One-Lung Ventilation and Postoperative Pulmonary Complications After Major Lung Resection Surgery. A Multicenter Randomized Controlled Trial.

Objectives: The effect of one-lung ventilation (OLV) strategy based on low tidal volume (TV), application of positive end-expiratory pressure (PEEP), and alveolar recruitment maneuvers (ARM) to reduce postoperative acute respiratory distress syndrome (ARDS) and pulmonary complications (PPCs) compared with higher TV without PEEP and ARM strategy in adult patients undergoing lobectomy or pneumonectomy has not been well established.

Design: Multicenter, randomized, single-blind, controlled trial.

Setting: Sixteen Italian hospitals.

Effectiveness and Tolerability of Repeated Courses of Viscosupplementation in Symptomatic Hip Osteoarthritis: A Retrospective Observational Cohort Study of High Molecular Weight Medium Molecular Weight Hyaluronic Acid No Viscosupplementation.

Nonsurgical management of symptomatic hip osteoarthritis needs real-world evidence. We evaluated the effectiveness and tolerability of US-guided intra-articular treatment of two hyaluronic acids (HAs) commercially available in Italy and investigated predictors of response. Outpatient records including three cohorts: 122 subjects treated with medium (1,500-3,200 kDa; Hyalubrix) molecular weight (MW) or high (hylan G-F20; Synvisc) MW HAs and 20 controls taking NSAIDs/analgesics on demand were retrospectively analyzed.

Levels of chemerin and interleukin 8 in the synovial fluid of patients with inflammatory arthritides and osteoarthritis.

Objectives: Chemerin and interleukin (IL)-8 are pro-inflammatory mediators whose role in joint inflammation and cartilage degradation has been demonstrated in in-vitro findings. Studies on their presence in synovial fluid (SF) samples may offer further information on their pathogenic role. The aim of this study was to investigate SF chemerin and IL-8 levels in patients with different joint diseases.

Camptothecin-7-yl-methanthiole: semisynthesis and biological evaluation.

The introduction of a methylenthiol group at position 7 of camptothecin was carried out in four steps. This preparation also yielded the corresponding disulfide, which behaves as a prodrug due to its reactivity with glutathione. Assessment of their antiproliferative activities, investigations of their mechanism of action, and molecular modeling analysis indicated that the 7-modified camptothecin derivatives described herein maintain the biological activity and drug-target interactions of the parent compound.

Synthesis and biological evaluation of new camptothecin derivatives obtained by modification of position 20.

The preparation and biological evaluation of a novel series of dimeric camptothecin derivatives are described. All the new compounds showed a significant ability to inhibit human tumor cell growth with IC(50) values ranging from 0.03 to 12.

Histone deacetylase and microtubules as targets for the synthesis of releasable conjugate compounds.

Design and synthesis of an HDAC inhibitor and its merger with three tubulin binders to create releasable conjugate compounds is described. The biological evaluation includes: (a) in vitro reactivity with glutathione, (b) antiproliferative activity, (c) cell cycle analysis and (d) quantification of protein acetylation. The cellular pharmacology study indicated that the HDAC-inhibitor-drug conjugates retained antimitotic and proapoptotic activity with a reduced potency.

Synthesis and biological evaluation of epothilone A dimeric compounds.

The preparation and biological evaluation of a novel series of dimeric epothilone A derivatives (1-6) are described. Two types of diacyl spacers were introduced to establish the various dimeric epothilone A constructs. The effect of these compounds on tubulin polymerization and their cytotoxicity against four different cancer cell lines are reported.

Sleep Apnea in Moderate-Severe Obese Patients.

Obesity induces multiple physiologic changes at the respiratory and circulatory systems level. A study was developed to identify symptoms and signs able to discriminate subjects at high risk of obstructive sleep apnea (OSA) and to evaluate the presence of OSA in a population of obese patients referred to the Clinical Nutrition Service of the Luigi Sacco Hospital for weight loss therapy. Twenty-seven obese patients (14 males, 13 females) without neurologic, cardiac, and lung diseases were measured for height, weight, neck, waist, and hip circumference; a sample of venous blood was taken for hematological data; and were given a pulmonary function test, hemogasanalysis, and full-night polysomnography.

Diet therapy for rheumatoid arthritis. A controlled double-blind study of two different dietary regimens.

Objective: To evaluate the effects of a diet therapy in patients with rheumatoid arthritis (RA).

Methods: Fifty RA patients entered a 24-week double-blind, randomised, controlled-study of two different dietary regimens (an experimental diet high in unsaturated fats, low in saturated fats with hypoallergenic foods vs. a control well-balanced diet).

Proinflammatory and regulatory cytokine levels in AIDS cachexia.

The serum concentrations of inflammatory (Interleukin-1 beta, Tumor necrosis alpha, Interleukin-6) and regulatory cytokines (Interleukin twelve) have been studied in ten AIDS cachectic patients and compared to a control group. A cytokine imbalance, and peculiarly a significant increase in proinflammatory cytokines (Interleukin-1, Interleukin-6, Tumor necrosis Factor alpha) and a decrease in regulatory cytokines such as Interleukin-12 were found. A significant correlation resulted between weight loss and Interleukin-1 beta and 6.

Risk retention groups offer alternatives to liability coverage.

Recent amendments to the Product Liability Risk Retention Act of 1981 allow self-insurers to form risk retention groups to cover all liability risks as well as product liability. This act makes it easier for qualified individuals and organizations to form association insurance captives or collectively purchase insurance on a group basis to solve the problem of availability and affordability of liability insurance.

Effects of moderate salt restriction in hypertensive patients treated with oxprenolol or chlorthalidone.

Ninety-five hypertensive out-patients, whose lying diastolic blood pressure was still greater than or equal to 95 mm Hg after a 4-week treatment with oxprenolol slow release 160 mg/day or chlorthalidone 25 mg/day, restricted their daily sodium intake for a 4-week period, while continuing to receive the previous pharmacological therapy. The dietary intervention, appositely formulated to moderately restrict sodium intake, resulted in a high patient compliance as assessed by the significant (p less than 0.01) reduction in the 24-hour urinary sodium excretion.

Comparison of three different methods of monitoring unwanted effects during antihypertensive therapy.

In a double-blind, randomized, crossover, multicenter study performed in 227 hypertensive outpatients, two antihypertensive drugs, oxprenolol and chlorthalidone, were investigated to determine unwanted effects. Three main methodologic procedures were applied: the conventional evaluation of unwanted effects by the physician and involving the whole patient population, the checklist, and the free questionnaire. The latter two were assigned by randomization to the patients themselves.