govindaraju S, Prati C, Toussirot E, Bertolini E. Efficacy of anakinra in a patient with refractory relapsing polychondritis. Joint Bone Spine 2008; 75:622-4. [PMID: 18674946 DOI: 10.1016/j.jbspin.2008.02.011] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2008] [Accepted: 02/06/2008] [Indexed: 12/01/2022]
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Penyalver R, García A, Ferrer A, Bertolini E, Quesada JM, Salcedo CI, Piquer J, Pérez-Panadés J, Carbonell EA, Del Río C, Caballero JM, López MM. Factors Affecting Pseudomonas savastanoi pv. savastanoi Plant Inoculations and Their Use for Evaluation of Olive Cultivar Susceptibility. Phytopathology 2006; 96:313-9. [PMID: 18944447 DOI: 10.1094/phyto-96-0313] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
ABSTRACT Pseudomonas savastanoi pv. savastanoi causes olive knot disease, which is present in most countries where olive trees are grown. Although the use of cultivars with low susceptibility may be one of the most appropriate methods of disease control, little information is available from inoculation assays, and cultivar susceptibility assessments have been limited to few cultivars. We have evaluated the effects of pathogen virulence, plant age, the dose/response relationship, and the induction of secondary tumors in olive inoculation assays. Most P. savastanoi pv. savastanoi strains evaluated were highly virulent to olive plants, but interactions between cultivars and strains were found. The severity of the disease in a given cultivar was strongly dependent of the pathogen dose applied at the wound sites. Secondary tumors developed in noninoculated wounds following inoculation at another position on the stem, suggesting the migration of the pathogen within olive plants. Proportion and weight of primary knots and the presence of secondary knots were evaluated in 29 olive cultivars inoculated with two pathogen strains at two inoculum doses, allowing us to rate most of the cultivars as having either high, medium, or low susceptibility to olive knot disease. None of the cultivars were immune to the disease.
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Santambrogio R, Podda M, Zuin M, Bertolini E, Bruno S, Cornalba GP, Costa M, Montorsi M. Safety and efficacy of laparoscopic radiofrequency ablation of hepatocellular carcinoma in patients with liver cirrhosis. Surg Endosc 2003; 17:1826-32. [PMID: 12802646 DOI: 10.1007/s00464-002-8960-1] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2002] [Accepted: 01/21/2003] [Indexed: 10/26/2022]
Abstract
BACKGROUND The optimal treatment for hepatocellular carcinoma (HCC) is surgical resection. However, only a small percentage of patients are operative candidates. Percutaneous radiofrequency interstitial thermal ablation (RITA) has been shown to be efficacious in the treatment of unresectable HCC. Recent advances in laparoscopic ultrasound have greatly improved the accuracy in detecting intrahepatic HCC nodules, many of which were missed by computed tomography. Our objective was to introduce a novel operative combination of laparoscopic ultrasound with laparoscopic RITA in the treatment of HCC. METHODS Eighty-eight patients with HCC in liver cirrhosis were submitted to laparoscopic RITA under sonographic guide. Most patients were in Child's A class of liver function. Patients with large tumors (> 5 cm), portal vein thrombosis, or severe liver disease (Child's C class) were excluded. RESULTS The laparoscopic RITA procedure was completed in 86 of 88 patients (98% feasibility rate). Laparoscopy with laparoscopic ultrasound identified 23 new malignant lesions (27%) in comparison with the results of preoperative imaging. A total of 127 lesions were treated by RITA. There was no operative mortality. Sixty-one patients had no complication (71%). After a mean follow-up of 14.3 +/- 11.6 months, a complete response with a 100% necrosis was achieved in 70 of 83 patients examined (86%). During follow-up, 9 patients (11%) locally recurred at the RITA site and 38 patients (46%) had new malignant nodules. CONCLUSIONS Laparoscopic RITA of HCC proved to be a safe and effective technique in the short term. This technique may be indicated when the percutaneous approach to the lesion is very difficult or if the patient is too ill to undergo laparotomy.
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MESH Headings
- Adult
- Aged
- Carcinoma, Hepatocellular/complications
- Carcinoma, Hepatocellular/diagnostic imaging
- Carcinoma, Hepatocellular/mortality
- Carcinoma, Hepatocellular/surgery
- Carcinoma, Hepatocellular/therapy
- Catheter Ablation/methods
- Ethanol/administration & dosage
- Ethanol/therapeutic use
- Feasibility Studies
- Female
- Follow-Up Studies
- Hepatitis, Viral, Human/complications
- Humans
- Life Tables
- Liver Cirrhosis/complications
- Liver Cirrhosis, Alcoholic/complications
- Liver Neoplasms/complications
- Liver Neoplasms/diagnostic imaging
- Liver Neoplasms/mortality
- Liver Neoplasms/surgery
- Liver Neoplasms/therapy
- Male
- Middle Aged
- Neoplasm Recurrence, Local
- Prospective Studies
- Safety
- Sclerosing Solutions/administration & dosage
- Sclerosing Solutions/therapeutic use
- Sclerotherapy
- Survival Analysis
- Treatment Outcome
- Ultrasonography, Interventional
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Affiliation(s)
- R Santambrogio
- Unità di Chirurgia Epato-biliare, Dipartimento di Medicina e Chirurgia San Paolo, Università degli Studi di Milano, Via A. di Rudinì 8, Italy.
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Bertolini E, Olmos A, Martínez MC, Gorris MT, Cambra M. Single-step multiplex RT-PCR for simultaneous and colourimetric detection of six RNA viruses in olive trees. J Virol Methods 2001; 96:33-41. [PMID: 11516487 DOI: 10.1016/s0166-0934(01)00313-5] [Citation(s) in RCA: 79] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A single-step multiplex RT-PCR was developed for the simultaneous and colourimetric detection of six RNA viruses (Cucumber mosaic virus, Cherry leaf roll virus, strawberry latent ringspot virus, Arabis mosaic virus, Olive latent-1 virus and Olive latent-2 virus) which infect olive trees. Six compatible primer set for one-step RT-PCR amplification in a single closed-tube and 3' digoxigenin labelled probes were designed in optimal, specific and conserved regions. The method has been assessed with 195 Spanish field olive trees, suggesting that approximately 1.5% of the tested material was infected by Cucumber mosaic virus and 0.5% by Cherry leaf roll virus. This method saves time and reagent costs compared with monospecific RT-PCR which needs several reactions for the same number of tests. Using colourimetric detection, it is possible to analyse many samples, it increases sensitivity 10-fold, and whilst facilitating the interpretation of results, it avoids the use of gels and the toxic ethidium bromide. The method could be used routinely for sanitary and certification programmes.
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Affiliation(s)
- E Bertolini
- Departamento de Protección Vegetal y Biotecnología, Laboratorio de Virología e Inmunología, Instituto Valenciano de Investigaciones Agrarias, Apartado oficial, 46113 Moncada Valencia, Spain
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Montorsi M, Santambrogio R, Bianchi P, Opocher E, Zuin M, Bertolini E, Bruno S, Podda M. Radiofrequency interstitial thermal ablation of hepatocellular carcinoma in liver cirrhosis. Role of the laparoscopic approach. Surg Endosc 2001; 15:141-5. [PMID: 11285956 DOI: 10.1007/s004640000242] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The laparoscopic approach to radiofrequency interstitial thermal ablation (RITA) of hepatocellular carcinoma (HCC) with intraoperative ultrasound guidance has been proposed with the aim of obtaining additional information for a better neoplastic staging and a complete and effective treatment of the liver lesions in patients with a difficult percutaneous approach. METHODS In this pilot study, 29 patients with HCC in liver cirrhosis were submitted to laparoscopic RITA under sonographic guide. Most of these patients were in Child's A class of liver function. Patients with large tumors (> 5 cm), portal vein thrombosis, or severe liver disease (Child's C class) were excluded from the study. RESULTS The laparoscopic RITA procedure was completed in 27 of 29 patients (93% feasibility rate). The laparoscopic ultrasound examination identified new malignant liver nodules in five patients (18.5%). A total of 44 lesions were treated. The mean operative time was 75.8 +/- 20.5 min (range, 45-120 min), and the mean RITA time was 18 +/- 10 min (range, 10-56 min). There was no operative mortality, and postoperative morbidity was low (four cases) without any mortality. A complete tumor necrosis was observed in 90% of the patients via spiral computed tomography (CT) 1 month after treatment. CONCLUSIONS Laparoscopic RITA of hepatocellular carcinoma proved to be a safe and effective technique, at least in the short term. Its role in the treatment of HCC needs to be defined in larger series.
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Affiliation(s)
- M Montorsi
- Istituto di Chirurgia Generale e Oncologia Chirurgica, Ospedale Maggiore, IRCCS Università di Milano, Milano, Italy
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Montorsi M, Santambrogio R, Bianchi P, Opocher E, Tagliaferri B, Zuin M, Bertolini E, Podda M. Laparoscopic radiofrequency of hepatocellular carcinoma (HCC) in liver cirrhosis. Hepatogastroenterology 2001; 48:41-5. [PMID: 11268995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND/AIMS In this report, the feasibility and efficacy of laparoscopic radiofrequency interstitial thermal ablation of hepatocellular carcinoma has been evaluated in 20 patients. METHODOLOGY The laparoscopic approach with the use of intraoperative ultrasonography allowed us to obtain additional information regarding liver nodules and a complete treatment of the liver lesions. RESULTS The complication rate was low and there was no operative mortality. A complete necrosis has been obtained in 90% of the cases at 1 month dynamic computed tomography following the treatment. CONCLUSIONS Laparoscopic radiofrequency thermal ablation of hepatocellular carcinoma proved to be a safe and effective technique; its use may be proposed in selected patients. Larger series are needed to accurately assess its role among the other ablative therapies of hepatocellular carcinoma.
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Affiliation(s)
- M Montorsi
- Istituto di Chirurgia Generale e Oncologia Chirurgica-Ospedale Maggiore IRCCS, Milan, Italy.
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Penyalver R, García A, Ferrer A, Bertolini E, López MM. Detection of Pseudomonas savastanoi pv. savastanoi in olive plants by enrichment and PCR. Appl Environ Microbiol 2000; 66:2673-7. [PMID: 10831456 PMCID: PMC110599 DOI: 10.1128/aem.66.6.2673-2677.2000] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The sequence of the gene iaaL of Pseudomonas savastanoi EW2009 was used to design primers for PCR amplification. The iaaL-derived primers directed the amplification of a 454-bp fragment from genomic DNA isolated from 70 strains of P. savastanoi, whereas genomic DNA from 93 non-P. savastanoi isolates did not yield this amplified product. A previous bacterial enrichment in the semiselective liquid medium PVF-1 improved the PCR sensitivity level, allowing detection of 10 to 100 CFU/ml of plant extract. P. savastanoi was detected by the developed enrichment-PCR method in knots from different varieties of inoculated and naturally infected olive trees. Moreover, P. savastanoi was detected in symptomless stem tissues from naturally infected olive plants. This enrichment-PCR method is more sensitive and less cumbersome than the conventional isolation methods for detection of P. savastanoi.
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Affiliation(s)
- R Penyalver
- Departamento de Protección Vegetal y Biotecnología, Instituto Valenciano de Investigaciones Agrarias, 46113 Moncada, Valencia, Spain
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Bazzani C, Bertolini A, Casalgrandi L, Bertolini E, Balugani A, Fiore L, Guarini S. Adrenocorticotropin release is not involved in the nicotine-induced reversal of hemorrhagic shock in anesthetized rats. Pharmacology 1995; 50:34-9. [PMID: 7899478 DOI: 10.1159/000139264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
In a model of volume-controlled hemorrhagic shock causing the death of all control animals within 30 min, the intravenous injection of nicotine produced a rapid, sustained and dose-dependent restoration of cardiovascular and respiratory functions, with 60 and 100% survival 2 h after the administration of 3 and 12 micrograms/kg, respectively. An effect similar to that of the highest dose of nicotine were obtained with the intravenous bolus injection of ACTH(1-24) at the dose of 160 micrograms/kg. However, the ACTH plasma levels of hemorrhage-shocked rats treated with nicotine was not different from that of hemorrhage-shocked rats treated with saline, thus excluding the possibility that nicotine-induced shock reversal may be due to the massive release of ACTH. Since in rats pretreated with cycloheximide at a dose (20 mg/kg intraperitoneally) causing an 82% inhibition of protein synthesis, and then bled to hemorrhagic shock, the effect of nicotine was greatly reduced (only the dose of 50 micrograms/kg producing 100% survival 2 h after treatment), protein synthesis, however, seems to be important for the effect of nicotine in hemorrhagic shock, at least at the lowest doses.
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Affiliation(s)
- C Bazzani
- Department of Biomedical Sciences, University of Modena, Italy
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Bertolini A, Poggioli R, Bernardi M, Genedani S, Guarini S, Bazzani C, Arletti R, Benelli A, Bertolini E, Balugani A. [Endogenous anti-analgesic systems]. Clin Ter 1994; 145:183-98. [PMID: 7813164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Nociception is of vital importance for the organism, while its inhibition by endogenous opioid systems is usually a sign of surrender. Therefore, it must be assumed that endogenous analgesic systems are balanced, and in fact, under normal conditions, overwhelmed, by teleologically far more important anti-analgesic systems. The two main anti-analgesic systems--i.e., the melanotropinergic and the cholecystokininergic--are here reviewed for their role, not only in nociception, but in a wide variety of vital functions (endocrine, gastrointestinal, ingestive, reproductive, cardiovascular, immune, etc.). Available data strongly suggest that these systems (particularly the melanotropinergic one) play a key role in the overall homeostasis of the body. Moreover, modulation of endogenous anti-analgesic systems may disclose a new, unforeseen approach to the treatment of pain.
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Affiliation(s)
- A Bertolini
- Dipartimento di Scienze Biomediche, Università degli Studi di Modena
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Bazzani C, Bertolini E, Balugani A, Bertolini A, Guarini S. ACTH-induced reversal of hemorrhagic shock: further studies on the mechanism of action. Riv Eur Sci Med Farmacol 1994; 16:27-31. [PMID: 7761678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
In a rat model of extremely severe hemorrhagic shock, invariably leading to death within 30 min, the i.v. bolus injection of ACTH-(1-24) at the dose of 160 micrograms/kg produced a dramatic and sustained reversal of the shock condition, with normalization of mean arterial pressure, pulse pressure and respiratory rate, and with survival of all rats at the end of the observation period (2 h). Such effect was neither prevented nor reduced by the bilateral anesthetization of carotid bodies, suggesting that chemoreceptors of these structures are of no relevance in the complex mechanism of the ACTH-induced reversal of hemorrhagic shock.
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Affiliation(s)
- C Bazzani
- Institute of Pharmacology, University of Modena, Italy
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Abstract
Ursodeoxycholic acid has been used widely to dissolve cholesterol gallstones and more recently was shown to improve clinical symptoms and biochemical indices in different chronic liver diseases, including that associated with cystic fibrosis. We treated 10 cystic fibrosis patients (5 males, 5 females, age range 2-22 years) with pancreatic insufficiency and normal liver function with ursodeoxycholic acid 15-20 mg/kg/day. Seven patients had radiolucent gallstones (in 3 cases associated with biliary sludge) and 3 had sludge; all were asymptomatic. Before treatment, the gallbladder was well opacified in oral cholecystogram. The gallbladder was scanned by ultrasound in similar conditions and by the same operator before administration of ursodeoxycholic acid and after a median period of treatment of 16 months (range 11-32 months). During treatment, all patients remained asymptomatic and the relative proportion of ursodeoxycholic acid in duodenal bile increased from 4.7 +/- 3.2% at baseline to 34.7 +/- 8.6%. Complete or partial dissolution of gallstones was never observed and the maximum diameter of stones increased from a mean of 6.1 +/- 3.4 to 8.0 +/- 5.3 mm; in one case the development of biliary sludge occurred during bile acid therapy. Sludge disappeared in 1 of the 6 patients who initially had it, while in 2 cases its volume increased. We conclude that ursodeoxycholic acid is not effective in most CF patients with gallstones, probably because cholesterol is not the main component of stone or sludge.
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Affiliation(s)
- C Colombo
- Department of Pediatrics, Ospedale San Paolo, University of Milan, Italy
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Abstract
We retrospectively investigated anti-HCV prevalence in a series of 160 consecutive patients with primary biliary cirrhosis who presented between 1980 and 1989. Of these, 19 (12%) were positive for anti-HCV by C-100 ELISA. Serum IgG levels were significantly higher in anti-HCV-positive patients and correlated to optical density values. A serum sample was again collected from all the patients from the same series who were seen in 1990 for follow-up, after a median period of 32 months. Anti-HCV positivity was found to be substantially unchanged in this subgroup of patients when the freshly drawn blood samples were retested with C-100 ELISA, while it increased from 10% to 17% when second generation ELISA was used. Three of the C-100 ELISA positive samples were C-100 RIBA reactive, and six of the second generation ELISA positive samples were 4-RIBA reactive. The HCV genome was not detected in any of the seven anti-HCV C-100 ELISA and second generation ELISA positive sera which were studied by polymerase chain reaction, including four cases confirmed by 4-RIBA. Life expectancy, as determined by survival analysis, did not differ significantly between anti-HCV-positive and -negative patients. These findings suggest that anti-HCV positivity does not influence the clinical presentation and course of primary biliary cirrhosis.
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Affiliation(s)
- E Bertolini
- First Department of Medicine, School of Medicine S. Paolo, University of Milan, Italy
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Bazzani C, Tagliavini S, Bertolini E, Bertolini A, Guarini S. Influence of ACTH-(1-24) on metabolic acidosis and hypoxemia induced by massive hemorrhage in rats. Resuscitation 1992; 23:113-20. [PMID: 1321471 DOI: 10.1016/0300-9572(92)90196-j] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
In anesthetized rats, step-wise bleeding to a severe condition of hemorrhagic shock causes a decrease in arterial and venous pH and in venous PO2 and SO2 and an increase in arterial PO2 and in venous PCO2 and lactic acid. The intravenous bolus injection of ACTH-(1-24) (160 micrograms/kg)--which causes a rapid and sustained reversal of the shock condition--produces a gradual and almost complete recovery (within 60 min) of venous PO2, PCO2 and SO2; on the other hand, the normalization of blood pH and lactate is preceded by a further worsening during the first minutes after treatment. On the whole, these data are compatible with the ACTH-(1-24)-induced mobilization of the residual blood--which is pooled in poorly oxygenated tissues--and with the improved circulatory and respiratory functions.
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Affiliation(s)
- C Bazzani
- Institute of Pharmacology, University of Modena, Italy
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Bertolini E, Marelli F, Zermiani P, Battezzati PM, Zuin M, Moroni GA, Podda M. Antibodies to hepatitis C virus in primary biliary cirrhosis. Arch Virol Suppl 1992; 4:205-9. [PMID: 1333323 DOI: 10.1007/978-3-7091-5633-9_43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We investigated the prevalence of anti-HCV in 160 consecutive patients with primary biliary cirrhosis. By ELISA, 19 (12%) were positive, as compared to a 68% prevalence in 135 patients with chronic non-A, non-B hepatitis. Serum IgG levels were significantly higher in the anti-HCV positive group. By RIBA, seropositivity was confirmed for 4 patients, whereas 7 were indeterminate. A slight, non-significant reduction of life expectancy was found in anti-HCV positive patients. Until reliable and independent confirmatory tests become available, definitive conclusions on the importance of anti-HCV positivity in primary biliary cirrhosis are improper.
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Affiliation(s)
- E Bertolini
- Blood Transfusion Center, Ospedale S. Paolo, Milan, Italy
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Tagliavini S, Bertolini E, Bazzani C, Bertolini A, Guarini S. Influence of TRH on regional blood flow and metabolic acidosis in a model of volume-controlled hemorrhagic shock in rats. Neuropeptides 1991; 20:233-8. [PMID: 1812405 DOI: 10.1016/0143-4179(91)90013-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
In anesthetized rats, massive bleeding to a severe condition of hemorrhagic shock (invariably leading to death within 30 min) was obviously associated with a dramatic decrease in tissue blood flow and with profound modifications of several blood parameters leading to metabolic acidosis: decrease in arterial and venous pH, bicarbonate and BE, decrease in arterial pCO2 and in venous pO2 and SO2, increase in arterial pO2, venous pCO2 and venous lactate. The i.v. bolus injection of protirelin tartrate (TRH-T, 4 mg/kg), which produces a prompt and sustained reversal of the shock condition, caused a rapid increase in venous pO2, pCO2 and SO2; on the other hand, arterial and venous pH, bicarbonate and BE continued to decrease--and venous lactate to increase during the first few minutes after treatment. However venous pCO2 and lactate, as well as arterial and venous pH, returned to the pre-bleeding values within 60 min after treatment. The data are in keeping with the TRH-T-induced improvement of circulatory and respiratory functions, with mobilization of the residual blood from its capillary pooling and consequent immission of acid metabolites into the blood stream.
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Affiliation(s)
- S Tagliavini
- Institute of Pharmacology, University of Modena, Italy
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Crosignani A, Podda M, Battezzati PM, Bertolini E, Zuin M, Watson D, Setchell KD. Changes in bile acid composition in patients with primary biliary cirrhosis induced by ursodeoxycholic acid administration. Hepatology 1991. [PMID: 1959845 DOI: 10.1002/hep.1840140609] [Citation(s) in RCA: 78] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
We describe a detailed study of the effects of ursodeoxycholic acid administration on bile acid composition of the serum and bile of patients with primary biliary cirrhosis. Gas chromatography-mass spectrometry was used to analyze bile acids from 10 patients with primary biliary cirrhosis before and during ursodeoxycholic acid administration (500 mg/day, corresponding to approximately 8 mg/kg body wt), after group separation of the unconjugated and conjugated fractions by lipophilic anion exchange chromatography. These studies were directed at assessing whether the beneficial role of ursodeoxycholic acid in primary biliary cirrhosis was the consequence of a shift in the hydrophobic/hydrophilic balance of the bile acid pool and whether the hypercholeresis might result from the cholehepatic circulation of unconjugated ursodeoxycholic acid in bile. In basal conditions, the unconjugated bile acids accounted for only 5.5% and 2.5%, respectively, of the total bile acids of serum and bile; cholic acid was the major component of the conjugated fraction of serum and bile (56.0% +/- 4.0%, mean +/- S.E.M.), and ursodeoxycholic acid was present in only trace amounts. The conjugated fraction contained many unusual bile acids (representing 16.5% +/- 1.3% of total) including C25 bile acids, iso-chenodeoxycholic acid and several oxo-bile acids. After ursodeoxycholic acid administration biochemical indices of liver function all improved, but the proportions of the unconjugated bile acids in serum and bile did not significantly change.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- A Crosignani
- Department of Internal Medicine, University of Milan, Italy
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Crosignani A, Podda M, Bertolini E, Battezzati PM, Zuin M, Setchell KD. Failure of ursodeoxycholic acid to prevent a cholestatic episode in a patient with benign recurrent intrahepatic cholestasis: a study of bile acid metabolism. Hepatology 1991; 13:1076-83. [PMID: 2050325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
Ursodeoxycholic acid was administered to a patient with benign recurrent intrahepatic cholestasis to prevent cholestatic episodes. A detailed study of bile acid metabolism in this patient was carried out in the anicteric and icteric phases before and after ursodeoxycholic acid (750 mg/day) administration. Urinary, biliary and serum bile acids were measured by gas chromatography-mass spectrometry and by high-performance liquid chromatography techniques. During the anicteric phase the daily urinary excretion and serum concentrations of bile acids were within normal ranges, indicating normal hepatic uptake and secretion of bile acids during the cholestasis-free period. Only slight qualitative differences from normal individuals were observed; the relative proportions of deoxycholic acid in the bile and serum were higher, and 12-oxo-lithocholic acid was the predominant urinary bile acid. During the icteric phase a marked increase in the urinary excretion of primary bile acids and C-1, C-2, C-4 and C-6 hydroxylated metabolites was found. Serum bile acid concentrations increased before the rise in bilirubin, suggesting an acute disturbance in bile acid transport at the onset of the cholestatic attack. After ursodeoxycholic acid administration in the anicteric phase, bile became enriched with the exogenous bile acid, but little qualitative change was found in the other metabolites present in the urine, serum or bile during the anicteric or icteric phases. Prolonged administration of ursodeoxycholic acid failed to prevent recurrence of a cholestatic episode, suggesting that in benign recurrent intrahepatic cholestasis, oral ursodeoxycholic acid may be of little benefit in the treatment or prevention of cholestasis despite marked enrichment of the bile acid pool with this hydrophilic bile acid.
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Affiliation(s)
- A Crosignani
- Department of Internal Medicine, Ospedale S. Paolo, University of Milan, Italy
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Bertolini E, Zermiani P, Battezzati PM, Bruno S, Villa E, Manenti F, Marelli F, Moroni GA, Zuin M, Podda M. Lack of association between circulating HCV-RNA and anti-HCV positivity in primary biliary cirrhosis. Lancet 1991; 337:675-6. [PMID: 1672013 DOI: 10.1016/0140-6736(91)92491-j] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Zuin M, Petroni ML, Grandinetti G, Crosignani A, Bertolini E, Battezzati PM, Podda M. Comparison of effects of chenodeoxycholic and ursodeoxycholic acid and their combination on biliary lipids in obese patients with gallstones. Scand J Gastroenterol 1991; 26:257-62. [PMID: 1853147 DOI: 10.3109/00365529109025039] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
To study the effects of different bile acids on biliary lipids in obese patients with radiolucent gallstones, 12 subjects were given chenodeoxycholic acid (CDCA) at a dose of 15 mg/kg/day, ursodeoxycholic acid (UDCA) at a dose of 15 mg/kg/day, and an equimolar combination of the two (7.5 + 7.5 mg/kg/day) in accordance with a double-blind crossover design. Mean molar percentage of cholesterol and cholesterol saturation index corrected for urso-rich bile (CSI) decreased significantly with all three treatments, but the combination was more effective in decreasing the CSI than either of the two bile acids given alone (p less than 0.05). Bile became desaturated in 10 of 12 patients receiving the combination, in 4 of 12 receiving CDCA, and 3 of 12 receiving UDCA alone. Combination treatment was well tolerated since mild diarrhea and slight increase in transaminases were observed only in a few patients. We conclude that the combined administration of CDCA and UDCA in equimolar doses is the treatment of choice for dissolution of gallstones in obese patients.
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Affiliation(s)
- M Zuin
- Dept. of Internal Medicine, Ospedale S. Paolo, University of Milan, Italy
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Crosignani A, Battezzati PM, Setchell KD, Camisasca M, Bertolini E, Roda A, Zuin M, Podda M. Effects of ursodeoxycholic acid on serum liver enzymes and bile acid metabolism in chronic active hepatitis: a dose-response study. Hepatology 1991. [PMID: 1671665 DOI: 10.1002/hep.1840130222] [Citation(s) in RCA: 56] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The effect of ursodeoxycholic acid administration on liver function tests and on bile acid metabolism was investigated in 18 patients with chronic active hepatitis. Three different doses of ursodeoxycholic acid--250 mg, 500 mg and 750 mg--were administered daily to each patient for consecutive 2-mo periods. The order of doses was randomly assigned according to a replicated Latin-square design. A significant decrease in serum transaminases and gamma-glutamyl transpeptidase occurred with the lowest dose of ursodeoxycholic acid, which corresponded to 4 mg/kg body wt/day, and no further significant decrease with the higher doses was seen. Biliary bile acid composition was determined by high-performance liquid chromatography and gas chromatography-mass spectrometry. At entry the relative proportions of major bile acids were similar to those observed in normal individuals. During treatment the mean percentage of ursodeoxycholic acid in bile (22% with the 250 mg dose, 32% with the 500 mg dose and 34% with the 750 mg dose) was lower than values previously reported for patients with gallstones and normal liver function. The major bile acids were cholic, chenodeoxycholic and deoxycholic acids. A number of unusual bile acids were identified by gas chromatography-mass spectrometry, but these accounted for only 3% to 5% of the total and did not change during ursodeoxycholic acid therapy. No correlation between the improvement in liver function tests and the percentage of ursodeoxycholic acid in bile existed. These data suggest that even a slight enrichment of bile with ursodeoxycholic acid, as is attained with 250 mg/day, is effective in improving biochemical markers of liver function in patients with chronic active hepatitis.
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Affiliation(s)
- A Crosignani
- Department of Internal Medicine, Ospedale S. Paolo, University of Milan, Italy
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Abstract
In a rat model of volume-controlled hemorrhagic shock causing the death of all saline-treated animals within 30 min of treatment, the intravenous bolus injection of thyrotropin- releasing hormone tartrate (TRH-T) at the dose of 4 mg/kg induced the prompt and sustained disappearance of the ECG and EEG signs of heart and brain ischemia, along with the reversal of hypotension and respiratory depression and with 100% survival rate at the end of the 2 h observation period. These data confirm that, in a pre-terminal condition induced by massive hemorrhage, timely treatment with TRH-T will restore heart and brain perfusion to levels compatible with survival and with functional recovery from ischemia and maintain it at those levels for some hours.
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Affiliation(s)
- S Tagliavini
- Institute of Pharmacology, University of Modena, Italy
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46
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Abstract
Recent clinical studies have indicated that ursodeoxycholic acid (ursodiol), administered at dosages ranging between 10 and 15 mg/kg/day, improves liver function indices in both cholestatic and inflammatory chronic liver diseases. These dosages would be considered high for the use of ursodiol in gallstone dissolution therapy. To investigate the dose-response relationship to ursodiol administration, we planned a few studies in patients with primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC), and chronic hepatitis (CH). Patients with PBC were subdivided into two groups on the basis of their serum bilirubin values, with 2 mg/dl as the dividing line. Ursodiol was given at dosages of 250, 500, and 750 mg/day for consecutive periods of two months, the order of treatment being randomly assigned to each patient. The enrichment with ursodiol of biliary bile acids was similar in both PBC and CH and, within the PBC group, in both anicteric and icteric patients. Highly significant decreases in serum enzyme levels were observed in all groups with the 250 mg/day dose, corresponding to about 4-5 mg/kg/day. The two higher doses induced further improvements in serum enzyme levels, especially in patients with PBC, but no significant differences were found between the 500 and the 750 mg/day doses. The improvements were roughly proportional to the enrichment of conjugated biliary bile acids with ursodiol. Serum bilirubin levels, an important prognostic factor in PBC, were also significantly reduced by ursodiol administration in patients with initial serum levels higher than 2 mg/dl. The present study indicated that ursodiol is a potentially useful drug for chronic liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)
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Affiliation(s)
- M Podda
- Istituto di Medicina Interna, University of Milan, Italy
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