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Biomedical subjects

A A Conti

Publications and source records attributed to A A Conti.

30 records · Page 2Linked to original sources
PubMed1998

Cardiac troponin I and Q-wave perioperative myocardial infarction after coronary artery bypass surgery.

OBJECTIVE: To monitor cardiac troponin I (cTnI), a newly developed biochemical index for cardiac damage, in patients during and after coronary artery bypass surgery (CABS) to determine whether the measurement of the serum levels of this marker could be of value in formulating an early diagnosis of Q-wave perioperative myocardial infarction (PMI). DESIGN: Prospective study with sequential measurements of biological markers in a selected surgical patient group. SETTING: University research laboratory and general university hospital (Cardiac Surgery Unit and Anesthesiology and Reanimation Unit). PATIENTS: Forty-two patients undergoing elective CABS without concomitant valvular replacement. INTERVENTIONS: There were no interventions required for this study. However, patients entered into the study had CABS, sequential arterial blood samples, ECG recordings, and echocardiograms performed. MEASUREMENTS AND MAIN RESULTS: Pre-, intra-, and postoperative (up to 48 hrs) measurements of cardiac troponin I, MB-CK, and total creatine kinase, as well as serial electrocardiograms and echocardiograms. Perioperative infarction was assessed as the development of new persistent regional wall motion abnormalities in echocardiography together with electrocardiographic alterations and MB-CK increases. Eight patients had Q-wave PMI. All PMI patients had elevated peak cTnI values (all >9.2 ng/mL), whereas the 34 nonPMI patients had peak values <9.0 ng/mL; therefore, sensitivity and specificity (with a 9.0 ng/mL cut-off value) are 100%. MB-CK measurement peak values did not demonstrate such a high specificity and sensitivity. CONCLUSIONS: Because of its high specificity and sensitivity, serial measurements of cTnI provide a rapid and accurate method for confirming or excluding the diagnosis of perioperative myocardial injury. cTnI evaluation can therefore be used both as an independent prognostic marker for patients undergoing cardiac surgery and as a powerful tool for detecting smaller PMIs often missed with standard PMI diagnostic criteria.

Aged↗
PubMedDate not supplied

The historical evolution of the concept of apoptosis in rheumatic diseases.

Even if the idea of apoptosis may probably be detected for the first time in a Hippocratic treatise, it was Rudolph Virchow, the founder of cellular pathology in the XIX century, who gave the first structured description of the processes underlying the term. In the course of the XX century a body of systematic observations on cell death was elaborated in an organic way. In 1908 Mechnikov won the Nobel Prize for his studies on phagocytosis, while in the '30s and '40s many studies on metamorphosis were carried out, and Fell and Canti identified cell death in chondrocytes in culture. At the end of the '40s Saunders began to observe cell death in chick limbs, and Hamburger and Levi Montalcini began their exploration of nerve growth factors. In mid '50s research on lysosomes began, and in the '60s Kerr defined shrinkage necrosis. The term apoptosis was definitely introduced by Kerr in 1972 to indicate a particular form of death in which cells commit suicide by dissolving themselves into membrane-bounded apoptotic bodies. In the '80s ced-3 was described and at the beginning of the '90s apoptosis genes were identified. In more recent times new instruments have allowed a wide range of cellular deaths to be described, including apoptosis as currently defined. Extremely interesting are its role and function in many different diseases; in particular in rheumatic ones recent evidence indicates that, far from being simple, brief and monomorphic, apoptosis is a complex, long-lasting, and pleiomorphic process.

Apoptosis↗
PubMedDate not supplied

[The impact factor: a factor of impact or the impact of a (sole) factor? The limits of a bibliometric indicator as a candidate for an instrument to evaluate scientific production].

The Impact Factor is a bibliometric quantitative parameter introduced in 1971 and used to evaluate, classify and compare scientific journals. It is essentially the ratio between the number of citations they receive, computed on the basis of those included in the Science Citation Index, and the number of published articles. It is thus a dynamic parameter and an indicator of the editorial quality of a journal. It has also been considered a putative index of the scientific production of a single author. The Impact Factor was first proposed as a useful instrument for planning library choices, programming personal journal buying and reading, and directing scientific journal editors in their editorial strategies. However, since among the numerous variables which may influence the Impact Factor there are such parameters as: the average number of bibliographical references in a single article, self-citations, "salami publications", the Impact Factor, though adequate to judge entities such as journals, institutions and whole scientific communities, seems on the contrary inadequate to evaluate accurately the quality of the single investigator, paper, and research group. Furthermore, a limited number of papers, all focused on the so-called "hot topics", may contribute to increase the Impact Factor of a single journal. There is therefore still much research to be done to find truly "objective" methods to evaluate critically the "quality" (and not only the "quantity") of the work of a single author, a scientific group, and an entire institution, so that not only quantitative, but also qualitative evidence may be acquired!

Bibliometrics↗
PubMedDate not supplied

Macroscopic anatomy of the superficial veins of the lower limb: a systematic review based upon echography.

Saphenous Veins are described in Anatomy textbooks as superficial veins running in the amorphous fatty layer of the lower limbs. Recent papers have demonstrated the complex fascial relationship of Saphenous Veins with the connective framework of the lower limb hypodermis. The aim of the present paper was to systematically review the anatomy of lower limb superficial veins, based upon echographic findings, in a series of normal subject. Our results offer new insight into lower limbs superficial veins anatomy, with important clinical and surgical implications.

Adolescent↗
PubMedDate not supplied

Descriptive and morphometric anatomy of the architectural framework of microcirculation: a Videocapillaroscopic study on healthy adult subjects.

Conventional Capillaroscopy allows the observation of a limited number of areas, classically the fingernail-fold. Videocapillaroscopy, on the contrary, can be performed on any part of the skin and of clinically accessible mucosae. The aim of the present paper was to investigate the architectural frameworks of microcirculation in the various regions of the body and their morphometric parameters in healthy adult subjects. Our findings showed four basic architectural patterns plus two special patterns. The calibre of capillary loops ranged from 15 to 20 micrometers, and capillary density ranged from 14 to 30 capillary loops each square millimetre. These findings might be used as normal reference data for future studies.

Adult↗
PubMedDate not supplied

Tuberculosis: a long fight against it and its current resurgence.

Unlike the discovery of penicillin in 1928 by A. Fleming, largely due to fortuitous circumstances, the isolation of streptomycin by S.A. Waksman was the result of a systematic research project carried out by a number of workers. In 1952, Waksman received the Nobel Prize in Medicine for having produced the first useful drug against tuberculosis. Before the tubercle bacillus was recognised as the causative agent of the disease, various sanatoria had been set up, as the only remedy for sufferers of tuberculosis. Between 1880 and 1930 sanatoria spread across Europe and North America, and they were partially effective against the ever worsening diffusion of tuberculosis: therefore in the United Kingdom a government-funded agency, the Medical Research Council (MRC), was created in 1913. In 1947 streptomycin was put on the market, opening a new era in the history of modern medicine. Indeed, the first published report of the results of an (individually) randomised clinical trial was the 1948 paper by Bradford Hill and co-workers of the MRC's trial on the use of streptomycin. Streptomycin still represents a first-line agent in the recommended therapy of tuberculosis, whose burden is far higher in low-income countries. The current aim of any global intervention against tuberculosis should be the elimination of the pathology itself, an effort that will need both financial investments in scientific research and the targeted use of the fruits of that research to develop new, effective, preventive and therapeutic tools, such a tool as streptomycin proved to be more than fifty years ago.

Antitubercular Agents↗
PubMedDate not supplied

The concept of "context" in health care: historical perspective and current views.

The concept of "Context" presents various aspects ranging from the emotive to the cognitive, from the structural and organisational to the methodological, from the social to the educational, and therefore merits consideration. Furthermore, the influence of the health context on clinical outcomes has recently had a rebound of attention in biomedical literature, given that the ability of clinicians to modify their professional practice is considered to be strongly influenced by the organisational and managerial milieu of their work. In the past attention was largely focussed on the ability of the environment to modify the health status of individuals and so to cause, or con-cause, diseases. There was instead a relative lack of interest in the influence of the health context on health operators, and, more importantly, in its effect on the relationship between patients and health operators and, in turn, of this latter relationship on clinical outcomes. This interest has recently been investigated and research has provided preliminary evidence that physicians adopting a friendly and reassuring approach are more effective than those who keep visits and counselling at a formal level. An awareness that many features of the concept of context in health care have been relatively little studied should address future research to clarifying scientifically the global role of context in health. The promising findings of the studies available, such as those here illustrated, point to the fact that valid research would be both feasible and effective.

Delivery of Health Care↗
PubMedDate not supplied

Clinical application of fibrinolysis laboratory tests: a review.

The aim of this paper is to review fibrinolysis laboratory tests of potential clinical usefulness. Since the activation of the fibrinolytic system may be responsible for several relevant pathological scenarios, it is crucial to know whether and to what extent fibrinolysis laboratory tests are useful for the diagnosis and therapy of individual patients. The plasma fibrinolytic system may be altered by deficiencies and/or abnormalities of some of its components. Few doubts remain concerning the possible role of fibrinolysis alterations in the pathophysiology of some hemorrhagic and thrombotic disorders. In hemorrhagic patients, laboratory tests may demonstrate the existence of increased plasmin activity and the presence of specific congenital defects leading to primary hyperfibrinolysis. Alterations of the fibrinolytic system should be looked for only in selected patients who have a history of venous thrombosis and negative results of initial screening tests.

Blood Coagulation Tests↗
PubMedDate not supplied

Endothelins: an overview of recent achievements.

The aim of this study is to review the recent developments in research on the pathophysiological role of endothelins in the reproductive system and lungs, as well as in systemic disorders such as sepsis, acute respiratory distress syndrome and multiple organ failure. The international literature of the last 9 years, as available on MEDLINE, was duly scanned. Only relevant, original and update studies were selected for the purpose of this survey. The results of the most significant studies in humans are summarized. The potential roles of endothelins in systemic diseases are currently under investigation. A possible role of these peptides is suggested in the pathophysiology of heart failure and in the mechanism of post-ischemic renal failure. Studies have been conducted also on other systems, namely the reproductive system, the endocrine system and the lungs as well as on a number of tissue disorders such as sepsis, acute respiratory distress syndrome multiple organ failure, preeclampsia and related abnormalities. Full understanding of the role and action of this group of regulatory mediators in tissues should enable complete insight into the pathophysiological mechanisms of localized diseases as well as of multiple organ diseases. As a result, adequate therapy may be established.

Cardiovascular Diseases↗