1
|
Hemorrhagic Blister in an Infant. Dermatol Pract Concept 2023; 13:dpc.1304a200. [PMID: 37992366 PMCID: PMC10656160 DOI: 10.5826/dpc.1304a200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 11/24/2023] Open
|
2
|
New insights on acral peeling dermatoses: An overlooked skin manifestation during COVID-19 pandemic. J Eur Acad Dermatol Venereol 2023; 37:e449-e450. [PMID: 36514988 PMCID: PMC9877920 DOI: 10.1111/jdv.18815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/30/2022] [Indexed: 12/15/2022]
|
3
|
Florid cutaneous papillomatosis and acanthosis nigricans as cutaneous findings in a patient with ovarian carcinoma. J Cosmet Dermatol 2023. [PMID: 36892107 DOI: 10.1111/jocd.15699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/05/2023] [Accepted: 02/16/2023] [Indexed: 03/10/2023]
|
4
|
An unusual swelling of the fingers. Clin Rheumatol 2023; 42:307-309. [PMID: 36045305 DOI: 10.1007/s10067-022-06355-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
5
|
Branching Dilated Vessels: A Possible Trichoscopic Clue for Diagnosis of Erosive Pustular Dermatosis of the Scalp in Children. Skin Appendage Disord 2022; 8:482-485. [PMID: 36407645 PMCID: PMC9672863 DOI: 10.1159/000524650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 04/13/2022] [Indexed: 11/03/2023] Open
Abstract
Introduction Erosive pustular dermatosis of the scalp (EPDS) is an inflammatory scalp condition that usually affects the elderly, while only few cases have been reported in childhood. In children, it may mimic fungal or bacterial infections, especially kerion. Case Presentation We describe the usefulness of trichoscopy as a supportive diagnostic tool in 2 cases of pediatric EPDS. Discussion Clinical distinction between EPDS and different types of alopecia in children is difficult, with a significant likelihood of diagnostic errors and delay in therapy. Trichoscopy may provide a noninvasive option that can help avoid invasive diagnostic procedures in children.
Collapse
|
6
|
Ultrasound patterns of localized cutaneous leishmaniasis and clinical correlations. J Ultrasound 2022; 25:343-348. [PMID: 33527311 PMCID: PMC9148356 DOI: 10.1007/s40477-020-00537-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 10/22/2020] [Indexed: 11/24/2022] Open
Abstract
A single-center retrospective study reviewed the following sonographic features of 18 confirmed cases of localized cutaneous leishmaniasis to identify shared presentation patterns: echotexture, lesion borders, hypodermal involvement, soft-tissue changes, and vascular pattern. A second objective was to correlate these patterns with clinical characteristics, including sex, age, anatomical location, nodule vs. plaque presentation, raised borders, granulation tissue, swelling, hyperkeratotic crusting, disease onset, and healing time. Two main patterns were identified with high-frequency ultrasonography. The first pattern was characterized by a high level of inflammation and deep hypodermal involvement, while the second variant showed involvement limited to the dermis, with minimal inflammation. The "inflammatory pattern" showed ill-defined borders, mixed echotexture, prominent vascularity with central distribution, and was correlated with clinical signs of ulceration, granulation tissue, raised borders, and longer healing time (p < 0.05). The "pauci-inflammatory pattern" presented a well-defined structure with decreased echogenicity, reduced or absent vascularity with minimal soft-tissue changes, and was associated with a shorter healing time (p < 0.05).
Collapse
|
7
|
Guidelines for Vascular Anomalies by the Italian Society for the study of Vascular Anomalies (SISAV). INT ANGIOL 2022; 41:1-130. [PMID: 35546136 DOI: 10.23736/s0392-9590.22.04902-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
8
|
Abstract
Vulvar vitiligo (VV) and vulvar lichen sclerosus (VLS), both feature skin and mucosal hypo-/depigmentation. The aim of this study was to describe the clinical and dermoscopic features of VV and VLS in the pediatric population, providing diagnostic clues, and to define their association. We performed a systematic literature review of the clinical and dermoscopic features of pediatric VV and VLS. An observational study was conducted on children affected by VLS associated with VV, referred to the Dermatology Unit of the Sant'Orsola Polyclinic in Bologna, Italy. Medical history, age at diagnosis, ethnicity, clinical and dermoscopic features, and symptoms were recorded for all patients. 124 cases of VLS and 10 cases of VV were reviewed. Clinical manifestations included hypo-/depigmented patches in both conditions, while ecchymosis/purpura and fissures/erosion were observed in VLS. Symptoms including pruritus, pain, or burning were reported only by VLS patients. In our study five patients with VLS associated with VV were retrieved. Clinical features included well-demarcated depigmented patches in VV and translucent areas, erythema, ecchymoses/purpura, and labial fusion in VLS. Dermoscopy showed white structureless areas with a whipped cream-like appearance, linear or dotted vessels, white chrysalis-like structures, erosion and red-purpuric blotches in VLS and reduced pigment network or pigment absence, intralesional spots of residual pigmentation and telangiectasias in VV. Symptoms were present in all patients. Both VV and VLS show hypo-/depigmented patches. In the presence of associated symptoms, possible VLS should be investigated with clinical and dermoscopic examination to achieve a prompt diagnosis.
Collapse
|
9
|
An Unusual Case of Meyerson Phenomenon Around Infantile Hemangioma. Dermatol Pract Concept 2021; 11:e2021039. [PMID: 34414001 DOI: 10.5826/dpc.1103a39] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2020] [Indexed: 10/31/2022] Open
|
10
|
Therapeutic approaches and targets for treatment of autoimmune bullous diseases. Dermatol Ther 2021; 34:e15032. [PMID: 34145701 DOI: 10.1111/dth.15032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 06/14/2021] [Indexed: 01/22/2023]
Abstract
Autoimmune bullous diseases are a heterogeneous group of diseases characterized by the development of cutaneous and mucosal vesicles, blisters, and finally erosions. The common pathogenetic mechanism is the presence of autoantibodies targeting structural proteins of the skin and mucous membranes (demosomes and hemidesmosomes): in the case of pemphigus, the antigens are intraepidermal, whereas in the case of pemphigoid, dermatitis herpetiformis, and epidermolysis bullosa acquisita they are subepidermal. Mucosal involvement typically affects the oral and ocular mucosa, but in some cases, the upper airways or the upper digestive tract are affected. The burden on patients' lives could be severe due to the impairment of normal feeding or breathing. In other cases, they may represent paraneoplastic syndromes. Since autoimmune bullous diseases may result in significant morbidity and mortality, depending on the grade of cutaneous and mucosal involvement, a prompt therapeutic approach is mandatory and, in recalcitrant cases, may be challenging. The first line therapy consists of corticosteroids, both topical and systemic. Once remission or control of the acute phase is obtained, adjuvant therapies need to be introduced in order to spare the corticosteroid load and minimize side effects such as iatrogenic diabetes or osteoporosis. Herein, we describe all current therapeutic approaches to autoimmune bullous diseases, also including emerging therapies.
Collapse
|
11
|
Genitale Papeln bei einem Kind. J Dtsch Dermatol Ges 2021; 19:469-470. [PMID: 33709585 DOI: 10.1111/ddg.14188_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
12
|
Severe hidradenitis suppurativa in a patient affected by Hermansky-Pudlak Syndrome type 9: possible shared pathogenetic aspects. Ital J Dermatol Venerol 2021; 156:254-255. [PMID: 33423449 DOI: 10.23736/s2784-8671.20.06602-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
13
|
Infantile hemangioma with minimal or arrested growth and isolated spinal dysraphism: A new or underrecognized entity? Indian J Dermatol 2021; 66:559-561. [PMID: 35068518 PMCID: PMC8751710 DOI: 10.4103/ijd.ijd_267_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
14
|
Concomitant Onychomadesis and Skin Rash in a 3-Year-Old Child Affected by Hand, Foot, and Mouth Disease. Indian J Dermatol 2021; 66:106-108. [PMID: 33911309 PMCID: PMC8061493 DOI: 10.4103/ijd.ijd_325_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
|
15
|
Does ethnic psoriasis exist? Ital J Dermatol Venerol 2020; 156:617-618. [PMID: 33314898 DOI: 10.23736/s2784-8671.20.06834-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
16
|
Terra firma-forme dermatosis: a systematic review. Int J Dermatol 2020; 60:933-943. [PMID: 33280096 DOI: 10.1111/ijd.15301] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 09/12/2020] [Accepted: 10/15/2020] [Indexed: 02/03/2023]
Abstract
Terra firma-forme dermatosis (TFFD) is an acquired pigmentation disorder that promptly regresses after applying isopropyl alcohol 70%. The clinical presentation ranges from patches of brownish discoloration to velvety hyperkeratotic plaques. Critical analyses of current data are lacking, so etiologies, pathogenesis, and disease associations are still debated in the literature. A literature search was done in the PubMed and Google Scholar databases to identify the published papers reporting clinical cases of TFFD. Of 102 papers screened, 64 met the including criteria. Overall, the records of 256 patients presenting a mean age of 18.34 years and a female:male ratio of 1:37 were reviewed. The present article aims to provide a key point-summary regarding the clinical outcome, associated comorbidities, pathogenesis, histopathology, dermoscopy, and therapeutic modalities of TFFD.
Collapse
|
17
|
Aplasia cutis: clinical, dermoscopic findings and management in 45 children. J Eur Acad Dermatol Venereol 2020; 34:e724-e726. [PMID: 32346876 DOI: 10.1111/jdv.16542] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
18
|
Genital papules in a child. J Dtsch Dermatol Ges 2020; 19:469-470. [PMID: 32776638 DOI: 10.1111/ddg.14188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
19
|
Scalp hair whorl patterns in patients affected by Neurofibromatosis Type 1: A case-control study. Int J Trichology 2020; 12:56-61. [PMID: 32684676 PMCID: PMC7362971 DOI: 10.4103/ijt.ijt_25_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 03/14/2020] [Accepted: 03/21/2020] [Indexed: 11/04/2022] Open
Abstract
Background The hair whorl denotes the spiral disposition of hairs around an axis, which is determined by the follicle growing direction. Atypical variants of scalp hair patterns, identified by abnormally placed or multiple whorls, have been associated with early brain developmental disorders and several dysmorphic syndromes. Materials and Methods A 6-month case-control, prospective monocentric study included an overall number of 557 children. A logistic regression analysis was performed to evaluate the relationship between localization, the number of scalp hair whorls, and their association with neurofibromatosis type 1 (NF1). Results NF1 positively correlates with a frontal localization, whereas a negative association was found with a parietal whorl pattern (P < 0.001). Conclusion Evaluation of scalp whorls gains importance in the neonatal settings and may contribute to suspect the early diagnosis of NF1, as the related National Institutes of Health diagnostic criteria cannot be usually observed at an early age.
Collapse
|
20
|
Successful treatment of atypical mycobacteriosis of the scalp with photodynamic therapy. Dermatol Ther 2020; 33:e13338. [PMID: 32222018 DOI: 10.1111/dth.13338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 03/24/2020] [Indexed: 11/27/2022]
|
21
|
Pachydermodaktylie und Schilddrüsenerkrankung: Wo ist der Zusammenhang? J Dtsch Dermatol Ges 2019; 17:1287-1288. [PMID: 31885165 DOI: 10.1111/ddg.14000_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
22
|
|
23
|
Sonographic features of vaccination granulomas in children with delayed-type hypersensitivity to aluminum. Pediatr Dermatol 2019; 36:1012-1016. [PMID: 31475384 DOI: 10.1111/pde.13953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
In this article, we report the sonographic features of vaccination granulomas in three children sensitized to aluminum. Although the recognition of the vaccination granuloma relies on the clinical examination, misdiagnosis is frequent, leading to distressful procedures or prolonged antibiotic administration. In all our cases, sonography revealed a teardrop-shaped echogenic central structure, suggesting the deposition of aluminum crystals along the route of administration with consequent subcutaneous degenerative changes, and a surrounding hypoechoic cap, which reflects the changeable inflammatory reaction and the granuloma formation.
Collapse
|
24
|
Delayed hypersensitivity to natural rubber latex: Does it exist or not? Contact Dermatitis 2019; 81:404-405. [PMID: 31290999 DOI: 10.1111/cod.13353] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 07/09/2019] [Indexed: 11/29/2022]
|
25
|
Disseminate Recurrent Folliculitis and Hidradenitis Suppurativa Are Associated Conditions: Results From a Retrospective Study of 131 Patients With Down Syndrome and a Cohort of 12,351 Pediatric Controls. Dermatol Pract Concept 2019; 9:187-194. [PMID: 31384491 DOI: 10.5826/dpc.0903a03] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2019] [Indexed: 12/25/2022] Open
Abstract
Background Hidradenitis suppurativa (HS) is a chronic, inflammatory, recurrent skin disease of the pilosebaceous unit characterized by protean manifestations. Several studies have found an increased incidence and earlier presentation of this disease in patients carrying trisomy 21. Patients with Down syndrome (DS) have a higher risk of developing a wide range of cutaneous manifestations, including HS and chronic folliculitis. Recently, disseminate recurrent folliculitis (DRF) has been reported as an atypical monosymptomatic feature of HS at its onset. Objective To assess the prevalence of HS and DRF by comparing a cohort of patients carrying trisomy 21 vs pediatric controls. Methods A retrospective 2-year monocentric clinical study was performed by collecting clinical data of 131 patients with DS, aged 4-36 years, followed at the Dermatology Unit and Down Syndrome Regional Center of Bologna University. Data were matched with those coming from 12,351 pediatric controls. Results In DS patients, DRF and HS showed a prevalence of, respectively, 6.8% and 24.4%, while 5.3% of patients presented both diseases. In the control group the prevalence for HS+ and DRF+ was 0.5% and 1.2%, respectively, with a 0.14% of overlap cases. The association between HS and DRF proved to be statistically significant in both groups (P < 0.05). In the DS cohort the mean age of symptoms onset was 15.67 (SD: 2.29) years for HS and 13.11 (SD: 4.93) years for DRF. Buttocks were the most frequently affected body area for DRF followed by the inguinocrural area, while in HS buttocks were less frequently involved than groins and upper thighs. Conclusions Because of the later onset of HS, patients with DRF at an early age should be monitored for the possible onset of HS in the apocrine-bearing areas.
Collapse
|
26
|
Does chronic immunosuppressive therapy for autoimmune disease influence the risk of developing active tuberculosis? Dermatol Ther 2018; 32:e12777. [PMID: 30371983 DOI: 10.1111/dth.12777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/03/2018] [Accepted: 10/25/2018] [Indexed: 11/29/2022]
|
27
|
Skin and diabetes: an experts' opinion from the Italian diabetologists and dermatologists of the DiaDex group. GIORN ITAL DERMAT V 2018; 153:649-658. [DOI: 10.23736/s0392-0488.18.06080-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
|
28
|
|
29
|
Zoon's plasma cell balanitis: clinical and dermoscopic features in pediatric patients. Int J Dermatol 2018; 57:e142-e144. [DOI: 10.1111/ijd.14176] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2018] [Revised: 05/16/2018] [Accepted: 07/17/2018] [Indexed: 11/29/2022]
|
30
|
Multiple perianal ulcers due to suppositories. Australas J Dermatol 2018; 60:50-52. [PMID: 30039854 DOI: 10.1111/ajd.12888] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 06/16/2018] [Indexed: 11/30/2022]
Abstract
We report a case of long-standing inexplicable perianal ulcers. After exclusion of an inflammatory, infectious or neoplastic origin, a thorough personal history revealed that for many years the patient had been using analgesic suppositories containing indomethacin, caffeine, and prochlorperazine dimaleate, four to five times a week, for migraine. On stopping the suppositories, there was complete healing within 12 weeks. We hypothesize that vasoconstriction and vascular damage were the pathogenetic mechanisms behind the perianal ulcers.
Collapse
|
31
|
|
32
|
|
33
|
Syphilitic balanitis of Follmann. Ital J Dermatol Venerol 2018; 153:287-288. [PMID: 29564878 DOI: 10.23736/s0392-0488.17.05512-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
34
|
Primary cutaneous small/medium-sized pleomorphic T-cell lymphoproliferative disorder shows a common vascular pattern at dermoscopy. J Eur Acad Dermatol Venereol 2018; 32:e318-e321. [DOI: 10.1111/jdv.14872] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
35
|
Pigmented fungiform lingual papillae: dermoscopic and clinical features. J Eur Acad Dermatol Venereol 2018; 32:935-939. [DOI: 10.1111/jdv.14809] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 01/10/2018] [Indexed: 02/06/2023]
|
36
|
Extramedullary metastatic plasmacytoma in multiple myeloma. GIORN ITAL DERMAT V 2017; 153:741-743. [PMID: 29144100 DOI: 10.23736/s0392-0488.17.05687-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
37
|
An algorithm to improve the estimation accuracy of a non-invasive method for cardiac output measurement based on prolonged expiration. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2013; 2013:1823-6. [PMID: 24110064 DOI: 10.1109/embc.2013.6609877] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Cardiac output (CO) monitoring is important in the hemodynamic management of critically ill patients. In a previous study, a novel non-invasive technique for CO monitoring based on prolonged expiration was proposed. The novel method showed good agreement with thermodilution on stable mechanically ventilated patients; unstable patients were excluded. The aim of this study is to improve the outcome of the above mentioned method on hemodynamic unstable patients, requiring vasoactive medications, and showing marked cardiogenic oscillations on waveforms related to expired gases. This prospective study has been carried out on three cardiac surgery patients; eighteen CO measurements were performed on each patient, and these values were compared with data obtained by thermodilution. The designed and tested algorithm allowed to reach a good agreement between CO measured by our method and by thermodilution (e.g., the mean percentage differences were 4%, 11% and 3%). Even though further validation is necessary, the results are quite promising and the adopted solution appears to allow the suitability of the prolonged expiration method also on unstable patients.
Collapse
|
38
|
Prognostic value of Bcl-2 in breast cancer patients treated with neoadjuvant anthracycline-based chemotherapy. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
39
|
Predictive value of apoptosis, proliferation, HER-2, and topoisomerase IIα for anthracycline chemotherapy in locally advanced breast cancer. Breast Cancer Res Treat 2005; 92:69-75. [PMID: 15980993 DOI: 10.1007/s10549-005-1721-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
PURPOSE Laboratory evidence indicates that tumor growth depends on the balance between cell proliferation and cell death, and many anticancer agents may exert their therapeutic effect by decreasing proliferation and increasing apoptosis. Additionally, clinical observations indicate that overexpression of HER-2 or topoisomerase IIalpha (topo IIalpha) may be predictors of better response to anthracyclines in breast cancer. The objective of this study was to determine if proliferation (Ki-67), apoptosis (TUNEL), and expression of HER-2 and topo IIalpha are affected by anthracycline treatment, and if these molecular markers predict anthracycline responsiveness. EXPERIMENTAL DESIGN Thirty-three women with primary breast tumors > or =3 cm received either doxorubicin (75 mg/m(2)) or epirubicin (120 mg/m(2)) for 4 cycles before surgery. Clinical response was evaluated after 4 cycles of treatment. Changes in molecular markers were assessed from core needle taken before treatment (D0), at 24-48 h (Dl) and on day 7 (D7) while on treatment, and from the surgical specimen excised on day 84 (D84) after the fourth cycle of chemotherapy. RESULTS The overall response rate was 51% (17 of 33 patients), with a 12% complete clinical response rate (4 of 33 patients). There were trends for tumors with higher apoptosis and topo IIalpha at baseline (D0) to be more responsive to anthracyclines, p = 0.1 and p = 0.08, respectively. Median apoptosis increased from D0 to Dl (p = 0.06) while median Ki-67 decreased (p = 0.07). Overall, expression of HER-2 remained stable throughout the chemotherapy administration. By Day 84, topo IIalpha had significantly decreased from baseline in responders, while it increased in non-responders, p = 0.03. CONCLUSIONS In human primary breast cancer, anthracycline treatment causes an early increase in apoptosis and a decrease in proliferation. In this pilot study, higher apoptosis and topo IIalphaa levels in primary tumors were associated with greater responsiveness to anthracyclines, and topo IIalpha levels declined in responsive tumors.
Collapse
MESH Headings
- Adult
- Aged
- Antibiotics, Antineoplastic/pharmacology
- Antibiotics, Antineoplastic/therapeutic use
- Antigens, Neoplasm/biosynthesis
- Apoptosis/drug effects
- Biomarkers, Tumor/biosynthesis
- Breast Neoplasms/drug therapy
- Breast Neoplasms/pathology
- Breast Neoplasms/physiopathology
- Carcinoma, Ductal, Breast/drug therapy
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/physiopathology
- Carcinoma, Lobular/drug therapy
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/physiopathology
- Cell Proliferation/drug effects
- DNA Topoisomerases, Type II/biosynthesis
- DNA-Binding Proteins/biosynthesis
- Doxorubicin/pharmacology
- Doxorubicin/therapeutic use
- Epirubicin/pharmacology
- Epirubicin/therapeutic use
- Female
- Genes, erbB-2/physiology
- Humans
- Middle Aged
- Neoplasm Staging
- Pilot Projects
- Predictive Value of Tests
Collapse
|