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Russo F, Giampetruzzi AR, Pilla MA, De Pità O, Camela E. Revolutionizing the management of patients with atopic dermatitis: practical considerations. Expert Opin Biol Ther 2024; 24:213-215. [PMID: 38523270 DOI: 10.1080/14712598.2024.2334380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Accepted: 03/20/2024] [Indexed: 03/26/2024]
Affiliation(s)
- Filomena Russo
- Department of Dermatology, IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | | | | | - Ornella De Pità
- Department of Dermatology, IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
| | - Elisa Camela
- Department of Dermatology, IDI-IRCCS, Dermatological Research Hospital, Rome, Italy
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Picozza M, Cristofoletti C, Bresin A, Fioretti M, Sambucci M, Scala E, Monopoli A, Cantonetti M, Pilla MA, Accetturi MP, Borsellino G, D’Atri S, Caprini E, Russo G, Narducci MG. Genetically driven CD39 expression affects Sezary cell viability, IL-2 production and detects two patient subsets with distinct prognosis. J Invest Dermatol 2022; 142:3009-3019.e9. [DOI: 10.1016/j.jid.2022.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 03/29/2022] [Accepted: 04/14/2022] [Indexed: 12/15/2022]
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Provini A, Ruggeri S, Mazzanti C, Pilla MA, Ricci F, Panebianco A, Abeni D, Fania L. Successful treatment of two cases of perianal Bowen disease with photodynamic therapy followed by imiquimod cream. Dermatol Ther 2020; 33:e13759. [PMID: 32495969 DOI: 10.1111/dth.13759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 05/27/2020] [Accepted: 05/30/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Alessia Provini
- First Dermatology Unit, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | - Salvatore Ruggeri
- First Dermatology Unit, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | - Cinzia Mazzanti
- First Dermatology Unit, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | | | - Francesca Ricci
- Laboratory of Dermatopathology, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | | | - Damiano Abeni
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
| | - Luca Fania
- First Dermatology Unit, Istituto Dermopatico dell'Immacolata-IRCCS, Rome, Italy
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Fania L, Morelli M, Scarponi C, Mercurio L, Scopelliti F, Cattani C, Scaglione GL, Tonanzi T, Pilla MA, Pagnanelli G, Mazzanti C, Girolomoni G, Cavani A, Madonna S, Albanesi C. Paradoxical psoriasis induced by TNF-α blockade shows immunological features typical of the early phase of psoriasis development. J Pathol Clin Res 2019; 6:55-68. [PMID: 31577850 PMCID: PMC6966707 DOI: 10.1002/cjp2.147] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2019] [Revised: 09/17/2019] [Accepted: 09/19/2019] [Indexed: 12/11/2022]
Abstract
Immunomodulation with anti‐TNF‐α is highly effective in the treatment of various immune‐mediated inflammatory diseases, including hidradenitis suppurativa (HS). However, this may be responsible for unexpected paradoxical psoriasiform reactions. The pathogenic mechanisms underlying the induction of these events are not clear, even though the involvement of innate immune responses driven by plasmacytoid dendritic cells (pDC) has been described. In addition, the genetic predisposition to psoriasis of patients could be determinant. In this study, we investigated the immunological and genetic profiles of three HS patients without psoriasis who developed paradoxical psoriasiform reactions following anti‐TNF‐α therapy with adalimumab. We found that paradoxical psoriasiform skin reactions show immunological features common to the early phases of psoriasis development, characterized by cellular players of innate immunity, such as pDC, neutrophils, mast cells, macrophages, and monocytes. In addition, IFN‐β and IFN‐α2a, two type I IFNs typical of early psoriasis, were highly expressed in paradoxical skin reactions. Concomitantly, other innate immunity molecules, such as the catheledicin LL37 and lymphotoxin (LT)‐α and LT‐β were overproduced. Interestingly, these innate immunity molecules were abundantly expressed by keratinocytes, in addition to the inflammatory infiltrate. In contrast to classical psoriasis, psoriasiform lesions of HS patients showed a reduced number of IFN‐γ and TNF‐α‐releasing T lymphocytes. On the contrary, IL‐22 immunoreactivity was significantly augmented together with the IL‐36γ staining in leukocytes infiltrating the dermis. Finally, we found that all HS patients with paradoxical reactions carried allelic variants in genes predisposing to psoriasis. Among them, SNPs in ERAP1, NFKBIZ, and TNFAIP genes and in the HLA‐C genomic region were found.
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Affiliation(s)
- Luca Fania
- Laboratory of Experimental Immunology and 1st Dermatology Division, IDI-IRCCS, Rome, Italy
| | - Martina Morelli
- Laboratory of Experimental Immunology and 1st Dermatology Division, IDI-IRCCS, Rome, Italy.,Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy
| | - Claudia Scarponi
- Laboratory of Experimental Immunology and 1st Dermatology Division, IDI-IRCCS, Rome, Italy
| | - Laura Mercurio
- Laboratory of Experimental Immunology and 1st Dermatology Division, IDI-IRCCS, Rome, Italy
| | - Fernanda Scopelliti
- Istituto Nazionale per la promozione della salute delle popolazioni Migranti ed il contrasto delle malattie della Povertà, INMP, Rome, Italy
| | - Caterina Cattani
- Istituto Nazionale per la promozione della salute delle popolazioni Migranti ed il contrasto delle malattie della Povertà, INMP, Rome, Italy
| | - Giovanni Luca Scaglione
- Laboratory of Experimental Immunology and 1st Dermatology Division, IDI-IRCCS, Rome, Italy.,Laboratory of Molecular Oncology, "Giovanni Paolo II" Foundation, Catholic University of Sacred Heart, Campobasso, Italy
| | - Tiziano Tonanzi
- Laboratory of Experimental Immunology and 1st Dermatology Division, IDI-IRCCS, Rome, Italy
| | - Maria Antonietta Pilla
- Laboratory of Experimental Immunology and 1st Dermatology Division, IDI-IRCCS, Rome, Italy
| | - Gianluca Pagnanelli
- Laboratory of Experimental Immunology and 1st Dermatology Division, IDI-IRCCS, Rome, Italy
| | - Cinzia Mazzanti
- Laboratory of Experimental Immunology and 1st Dermatology Division, IDI-IRCCS, Rome, Italy
| | - Giampiero Girolomoni
- Section of Dermatology, Department of Medicine, University of Verona, Verona, Italy
| | - Andrea Cavani
- Istituto Nazionale per la promozione della salute delle popolazioni Migranti ed il contrasto delle malattie della Povertà, INMP, Rome, Italy
| | - Stefania Madonna
- Laboratory of Experimental Immunology and 1st Dermatology Division, IDI-IRCCS, Rome, Italy
| | - Cristina Albanesi
- Laboratory of Experimental Immunology and 1st Dermatology Division, IDI-IRCCS, Rome, Italy
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Fania L, Di Zenzo G, Didona B, Pilla MA, Sobrino L, Panebianco A, Mazzanti C, Abeni D. Increased prevalence of diabetes mellitus in bullous pemphigoid patients during the last decade. J Eur Acad Dermatol Venereol 2017; 32:e153-e154. [PMID: 29055144 DOI: 10.1111/jdv.14649] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Affiliation(s)
- L Fania
- Istituto Dermopatico dell'Immacolata-IRCCS, FLMM, Rome, Italy
| | - G Di Zenzo
- Istituto Dermopatico dell'Immacolata-IRCCS, FLMM, Rome, Italy
| | - B Didona
- Istituto Dermopatico dell'Immacolata-IRCCS, FLMM, Rome, Italy
| | - M A Pilla
- Istituto Dermopatico dell'Immacolata-IRCCS, FLMM, Rome, Italy
| | - L Sobrino
- Istituto Dermopatico dell'Immacolata-IRCCS, FLMM, Rome, Italy
| | - A Panebianco
- Istituto Dermopatico dell'Immacolata-IRCCS, FLMM, Rome, Italy
| | - C Mazzanti
- Istituto Dermopatico dell'Immacolata-IRCCS, FLMM, Rome, Italy
| | - D Abeni
- Istituto Dermopatico dell'Immacolata-IRCCS, FLMM, Rome, Italy
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Lombardo GA, Pilla MA, Benucci R, Monopoli A, Baliva G, Gobello T, Di Zenzo G, Zambruno G, Guerra L. Paraneoplastic Epidermolysis Bullosa Acquisita Associated with Thyroid Carcinoma. Acta Derm Venereol 2016; 96:414-5. [PMID: 26303980 DOI: 10.2340/00015555-2219] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Fortes C, Mastroeni S, Boffetta P, Antonelli G, Pilla MA, Bottà G, Anzidei P, Venanzetti F. The protective effect of coffee consumption on cutaneous melanoma risk and the role of GSTM1 and GSTT1 polymorphisms. Cancer Causes Control 2013; 24:1779-87. [PMID: 23860951 DOI: 10.1007/s10552-013-0255-4] [Citation(s) in RCA: 17] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 06/24/2013] [Indexed: 01/12/2023]
Abstract
PURPOSES The authors examined the association between coffee consumption and cutaneous melanoma and the implication of GSTM1 and GSTT1 polymorphisms. METHODS A hospital-based case-control study was conducted in the inpatient wards of IDI-San Carlo Rome, Italy, including 304 incident cases of cutaneous melanoma and 305 controls. Information on socio-demographic characteristics, medical history, smoking, sun exposure, pigmentary characteristics and diet was collected for all subjects. Within the study, individual patterns at two polymorphic genes (GSTM1 and GSTT1) belonging to glutathione S-transferases family were investigated in 188 cases of cutaneous melanoma and 152 controls. Logistic regression was the method used to estimate odds ratio and 95 % confidence intervals. RESULTS High frequency of coffee drinking (>once daily), compared with low-frequency consumption of coffee (≤7 times weekly) was associated with a protective effect for cutaneous melanoma (OR 0.46; 95 % CI 0.31-0.68) after adjusting for sex, age, education, hair colour, common nevi, skin phototype, and sunburn episodes in childhood. When stratified by GSTM1 and GSTT1 genotype, the protective effect of coffee was extremely high for subjects with both GSTM1 and GSTT1 null polymorphisms (OR 0.01; 95 % CI 0.0003-0.54). CONCLUSIONS Our results show a protective effect of coffee consumption for cutaneous melanoma, in particular for those with homozygous deletion for GSTM1 and GSTT1.
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Affiliation(s)
- Cristina Fortes
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata, IDI-IRCSS, Via dei Monti di Creta, 104, 00167, Rome, Italy,
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Fortes C, Mastroeni S, Pilla MA, Antonelli G, Lunghini L, Aprea C. The relation between dietary habits and urinary levels of 3-phenoxybenzoic acid, a pyrethroid metabolite. Food Chem Toxicol 2012; 52:91-6. [PMID: 23146693 DOI: 10.1016/j.fct.2012.10.035] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 10/08/2012] [Accepted: 10/25/2012] [Indexed: 11/28/2022]
Abstract
Concerns about pesticide exposure through food consumption have increased during the past several years. Pyrethroids are applied as insecticides throughout the world. Human metabolism of pyrethroids results in urinary metabolites that are suitable for biological monitoring. The objective of our study was to investigate the relation between food consumption and urinary levels of 3-phenoxybenzoic acid (3-PBA), a general metabolite of pyrethroids, in a non-occupational exposed adult population from the IDI-IRCCS, Rome, Italy. Information on socio-demographic characteristics, smoking, diet and self-reported household pesticide exposure was collected. Urinary 3-PBA level of each subject was measured and adjusted by urinary creatinine. We found that people consuming both raw and cooked vegetables five times weekly or more had higher mean levels of 3-PBA in urine (1.03 μg/g creatinine versus 0.52 μg/g creatinine; p=0.009 and 0.99 μg/g creatinine versus 0.58 μg/g creatinine; p=0.01, respectively) than subjects consuming less than five times weekly. In a multivariate model, after adjusting for age, sex, BMI, smoking and household insecticide exposure, high intake of raw vegetables (OR: 5.31; 95%CI: 1.32-21.3) and high intake of cooked vegetables, in particular cruciferous (OR: 4.67; 95%CI: 1.07-20.5) and leafy vegetables (OR: 6.88; 95%CI: 1.50-31.7), were associated with high urine 3-PBA levels (≥0.70 μg/g creatinine). The results of this study suggest that part of the variation in pyrethrois intake is explained by vegetable intake.
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Affiliation(s)
- C Fortes
- Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Roma, Italy.
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Fortes C, Mastroeni S, Bakos L, Antonelli G, Alessandroni L, Pilla MA, Alotto M, Zappalà A, Manoorannparampill T, Bonamigo R, Pasquini P, Melchi F. Identifying individuals at high risk of melanoma: a simple tool. Eur J Cancer Prev 2010; 19:393-400. [DOI: 10.1097/cej.0b013e32833b492f] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
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Scala E, Abeni D, Pomponi D, Narducci MG, Lombardo GA, Mari A, Frontani M, Picchio MC, Pilla MA, Caprini E, Russo G. The role of 9-O-acetylated ganglioside D3 (CD60) and {alpha}4{beta}1 (CD49d) expression in predicting the survival of patients with Sezary syndrome. Haematologica 2010; 95:1905-12. [PMID: 20663947 DOI: 10.3324/haematol.2010.026260] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND Sézary syndrome is a rare and very aggressive leukemic variant of cutaneous T-cell lymphoma characterized by extensive skin involvement and a malignant circulating CD4(+) T-cell clone which homes to the skin, over-expresses CD60, and lacks CD7, CD26 and CD49d. So far prognostic markers in this disease are limited to treatment with systemic steroids, age, serum lactate dehydrogenase, and a white blood cell count of 20×10(9)/L or higher: no other biological marker with prognostic value, especially related to malignant cells, has been described. DESIGN AND METHODS We used flow activated cell sorting analysis to compare the distribution of the T-cell receptor-Vβ repertoire and several surface molecules (CD7, CD26, CD49d and CD60) within the circulating CD4(+) T-cell population in 62 patients with Sézary syndrome, 180 with mycosis fungoides, 6 with B-cell lymphomas, and 19 with chronic eczema. We calculated the 5-year overall survival of patients with Sézary syndrome after first hospital admission using Kaplan-Meier product-limit estimates and hazard ratios from the Cox proportional hazards model. RESULTS We found that both higher number of CD60(+) and lower number of CD49d(+) cells within circulating CD4(+) T cells at disease presentation were significantly associated with a lower probability of survival. An exceedingly high risk of death was observed for patients with a combination of a high proportion of CD4(+)CD60(+) cells (≥ 0.5×10(9)/L) and low proportion of CD4(+)CD49d(+) cells (<0.5×10(9)/L) (hazard ratio = 12.303, 95% confidence interval 1.5-95.9; P<0.02). In addition, a skewed usage of T-cell receptor-Vβ subfamilies was observed in the circulating T-cell clone for 61.9% of all patients with Sézary syndrome, T-cell receptor-Vβ 2 and 5.1 subfamilies being the most frequently represented (42.8%), followed by T-cell receptor-Vβ 12 and 13.1. CONCLUSIONS In this study we showed that up-regulation of CD60 and down-regulation of CD49d on circulating CD4(+) T cells are two useful markers for predicting a very poor outcome in patients with Sézary syndrome.
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Affiliation(s)
- Enrico Scala
- Center for Molecular Allergology, IDI-IRCCS, Via dei Monti di Creta 104, I-00167 Rome, Italy.
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Fortes C, Mastroeni S, Melchi F, Pilla MA, Antonelli G, Camaioni D, Alotto M, Pasquini P. A protective effect of the Mediterranean diet for cutaneous melanoma. Int J Epidemiol 2008; 37:1018-29. [PMID: 18621803 DOI: 10.1093/ije/dyn132] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Many studies have investigated the Mediterranean diet as a risk factor for cancer, none of which has included cutaneous melanoma. The latter is usually fatal, rendering knowledge about prevention extremely important. We assessed the role of some food components of the Mediterranean diet and cutaneous melanoma. METHODS A hospital-based case-control study was conducted in the inpatient wards of IDI-San Carlo Rome, Italy including 304 incident cases of cutaneous melanoma and 305 controls, frequency matched to cases. Information on socio-demographic characteristics, medical history, smoking, sun exposure, pigmentary characteristics and diet was collected. Logistic regression was the method used to estimated odds ratio and 95% CIs. RESULTS After careful control for several sun exposure and pigmentary characteristics, we found a protective effect for weekly consumption of fish (OR, 0.65, 95%CI = 0.43-0.97), shellfish (OR, 0.53, 95%CI = 0.31-0.89), fish rich in n-3 fatty acids (OR, 0.52, 95%CI = 0.34-0.78), daily tea drinking (OR, 0.42, 95%CI, 0.18-0.95; P(trend) = 0.025) and high consumption of vegetables (OR, 0.50, 95%CI = 0.31-0.80, P(trend) = 0.005) in particular carrots, cruciferous and leafy vegetables and fruits (OR, 0.54, 95%CI =0.33-0.86, P(trend) = 0.013), in particular citrus fruits. No association was found for alcohol consumption and any other food items. CONCLUSION Overall, our findings suggest that some dietary factors present in the Mediterranean diet might protect from cutaneous melanoma.
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Affiliation(s)
- C Fortes
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata, IDI-IRCCS, Via dei Monti di Creta, 104, 00167 Rome, Italy.
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Fortes C, Mastroeni S, Melchi F, Pilla MA, Alotto M, Antonelli G, Camaione D, Bolli S, Luchetti E, Pasquini P. The association between residential pesticide use and cutaneous melanoma. Eur J Cancer 2007; 43:1066-75. [PMID: 17331713 DOI: 10.1016/j.ejca.2007.01.013] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [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: 11/08/2006] [Revised: 12/13/2006] [Accepted: 01/02/2007] [Indexed: 10/23/2022]
Abstract
Occupational pesticide exposure has been linked to cutaneous melanoma in epidemiological studies. We studied the association between cutaneous melanoma and the residential use of pesticides. This is a case-control study of cutaneous melanoma (287 incident cases; 299 controls). Data on pesticide use was obtained with a standardised interview. An increased risk of melanoma was found for high use (4 times annually) of indoor pesticides (odds ratio (OR)=2.18; 95% confidence intervals (CI) 1.07-4.43) compared to low use (1 times annually), after adjustment for sex, age, education, sun exposure and pigmentary characteristics. Subjects exposed for 10 years or more had two and a half times the risk (OR=2.46; 95% CI 1.23-4.94) of those exposed for less than 10 years. A dose response was observed for the intensity of pesticides use (p(trend)=0.027). The results indicate that residential pesticide exposure may be an independent risk factor for cutaneous melanoma.
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Affiliation(s)
- Cristina Fortes
- Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata (IDI-IRCCS), Via dei Monti di Creta, 104, 00167 Rome, Italy.
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Pilla MA. Blood transfusions in critical care. N Engl J Med 1999; 341:123; author reply 124. [PMID: 10409022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Tobias MD, Wambold D, Pilla MA, Greer F. Differential effects of serial hemodilution with hydroxyethyl starch, albumin, and 0.9% saline on whole blood coagulation. J Clin Anesth 1998; 10:366-71. [PMID: 9702614 DOI: 10.1016/s0952-8180(98)00034-8] [Citation(s) in RCA: 55] [Impact Index Per Article: 2.1] [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: 02/08/2023]
Abstract
STUDY OBJECTIVES To determine by thrombelastography assessed coagulation, the effects of progressive hemodilution with three intravascular volume expanders. DESIGN Prospective, controlled, whole blood, volumetric ex vivo hemodilution study. SETTING University of Pennsylvania Medical Center Operating Rooms. PATIENTS 60 ASA physical status I and II patients; phlebotomy prior to administration of IV fluids or medications. INTERVENTIONS Analysis of whole blood clotting determined by six thrombelastographic channels for control and five volumetric hemodilutions (11%, 25%, 33%, 50%, and 75%) with 0.9% saline, 5% albumin, and 6% hydroxyethyl starch (n = 20 for each diluent group). MEASUREMENTS AND MAIN RESULTS Thrombelastographic parameters R (minutes), angle alpha (degree), MA (mm), and lysis (%) were measured and compared to the sample control for each dilution of the same specimen. There was no significant difference between control groups in any thrombelastographic variable (R, angle alpha, MA, or lysis). No changes were seen in any variable from any diluent at 11% hemodilution. Seventy-five percent hemodilution caused significantly hypocoagulable changes from control for all thrombelastographic parameters for all three diluents. Thrombelastographic indices differed significantly from controls at intermediate hemodilutions. Both colloids caused decreases in measured angle alpha and MA at lower hemodilution than did 0.9% saline. Albumin 5% caused significant hypocoagulable changes from control values at lower hemodilution than did either 0.9% saline or 6% hydroxyethyl starch for all thrombelastographic parameters. Saline 0.9% increased angle alpha significantly at 50% hemodilution. Abnormal lysis did not occur at any dilution. Differing ex vivo effects of three different intravascular fluids thrombelastography assessed coagulation are found. CONCLUSION No differences were found after 11% hemodilution with any volume expanders. Hemodilution with up to 50% saline maintained thrombelastographic indices. Albumin produced early and profound hypocoagulable effects. Significant hypocoagulability occurred for all three diluents at 75% hemodilution. The study supports the use of albumin in patients at risk for thrombosis, and saline in patients with a need for normal hemostasis.
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Affiliation(s)
- M D Tobias
- Department of Anesthesia, Hospital of the University of Pennsylvania, Philadelphia 19102, USA
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Pala S, Risi R, Zicari L, Dianzani C, Pilla MA, Orru A, Gentile G, Mansi A, Petronio M, Chiarini F. [Clinico-diagnostic considerations on various cases of lymphogranuloma venereum]. MINERVA UROL NEFROL 1996; 48:103-7. [PMID: 8815554] [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: 02/02/2023]
Abstract
The authors report some recently observed cases of lymphogranuloma venereum and focus their attention on the complex approach to clinical and laboratory diagnosis. Furthermore they underline the importance and the spread of this disease in new geographical area, such as Europe.
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Affiliation(s)
- S Pala
- Istituto di Clinica Dermatologica, Università degli Studi di Roma, La Sapienza, Roma
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Abstract
Lidocaine in the epidural space, through inhibitory effects upon coagulation, may contribute to inefficacy of epidural autologous blood patch (EBP). This study was undertaken to evaluate the effect of achievable epidural concentrations of lidocaine on blood coagulation as a step in testing this hypothesis. Ex vivo blood coagulation using whole blood (n = 20) was studied with computerized thrombelastography (TEG). Each blood specimen was exposed to serial dilutions of lidocaine hydrochloride or saline to form end-concentrations of 0.0 mM, 2.3 mM, 4.6 mM, 9.2 mM, 18.5 mM, and 36.9 mM lidocaine. Statistical analysis using analysis of variance for repeated measures revealed that the three highest lidocaine concentrations tested caused hypocoagulable and/or fibrinolytic changes as compared with controls. Achievable epidural admixtures of lidocaine and whole blood will impair coagulation. Therefore, residual lidocaine in the epidural space may contribute to failures of immediate or early EBP.
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Affiliation(s)
- M D Tobias
- Department of Anesthesia, University of Pennsylvania School of Medicine, Philadelphia, USA
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