Introduction
The posterior transpedicular fixation technique is a standard procedure for stabilizing the injured thoracolumbar spine but the long-term results of this approach are controversial. ...Clear guidelines are missing and the literature shows complete disagreement regarding indications, approaches, surgical techniques, and type of fixation.
Material and method
The objective of this study is to investigate if the surgical treatment by posterior approach alone is always enough to prevent the late kyphotic deformity through the retrospective analysis of 219 patients affected with a thoracolumbar injury. Follow-up examinations included radiographic measurements of the sagittal index (SI) and the sagittal plane kyphosis (SPK).
Result
Results show that, at the follow-up, the SI remains almost stable after the surgical correction, while the SPK (which describes the eventual injury of the affected intervertebral disc) decreases indicating a progressive regional kyphotic deformity. Thus, in some cases posterior fixation alone is not sufficient for long-term spinal stabilization and often can be not effective to prevent the late kyphotic deformity.
•In the present study, we study what doses can determines direct cardiotoxic effects of 5-fluorouracil on rat cardiocytes.•We have found that 5-FU induced 50% growth inhibition at 72h with ...concentrations of 400μM on H9c2 cardiocytes.•We have found that the addition of Levofolinic Acid (LF) to 5-FU potentiated the growth inhibition induced by 5-FU.•The growth inhibition induced by 5-FU alone or in combination with LF in cardiocytes was paralleled by an increase of Tbars and end products of NO.•Our data suggest that 5-FU can also induce cardiocyte damage by oxidative stress.
Fluoropyrimidines are key agents for the treatment of gastrointestinal tract adenocarcinomas. The possible cardiotoxic effects in patients and occupationally exposed workers are multifactorial and remain a puzzle to solve for investigators. In the present study, we study what cell death pathways and what doses can determine direct cardiotoxic effects of 5-fluorouracil (5-FU) and doxorubicin (DOXO) on rat cardiocytes (H9c2) and a human colon adenocarcinoma (HT-29) cell line, already reported to be sensitive to 5-FU. We have found that 5-FU induced 50% growth inhibition (IC:50) at 72h with concentrations of 400μM and 4μM on H9c2 and HT-29, respectively. Moreover, we have found that the addition of Levofolinic Acid (LF) to 5-FU potentiated the growth inhibition induced by 5-FU. The growth inhibition induced by 5-FU alone or in combination with LF in cardiocytes was paralleled by an increase of thiobarbituric acid-reactive species (Tbars) and end products of nitric oxide (NO) suggesting the increase of the oxidative stress status in cardiocytes. Interestingly, these effects were strongly potentiated by the addition of LF, a biochemical modulator of 5-FU activity.
Our data suggest that agents such as 5-FU different from anthracyclines, conventionally related to the induction of cardiotoxic effects, can also induce cardiocyte damage paralleled by oxidative stress. The strategies based upon the use of scavengers could be used in order to prevent this effect.
: Several guidelines have been developed for the diagnosis, treatment and prevention of infectious diseases. Actually, evidence‐based clinical practice guidelines provide physicians and other health ...care professionals with scientific information about the most appropriate strategy for the management of these patients, in order to avoid unnecessary or inappropriate interventions. As medical technology rapidly increases and becomes more complex, clinical guidelines can help health care providers to assess current practices and integrate new technological advances. Since AIDS was first recognized nearly 20 years ago, remarkable progress has been made in improving the quality and duration of life for HIV+ patients. In this area, clinical guidelines have been developed to manage patient care, focusing on: antiretroviral therapy, prevention of opportunistic infections, and treatment of tuberculosis. The quality of the guideline is notable when appropriate methodologies are applied. Different methods for developing guidelines are evaluated here: Agency for Health Care Policy and Research (AHPCR) methodology is designed to produce evidence‐based guidelines that are valid, clinically applicable, and flexible. Finally, the problems associated with the implementation of guidelines for HIV‐related diseases and other infectious diseases are examined.
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