Biomedical subjects

Bruno Sposato

Publications and source records attributed to Bruno Sposato.

6 recordsLinked to original sources

PubMed2005

Neurotrophin system expression in human pulmonary carcinoid tumors.

Neurotrophin (NT) and NT receptor expression was assessed in 12 typical (TC) and 8 atypical (AC) human pulmonary carcinoids by Western blot and immunohistochemistry. TC and AC carcinoid express to different extent NT and NT receptor proteins. Nerve growth factor (NGF) was expressed by 83% of the TC but not by the AC carcinoids. Brain derived neurotrophic factor (BDNF) was expressed by 33 and 100% of TC and AC carcinoids, respectively. NT-3 was expressed by 58% of the TC and 38% of AC carcinoids. TC carcinoids express high affinity NT receptors while 50% of the AC carcinoids express the TrkB receptor. Our results demonstrate that NGF/TrkA and BDNF/TrkB signaling need to be considered as regulatory pathways that may address survival, differentiation and/or aggressiveness of human pulmonary carcinoids. Contrarily to the BDNF/TrkB, expression of the NGF/TrkA signaling may overcome aggressiveness of carcinoid cells. NTs may be useful as markers in the clinic.

Adult↗

PubMed2004

Pulmonary alveolar microlithiasis: report on 576 cases published in the literature.

BACKGROUND AND AIM OF THE WORK: Pulmonary alveolar microlithiasis (PAM) is a rare disease characterized by intra-alveolar calcium deposits. The etiology of the disease is still unknown and many authors have supposed that an inherited local enzymatic defect is responsible for calcium deposition. The present paper aimed to study the disorder throughout the world, emphasizing the diagnostic and therapeutic views. METHODS: All the papers published on this subject in the literature were reviewed. RESULTS: Cases studied were 576 and most of them came from Europe (42.7%) and Asia (40.6%). The countries involved were fifty-one and twelve of them were attributed with at least ten cases each (Bulgaria, France, Germany, India, Italy, Poland, Spain, Russia, Japan, Turkey, USA, ex-Yugoslavia). Symptoms were absent in more than half the patients; dyspnoea, cough and chest pain were reported in the other cases. Family history for the disease was found in one-third of the patients. Chest x-rays and computed tomography were so characteristic that they were enough to diagnose the disease even if microscopic evidence of the microliths into the alveoli was obtained in most cases (e.g. by biopsy, autopsy, bronchoalveolar lavage). Pulmonary tuberculosis or sarcoidosis were misdiagnosed in 88 cases out of the 576. The course of the disease was slow and patients usually died as a result of cardio-respiratory failure. CONCLUSIONS: This review of PAM has shown that the etiology of the disease is still unknown, it is widespread throughout the world and easy to diagnose; it develops slowly and therapy is ineffective except for lung transplantation.

Adolescent↗

PubMed2003

[Legionnaire's pneumonia with rhabdomyolysis and acute renal failure. A case report].

Legionella pneumophyla is the agent responsible of Legionnaire's disease. It appears as a severe pneumonia and often requires admission in Intensive Care Unit. In literature, renal failure is reported to occur in 15 percent of Legionnaire disease and this event induce a mortality over 50% of these cases. The authors describe a case of Legionnaire's pneumonia with respiratory failure, rhabdomyolysis and acute renal failure. Patient was a female, 61 yrs old, admitted to our hospital because of fever (38 degrees-38.5 degrees C), severe respiratory failure (pH = 7.49, PaCO2 = 23.1 mmHg, PaO2 = 56.7 mmHg), oliguria (< 200 ml/24 h); chest x-rays and computed tomography (TC) showed a pneumonia at right lower lobe. Among other things, in blood analysis was noted the following values: BUN = 47 mg/dl, creatinine = 2.1 mg/dl, Na+ = 133 mmol/L, Cl- = 97 mmol/L, Ca+ = 7.2 mg/dl, K+ = 5.8 mmol/L, AST = 213 U/L, ALT = 45 U/L, LDH = 1817 U/L, CPK = 16738 U/L, CPK-MB = 229 U/L, myoglobin > 4300 ng/ml., leucocyte count = 17,500/mmc (N = 92%, L = 3%, M = 5%), positive anti Legionella IgG and IgM (IgG > 1:64, IgM > 1:96), evidence of Legionella soluble antigen in the urine analysis. Therapy with clarytromicyne (500 mg b.i.d i.v.) and rifampicin (600 mg/die i.v.) was begun; computed tomography showed after six days an improvement of pulmonary lesion but, in the following days, health status and blood analysis got worse. Patient went on antibiotics and underwent haemotherapy (Hb: 8 gr/dl), haemodialysis because of acute renal failure but healthy status worse furthermore and she died on 18th days after admission. This case point out rhabdomyolysis with acute renal failure is suggestive for Legionnaire's disease and is associated with high rate of mortality.

Acute Kidney Injury↗

PubMed2002

[Nocturnal desaturation in chronic obstructive pulmonary disease].

Chronic obstructive pulmonary (COPD) patients with mild-moderate daytime hypoxia or normoxia (PaO2 > 60 mmHg) may also have transient oxygen desaturation during sleep. Revisiting literature, the authors consider various features of this condition: the prevalence, causes, diagnostic procedures, symptoms, predisposing factors, consequences and therapy. The conclusion is that isolated nocturnal oxygen desaturation in COPD patients is a pathologic condition not yet sufficiently cleared; it likely represents an intermediate step in the evolution of COPD to overt respiratory failure. Since negative outcomes are possible, nocturnal oxygen desaturation must be early put in evidence and then treated with suitable drugs, correct dietetic regimen, respiratory physiotherapy and nocturnal oxygen-therapy.

Aged↗

PubMedDate not supplied

Time intervals (3' or 5') between dose steps can influence methacholine challenge test.

Bronchial hyperresponsiveness (BHR) is a common feature in the majority of asthmatic subjects and methacholine is the most frequently used agent for the test. The influence of 3 or 5 min time intervals between doses steps in a double methacholine challenge test (MCH-3' or MCH-5') was investigated. Using the MCH-3' challenge, 52 intermittent asthmatics were classified as having moderate (BHR-M; 18 subjects), mild (BHR-m; 19 subjects), or bordeline (BHR-B; 15 subjects) BHR. The cumulative dose and the PD20FEV(1) were higher for MCH-5' compared with MCH-3' in BHR-m (p < 0.05) and BHR-B (p < 0.05) but not in the BHR-M group. Also the dose response slopes, FEV(1)% decline/cumulative methacholine dose, calculated for the two challenge tests were statistically different only in BHR-m (p < 0.05) and BHR-B (p < 0.01). At MCH-5', there were 16 subjects with BHR-M, 18 with BHR-m, 12 with BHR-B and 6 subjects with normal reactivity. Results may suggest that in the group of BHR-m and BHR-B subjects, at MCH-5' compared with MCH-3', the cumulative effect of the administered drug, quickly metabolized by cholinesterase, is not complete, thus leading to an incorrect estimation of bronchial hyperresponsiveness degree. It is hoped that time interval between doses be standardized to ensure maximum comparability within and between subjects in challenge tests.

Adult↗

PubMedDate not supplied

Reversibility test in the early stages of bronchial asthma.

In the early stages of bronchial asthma, it is frequent to find subjects with a positive history and an FEV1 or FEV1/FVC > 80% of the predicted value. This study investigated if the test of reversibility showed a reversible airway obstruction (RAO) in 291 subjects with the above clinical and functional features. Forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and expiratory flows (PEF, MEF50, FEF(25-75)) were registered before and 20 minutes after salbutamol administration (200 mcg by MDI). Of 291 subjects, FEV1 increased in 73 (25%) after bronchodilator > or = 12% compared to baseline; the number of subjects with a > or = 35% increase in MEF50 or FEF(25-75) were similar in terms of percentage (respectively, 29.2% and 29%), whereas those with increases in FVC (> or = 12%) and in PEF (> or = 15%) were significantly lower (respectively, 2.7% and 12.3%). The percentage of subjects with RAO (FEV1 increase after bronchodilator > or = 12%) was lower (12%) in the subgroup (108 subjects), with an MEF50 > or = 70% of the value predicted at the baseline assessment, and higher (36%) in the subjects of the subgroup (183 subjects) with an MEF50 < 70%. In conclusion, it is advisable to carry out reversibility tests in all subjects with symptoms indicative of asthma even if their functional tests are "normal" because in a considerable number of cases the RAO was found to confirm the suspected diagnosis and provided a more reliable classification of the disease.

Adrenergic beta-Agonists↗