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Biomedical subjects

A Alberti

Publications and source records attributed to A Alberti.

At least 271 records · Page 15Linked to original sources
PubMed1989

Long-term effect of low dose recombinant interferon therapy in patients with chronic hepatitis B.

Thirty three heterosexual chronic hepatitis B virus (HBV) carriers were randomized, with stratification for disease activity, to receive intramuscular recombinant interferon alpha-2a (r-IFN) at doses of 4.5 megaunits thrice weekly for 4 months, or no treatment. During r-IFN treatment, serum HBV-DNA levels fell in all, but 2 patients. Final evaluation at 16 months after randomization revealed that the rate of complete response, i.e., loss of both HBV-DNA and HBeAg with ALT normalization was 22.2% (2 of 9 cases) in patients on interferon and 12.5% (1 of 8 cases) in untreated patients for the group with high serum alanine aminotransferase (ALT) and with piecemeal necrosis on liver biopsy on entry. The corresponding value was 25% (2 of 8 cases) in treated and 12.5% (1 of 8 cases) in untreated patients with low liver disease activity. Overall, a complete response was thus observed in 23.5% of treated patients and in 12.5% of controls. None of the patients on therapy became HBsAg negative. It is concluded that treatment of heterosexual patients with chronic hepatitis B with r-IFN in the dose regimen used here was not associated with a significant higher rate of serologic and clinical response compared to controls, independently of pretreatment biochemical and histologic activity of liver disease.

Adolescent↗
PubMed1989

Serum HBV-DNA in anti-HBe positive patients detected by filter and liquid phase hybridization assays.

Serum HBV-DNA is considered the best parameter for monitoring HBV replication in the liver. The filter hybridization assay (spot test) with 32P-labelled HBV-DNA has been the technique more frequently used to date. A simple solution hybridization assay, in which 125I HBV-DNA is used as labelled probe, has been recently standardized. We have compared the performances of these two assays for the detection of HBV-DNA. The results were similar with the two methods: an agreement was found in 39/44 (89%) samples. Three sera were positive only by the spot assay-and two only by the liquid phase assay. However, in these cases, HBV-DNA levels were near the sensitivity limits of the assay. Therefore, the filter and the liquid phase assays can be considered to be suitable methods to monitor HBV replication, a fundamental index for the clinical assessment and prognosis of patients with HBsAg positive chronic hepatitis.

Cloning, Molecular↗
PubMed1989

Exercise testing and dipyridamole echocardiography test before and 48 h after successful coronary angioplasty: prognostic implications.

The purpose of the present study was to determine the value of exercise testing (ET) and dipyridamole echocardiography test (DET) in the early functional evaluation after a successful coronary angioplasty (PTCA) and in the prediction of angina recurrence. 52 patients underwent ET and DET before and 48 h after a successful PTCA. During a 6-12 month follow-up period they all underwent clinical evaluation. Before PTCA, ET was positive in 49 of 52 patients (94%) and new asynergies were detected by DET in 47 of 52 patients (90%). 48 h after PTCA 23 patients (44%) had positive ET results and 10 had a positive DET response. During the follow-up, 17 patients experienced recurrence of angina. Positive predictive value (PPV) for angina recurrence of ET and DET performed early after the PTCA were, respectively, 57 and 80%. The PPV of ET increased to 88% when electrocardiographic (ECG) positivity was accompanied by angina. Negative predictive values of ET and DET were, respectively, 86% and 79%. Early after PTCA, exercise ECG positivity was not predictive of symptom recurrence while ECG positivity associated with angina revealed a high PPV, similar to that of DET.

Angioplasty, Balloon, Coronary↗
PubMed1989

Predictability before transplant of hepatic complications following allogeneic bone marrow transplantation.

This study was undertaken to evaluate the occurrence of VOD and other liver diseases following BMT in a patient population with a high incidence of hepatitis before conditioning regimen. We prospectively reviewed 186 consecutive patients undergoing BMT from 1976 to 1986 to determine incidence and type of liver disease after BMT and predisposing factors. Two of 186 patients experienced VOD (1.07%). Acute and chronic liver GVHD were found in 25.8% and 36% of the patients, respectively. Acute hepatitis (AH) was diagnosed in 29.4% and chronic hepatitis (CH) in 42.6% of the patients. Statistical analysis showed no influence of pretransplant variables on the occurrence of acute GVHD and AH; there was a weak correlation (P = 0.01) between pre-BMT abnormal transaminases and occurrence of chronic GVHD. Contingency table and Cox analysis showed a greater risk of CH for patients with abnormal pretransplant SGPT levels (P = 0.0004 and P = 0.0022). No other variables could be associated with posttransplant CH. Actuarial survival was 71% versus 69% for patients with normal versus abnormal transaminases (P = 0.2). As VOD was a rare event, despite 53% of patients having abnormal transaminase values before transplant, we suggest that a lower and slower TBI is more important than pretransplant normal transaminases in preventing this complication. We conclude that evidence of compensated hepatitis is not a relative contraindication for BMT.

Actuarial Analysis↗
PubMed1989

Usefulness of high-dose dipyridamole echocardiography test in coronary angioplasty.

Seventy-four consecutive patients with angina undergoing single-lesion percutaneous transluminal coronary angioplasty were evaluated with high-dose (up to 0.84 mg/kg during 10 minutes) dipyridamole echocardiography test (DET) before angioplasty and when possible, afterward. Angioplasty was clinically or angiographically successful in 63 patients and unsuccessful in 11. Before the procedure, 69 patients had a positive DET. Of these 69 patients, six with clinicall unsuccessful angioplasty had a dipyridamole time (i.e., the time from the onset of dipyridamole infusion to development of asynergy) lower than the 63 patients with clinically successfully angioplasty (4.2 +/- 2.9 vs. 7.0 +/- 2.9 minutes, mean +/- SD, p less than 0.01). In the five patients with angiographically unsuccessful angioplasty (residual stenosis diameter, greater than 50%), coronary stenosis decreased from 89 +/- 10 to 69 +/- 22 (p = NS); DET was positive in all five before and in four of the five after the procedure (100% vs. 80%, p = NS). In the 63 patients with angiographically successful angioplasty, coronary stenosis diameter was reduced from 85 +/- 9% to 30 +/- 10% (p less than 0.01). DET was positive in 58 patients before and in only 16 after the procedure (92% vs. 25%, p less than 0.01). In the 16 patients with positive DET, before and after angioplasty, dipyridamole time increased from 5.6 +/- 2.2 before to 7.3 +/- 2.4 minutes immediately after the procedure (p less than 0.05). After an average follow-up time of 10.8 +/- 5.9 months, angina recurred in eight of 47 patients with negative DET after angioplasty and in 11 of 16 patients with positive DET (17% vs. 69%, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Angioplasty, Balloon↗
PubMed1989

[Diaphanization and vascular study of the dog vertebra].

Using a technique of diaphanization, modified from the one described by Spalteholz in 1924 and once more modified, for this study, for studying bone, the authors had to use a decalcification process. The authors studied the differences in arterial vascularization between the cervical, thoracic and lumbar vertebrae and also the vascularization of each of the vertebral elements.

Animals↗
PubMed1989

[Arterial vascularization of the vertebral column. Injection-corrosion-fluorescence technic].

The authors have used the technique of injection-corrosion-fluorescence for a better knowledge of the arterial vascularization of the vertebral column of dogs. The vascular molds have been observed under ultraviolet light, and the magnificent fluorescence allowed easy reading of the results. At the cervical level they are the vertebral and the deep cervical arteries as the main arterial sources, at the thoracic level it is the intercostal, and in the lumbar region the lumbar arteries.

Animals↗
PubMed1988

Antibody response to pre-S2 and hepatitis B virus induced liver damage.

Antibodies to the pre-S2 encoded sequence of the hepatitis B virus (HBV) envelope were detected in 83% of patients recovering from acute hepatitis B. Such antibodies were absent in cases showing chronic evolution and were found in less than 10% of chronic hepatitis B cases, with no relation to liver disease activity. In acute infection anti-pre-S2 became detectable when maximum liver damage had already occurred and was still detectable in 30% of the cases tested 5-7 years after recovery, as well as in 40% of healthy individuals with naturally acquired immunity to HBV. 10 out of 20 recipients of a plasma-derived, pre-S2-containing, HB vaccine acquired anti-pre-S2 and had no evidence of concurrent liver damage or of autoimmune reactions to human albumin or of suppression of the anti-HBs response. These findings indicate that the antibody response to pre-S2 is a marker of HBV clearance and has no role in the pathogenesis of HBV-related liver damage.

Antibodies, Viral↗
PubMed1988

Hepatitis B core antigen in serum during acute hepatitis B.

Hepatitis B core antigen was measured in sera of patients with acute and chronic hepatitis B virus infection by a modified radioimmunoassay based on high molarity treatment of samples to avoid masking of antigen by homologous antibody. A good correlation between hepatitis B core antigen levels and serum HBV-DNA was observed in sera obtained during chronic infection. In contrast, acute phase sera were often HBcAg positive but HBV-DNA negative, particularly when obtained during maximum liver damage. Sequential studies in 5 patients with acute hepatitis B showed that HBcAg positivity persisted beside HBV-DNA clearance and was often enhanced at the time of maximum liver damage, suggesting release of antigen from infected hepatocytes undergoing immunolysis, even after termination of virus replication.

Acute Disease↗
PubMed1988

Expression of preS1 and preS2 in the liver of chronic hepatitis B virus carriers.

Using monoclonal antibodies we have studied the expression and distribution pattern of preS1 and preS2 proteins in the liver of 25 patients with chronic hepatitis B virus infection. Both preS1 and preS2 were detected in the liver of most cases, independently of viral replication and of the state of the viral genome in the liver. In fact, preS1 and preS2 were present in the liver of 14 out of 15 patients with HBV-DNA in the serum as well as of 7 out of 10 cases with no evidence of viral replication, including 2 with integrated HBV-DNA sequences in the liver and 5 patients with no evidence of liver damage. The pattern of distribution of preS proteins was identical to that of hepatitis B surface antigen, with exclusive cytoplasmic staining in cases without viral replication and cytoplasmic and membranous positivity in those with viral replication. These results clearly indicate that translation of preS proteins is independent of viral replication and is not necessarily associated with liver damage.

Antibodies, Monoclonal↗
PubMed1988

Investigation of nuclear clefts as a prognostic parameter in chronic lymphocytic leukemia.

The importance of cell morphology with respect to the presence or absence of nuclear clefts (NC) in peripheral blood lymphocytes has been investigated in 86 previously untreated chronic lymphocytic leukemia (CLL) patients. Cleaved cells were considered to be present in significant numbers when they exceeded 5% of the peripheral blood lymphocytes. On this basis patients could be divided into two morphological groups. Age, sex and distribution of stages, as well as mode of clinical presentation were alike in the two groups of patients. In contrast, lymph node involvement was more frequently encountered in patients with NC greater than 5% (p less than 0.01). Both survival and treatment-free period probabilities were not statistically correlated to the quantitative changes in the percent value of NC. We further confirm that Binet's clinical staging is a significant predictor of survival irrespective of NC.

Actuarial Analysis↗
PubMed1988

Cryptogenic chronic liver disease and serum or liver hepatitis B virus markers. Their possible correlations and etiologic significance.

In an attempt to evaluate a possible correlation between cryptogenic chronic liver disease and a present or past hepatitis B virus (HBV) infection, we studied 17 patients with hepatitis B surface antigen (HBsAg)-negative, nonalcoholic chronic liver disease; 9 of them were positive for serum HBsAg detected by a solid-phase enzyme immunoassay with monoclonal antibody (M-EIA) and 8 were negative for the same marker. Liver hepatitis B core antigen (HBcAg), studied by an indirect immunofluorescence technique, was present in 55.5% of the patients positive for serum HBsAg by M-EIA. In the same group of patients, liver HBV-DNA was found in 66.6% of the patients. On the other hand, only 1 patient without serum positivity for HBsAg by M-EIA was positive for liver HBcAg and HBV-DNA. None of our patients showed serum positivity for HBV-DNA sequences. We conclude that HBV infection may be a possible cause of cryptogenic chronic liver disease; this HBV-related, HBsAg-negative chronic liver disease seems to have no viral replication or undetectable levels of HBV-DNA in serum. HBsAg, detected by a monoclonal assay, seems to be a suitable marker to identify this subgroup of patients with HBsAg-negative chronic liver disease.

Antibodies, Monoclonal↗
PubMed1988

[Cardiac transplantation: role of echocardiography in the diagnosis of rejection].

Sixteen patients surviving orthotopic cardiac transplantation were studied by M-Mode and two dimensional echocardiography (ECHO) on the same day of cardiac biopsy during (n = 138) a mean follow-up of 6.2 +/- 4 months (range 1-4 months). The following parameters were measured: right ventricular end diastolic internal diameter (RVdD) left ventricular end diastolic internal diameter (LVdD), interventricular septum (IVS) and posterior wall (PW) diastolic thickness, myocardial mass (MM); LV cross sectional area (CSA) and ejection fraction (EF). LV and RV wall motion, pericardial effusion and myocardial echogenicity (brightness) were evaluated by inspection. Every ECHO was compared with the previous one for qualitative and quantitative changes. In the absence of rejection, analysis of the data during the first postoperative week showed the following results: mean EF = 51 +/- 6.8%, dilated overloaded RV (30.4 +/- 4.8 mm), various amount of pericardial effusion; FE increased significantly (55.3 +/- 4%; p less than 0.001) and RVdD decreased (26.6 +/- 5mm; p less than 0.001) after the 2nd week and remained stable thereafter, while pericardial effusion decreased or disappeared. The mean values of the remaining ECHO parameters did not very significantly during the follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1988

Interferon treatment of anti-HBe positive and HBV DNA positive chronic hepatitis B.

The efficacy of human lymphoblastoid interferon (Wellferon) was studied in 25 patients with anti-HBe positive, HBV DNA positive chronic hepatitis B. The patients were randomized to receive 5 MU/m2, three times weekly or no treatment for 6 months. The study is ongoing and to date 19 patients have been followed up for more than 3 months and 14 for more than 6 months. At 9 months, serum HBV DNA had become negative and ALT levels normalized in 57% of interferon-treated patients. This compared with 33% becoming serum HBV DNA negative and 16% with ALT normalization in the untreated group. Clearance of HBV DNA in interferon treated patients was not consistently associated with the appearance of transaminase peaks during therapy, in contrast with those seen in HBeAg positive patients. The preliminary results of this trial suggest that interferon reduces HBV replication in anti HBe/HBV DNA positive patients with chronic hepatitis B.

Alanine Transaminase↗
PubMed1987

Prognostic value of the lymphocyte doubling time in chronic lymphocytic leukemia.

The prognostic value of lymphocyte doubling time (LDT), expressed in months and obtained by means of a linear regression, has been studied in 99 previously untreated chronic lymphocytic leukemia (CLL) patients. LDT is defined as the period of time needed for lymphocytes to double in number the amount found at diagnosis. When the analysis was extended to the whole population, it showed clear differences in the life expectancy of patients with LDT of less than or equal to 12 months (median survival, 36 months; relative death rate [O/E]1.57) compared with those with LDT of more than 12 months (median survival not yet reached; O/E, 0.37) (P less than 0.001). The significance of LDT remained even after adjustments were made for age, sex, lymphocyte count, anemia, and thrombocytopenia. The lack of statistical significance after adjustment for Binet's clinical stage corresponds to the fact that clinical stages are not distributed homogeneously, high LDT being more frequently associated with earlier stages and low LDT with more advanced forms of the disease (P less than 0.001). In this study LDT was a useful parameter in predicting disease progression. Patients in Stages A and B and with rapidly increasing lymphocytes counts became worse more frequently (33.3% and 29.1%, respectively, at 12 months after diagnosis) than those with a slow increase (no change in clinical stage at 12 months). It is concluded that since LDT appears to predict the progression of the disease, it is useful in the clinical management of CLL.

Aged↗