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Biomedical subjects

A Ferrara

Publications and source records attributed to A Ferrara.

At least 91 records · Page 5Linked to original sources
PubMed1994

Hyperinsulinemia does not increase the risk of fatal cardiovascular disease in elderly men or women without diabetes: the Rancho Bernardo Study, 1984-1991.

The relation of fasting and 2-hour serum insulin to the risk for fatal cardiovascular disease was examined in men and women without diabetes. Between 1984 and 1987, 80% of all surviving local members of the Rancho Bernardo Study cohort had measures of insulin and glucose levels obtained before and after a 75-g oral glucose tolerance test. Over the next 5 years, there were 24 cardiovascular disease deaths among 538 men and 21 cardiovascular disease deaths among 705 women. Fasting insulin was unrelated to cardiovascular disease death in men or women; 2-hour insulin was significantly lower in men (but not in women) who died from cardiovascular disease. In men, a 1-standard deviation increase in 2-hour insulin was associated with a 36% reduction in cardiovascular disease mortality (p = 0.01). The significant inverse association of 2-hour insulin with cardiovascular disease death persisted in multiply adjusted models (relative hazard = 0.68; 95% confidence interval 0.47-0.96). Patterns were similar when the analysis was repeated, including men with non-insulin-dependent diabetes mellitus or heart disease at baseline. These findings were not explained by antihypertensive drug use or cigarette smoking. Hyperinsulinemia was not a risk factor for cardiovascular disease in these older men or women. The role of insulin as a cardiovascular disease risk factor requires further investigation.

Age Factors↗
PubMed1994

Motor determinants of incontinence after ileal pouch-anal anastomosis.

Anal canal pressure gradient and ileal pouch motor activity were studied in continent and incontinent patients after ileal pouch-anal anastomosis. A multichannel microtransducer catheter was positioned in eight continent and eight incontinent patients 15 months or more after operation and 24-h ambulatory motor activity recorded. Resting anal pressures were significantly lower for incontinent patients during the day and night. The frequency of high-pressure waves was identical in both groups, but peak pressures were higher for incontinent patients. For continent patients, each high-pressure wave was accompanied by a rapid increase in anal canal pressure such that pressure in the pouch was always less than that in the anal canal. For incontinent patients this response was often absent. Incontinent patients had lower resting pressure, more prolonged anal canal relaxation, higher amplitude high-pressure waves and a non-responsive anal canal; the anal canal pressure gradient was therefore frequently reversed.

Adult↗
PubMed1994

Ileal pouch pressures after defecation in continent and incontinent patients.

UNLABELLED: After ileal pouch-anal anastomosis, a pouch/anal canal pressure gradient is present such that mean pressures in the anal canal exceed pressures in the pouch facilitating fecal continence. Such a relationship was not present in incontinent patients. PURPOSE: Our aim was to evaluate characteristics of pouch pressures dynamically in continent and incontinent patients following ileal pouch-anal anastomosis (IPAA). METHODS: A multichannel microtransducer catheter was positioned in eight continent patients and nine incontinent patients after IPAA. Twenty-four-hour recordings of pouch pressures and large pressure wave contractions were recorded when patients were awake, asleep, and after evacuation. RESULTS: When patients were awake, pouch pressures were similar. However, nocturnal pouch pressures were higher in the incontinent group (P < 0.05). Large pressure wave amplitude was higher in incontinent patients when awake and asleep (P < 0.05). Moreover, pouch pressures failed to decline in the incontinent group after evacuation, unlike continent patients. CONCLUSION: Compared with continent patients, incontinent patients after IPAA had persistently high phasic and basal pouch pressures at night and following pouch evacuation.

Adult↗
PubMed1994

Intraoperative use of Toradol facilitates outpatient hemorrhoidectomy.

UNLABELLED: Pain after hemorrhoidectomy is widely feared by many patients who are mostly still treated with oral/intramuscular narcotics to control their pain postoperatively. PURPOSE: In an effort to decrease posthemorrhoidectomy pain by applying newer methods of analgesia, a prospective trial was conducted to investigate the postoperative analgesic effect of Toradol (ketorolac tromethamine; Syntex Labs, Palo Alto, CA) injected into the sphincter muscle at the time of hemorrhoidectomy and taken orally during a five-day postoperative period in a group of 24 patients (Toradol group). Results were compared with two other groups of matching patients: one group (narcotics, n = 18) treated with standard postoperative narcotic intramuscular/oral analgesics after overnight hospital stay, and a group (SQMP, n = 21) previously treated by one of us with outpatient, subcutaneous infusion of morphine sulfate (Roxane Laboratories, Columbus, OH) via a home infusion pump. METHOD: The length of hospitalization, severity of postoperative pain and complications, costs, and side effects were analyzed by patient questionnaire at the time of the first postoperative visit and hospital and clinic records were reviewed. Differences between groups were analyzed using Student's t-test with P < 0.05 being significant. RESULTS: Subjective pain response and hospitalization cost were significantly less in the SQMP group; however, this was at the expense of increased postoperative complications (urinary retention) and side effects (day until first bowel movement, nausea) although without a decrease in satisfaction rating. The Toradol group had pain control equivalent to that of the narcotics group, a higher satisfaction rating, and suffered no increase in complications relative to either group. Significantly, there was no urinary retention in the Toradol group. CONCLUSION: Postoperative pain after hemorrhoidectomy can be safely controlled as an outpatient using newer methods of pain control. These include both constant-infusion pain pump or supplemental use of the nonsteroidal analgesic ketorolac, both of which allow early release of the patient the day of surgery by diminishing postoperative pain. An important advantage of local injection of ketorolac is the elimination of urinary retention in our study group, probably by blunting the pain reflex response facilitated by prostaglandins, thus allowing safe same-day discharge.

Ambulatory Surgical Procedures↗
PubMed1994

Prolonged ambulatory recording of anorectal motility in patients with slow-transit constipation.

Our aim was to determine phasic contractile activity of the distal bowel and anus in patients with slow-transit constipation; if readily identifiable patterns were present, prolonged recordings could confirm a diagnosis of slow-transit constipation. In 12 healthy control subjects and 11 women patients with slow-transit constipation (mean colonic transit time: 120 +/- 11 hours) and normal pelvic floor function, a flexible catheter was positioned endoscopically with sensors in the sigmoid colon, rectum, and anal canal in order to perform ambulatory recordings. A motility index (MI = mm Hg/h/100) was calculated during fasting and after feeding. Overall, the rectal MI and the frequency of anal canal contractions were less in the patients with constipation compared with those in the control group (rectum: 22 +/- 5 mm Hg/h/100 in the control group versus 13 +/- 10 mm Hg/h/100 in the constipation group; anal contractions/h: 23 +/- 7 in the control group versus 3 +/- 2 in the constipation group, p < 0.05). Moreover, in response to feeding, only control subjects had a significantly increased MI and frequency of anal canal contractions. Compared with control subjects, patients with slow-transit constipation had significantly reduced motor activity in the distal bowel and anal canal. Phasic contractile activity recorded during fasting and in response to a meal may be a means of confirming the diagnosis of slow-transit constipation in patients with borderline marker transit times.

Adult↗
PubMed1994

Prediction of response to haloperidol in schizophrenia: neuroendocrine, neuromorphological and clinical variables.

Prediction of response to neuroleptics is a crucial topic since drug resistance phenomena can make the management of schizophrenia problematic and further deteriorate the outcome. Cerebral atrophy and enlarged ventricles have been suggested as the structural changes underlying negative symptoms and poor response to neuroleptic treatment. A higher percentage of non-suppressors to the dexamethasone suppression test (DST) among negative schizophrenics has been reported. Twenty-four schizophrenic in-patients, of both sexes, mean age 26.62 +/- 5.26 years, diagnosed according to DSM-III-R, with a mean duration of illness of 4.86 +/- 3.99 years, were treated with haloperidol 4-20 mg/day p.o. for 4 weeks. Clinical picture and extrapyramidal side effects were evaluated using BPRS and Simpson and Angus Scale at the beginning and end of the study. Ventricular brain ratio and basal and post-DST cortisol levels were evaluated at admission. The severity of the psychopathological picture, particularly positive symptoms at admission, were correlated to a higher amelioration at BPRS. Patients with ventricular enlargement and non-suppressors to DST showed higher variability of BPRS at baseline and more unpredictable clinical outcome than patients with normal ventricular brain ratio (VBR) and suppressors, even if a real difference in clinical outcome between patients characterized by normal or pathological parameters cannot be defined.

Adolescent↗
PubMed1994

Risk factors for breast cancer. Case-control study results.

The great importance of knowing the risk factors for breast pathology in order to reveal the risk categories is well known. In many geographical areas breast cancer is the most common female neoplasm. Recent Italian statistics point out that every year 83 women out of 100,000 develop breast cancer and that its incidence is increasing. Every year in Italy 10,000 women die of breast cancer. In our retrospective study 146 women suffering from breast cancer, treated in our Institute from 1970 to 1993, were enrolled. We excluded 4 patients, surgically treated in another Institute and 35 who presented a second or a third gynaecological cancer. We considered age, menarche, parity and menopausal age in all patients in order to evaluate the association of these risk factors with breast cancer development. The average age when neoplasm was first diagnosed was 53.07 years (between 30-84 years), with a 9.4% incidence in patients under 35 years old. In 41.1% of the cases, menarche was present under 12 years and in only 14.1% after 14 years, therefore confirming the reduction of mammary cancer risk in women with late menarche. Twenty one point five per cent of the patients were nulliparous. In our case series no protective factor seemed to be related with 1 or 2 pregnancies (43.9%). The menopausal average age was 50.2, with an average fertile life period of 37.1 years. Our study also considered the location of the primary neoplasia (60.7% in the upper-outer quadrant), the tumor size (3.08 cm average diameter) and the histological type (81.3% ductal form).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1993

Relationship between anal canal tone and rectal motor activity.

The anal sphincters facilitate fecal continence by maintaining a pressure barrier; whether proximal contractile events influence this barrier is unknown. The aim of this study was to determine whether a relationship exists between anal canal pressures and rectal motor activity. A fully ambulatory system for prolonged pressure recording was developed. In 12 healthy subjects (seven males and five females; mean age, 35 years; range, 22-43 years), a flexible transducer catheter (outside diameter, 4.5 mm) was introduced endoscopically such that sensors were 2, 3, 8, 12, 18, and 24 cm from the anal orifice. Twenty-four-hour spontaneous motor activity was stored in a 2.5-megabyte portable recorder for later transfer to a Microvax II for computerized analysis and display. Mean anal canal pressure was calculated, and rectal motor complexes (RMCs) were characterized. Mean and canal resting pressure was 75 +/- 12 mmHg. During sleep, anal pressures displayed cyclic decreases (mean periodicity, 1.6 hours; range, 1-4 hours), during which the mean +/- SD pressure trough was 15 +/- 4 mmHg (range, 8-21 mmHg). RMCs were identified in all subjects: mean frequency, 16 per 24 hours (range, 12-22 per 24 hours); duration, 15.3 minutes (range, 8-35 minutes); contractile frequency, two to three per minute; mean peak amplitudes, 58 +/- 18 mmHg; and periodicity, 78 +/- 24 minutes (range, 35-265 minutes). Importantly, an RMC was invariably accompanied by a rise in mean anal canal pressure and contractile activity such that pressure in the anal canal was always greater than pressure in the rectum. Anal canal relaxations never occurred during an RMC. Motor activities of the rectum and of the anal canal may be related; the onset of rectal contractions was accompanied by increased resting pressure and contractile activity of the anal canal. This temporal relationship represents an important mechanism preserving fecal continence.

Adult↗
PubMed1993

Plasma and platelet excitatory amino acids in psychiatric disorders.

Plasma and platelet levels of excitatory amino acids were measured in 38 psychiatric out-patients and in 19 comparison subjects; the patients had DSM-III-R diagnoses of organic mental disorders (N = 3), mood disorders (N = 15), schizophrenia (N = 13), and anxiety disorders (N = 7). The glutamate plasma levels were significantly higher in the patients with mood disorders than in the comparison group.

Ambulatory Care↗
PubMed1993

Defective insulin action in fibroblasts from noninsulin-dependent diabetes mellitus patients with Gln1152 insulin receptor mutation.

Insulin action was investigated in cultured skin fibroblasts from two consanguineous patients with a heterozygous point mutation in the insulin receptor kinase (Arg1152-Gln). In spite of normal binding, Gln1152 insulin receptor exhibited 20% increased basal kinase activity, but significantly reduced insulin-dependent autophosphorylation and kinase activity compared to controls from either weight-matched noninsulin-dependent diabetic patients (n = 4) or normal subjects (n = 5). In fibroblasts from the mutant patients, basal alpha-aminoisobutyric acid and 2-deoxyglucose (2-DG) uptake, cytochalasin-B (CB) plasma membrane binding, and glycogen synthase activity were increased to levels similar to those in maximally insulin-stimulated control cells. No insulin stimulation of these metabolic effects was detected in the mutant cells. In spite of the high basal 2-DG uptake and CB binding and the lack of further insulin response, fibroblasts from the mutant patients responded to 12-O-tetradecanoylphorbol-13-acetate with a further 50% increase in 2-DG uptake and CB binding. The magnitude of the effects of insulin and 12-O-tetradecanoylphorbol-13-acetate in control cells were nearly identical. We conclude that the Gln1152 insulin receptor impairs insulin regulation of metabolic responses in patient cells. Its presence in fibroblasts from the mutant patients appears to be accompanied by an increased pool of glucose transporters.

Adult↗
PubMed1993

Gas chromatographic detection of class I pesticide residuals in olive oil. Preliminary data for a project on food pollution and children's health.

The data are preliminary findings in order to study the possible pollution of fresh olive oil with Class I Pesticides, often misused by olive farmers, and it's effect on children's health. The oil produced from the olives of 8 farms in a small town of Southern Italy was collected at the mill in 1992, with no previous notice to the farmers, and was analyzed by Head Space Gas Chromatographic technique. The research for organophosphates and chlorinated pesticides was negative. The Kreis test excluded oil rancidity and the index of refraction confirmed the oils being fresh olive oil. The fact that the oil samples resulted free of pesticide residuals, however, might be explained by the unusual season weather not favourable to the olive parasites and the consequent reduced amounts of pesticides used by the farmers. The work will be repeated in 1993 and completed by a dietary semiquantitative questionnaire and epidemiologic evaluations on the children's health.

Agriculture↗
PubMed1993

Subjective shortening in humans' memory for stimulus duration.

Three experiments investigated memory for stimulus duration in humans using a modification of a delayed-matching technique previously used to study event memory in pigeons. In a session of 48 discrete trials subjects were presented with a sample stimulus (a 500-Hz tone with mean duration of 400 msec) then a comparison stimulus (the same duration as the sample, or longer or shorter), after a delay that was 1 to 10 sec in Experiments 1 and 2, and 2 to 16 sec in Experiment 3. After the comparison had been presented, subjects judged whether the sample and comparison had the same duration (a YES/NO decision, Experiment 1), or whether the comparison was longer, shorter, or of the same duration as the sample (Experiments 2 and 3). Overall, mean number of correct responses changed little with increases in the delay, but the change of number of correct responses with delay was markedly different on trials in which the sample and comparison were the same, the comparison was shorter, or the comparison was longer. In general, accuracy decline with increasing delay in the first case, remained constant in the second case, and increased when the comparison was longer than the sample. Examination of the types of errors made on the different sorts of trials (Experiment 3) suggested that the data were produced by two mechanisms: (1) subjective shortening of the sample as the delay between sample and comparison increased, and (2) a time-order error to respond that the sample was longer than the comparison. Overall, it appears that humans' working memory for duration exhibits a subjective shortening effect similar to that previously found in pigeons.

Adult↗
PubMed1992

Cloning and sequence analysis of a rapamycin-binding protein-encoding gene (RBP1) from Candida albicans.

Rapamycin (Rm) and FK506 are macrolide antifungal agents that exhibit potent immunosuppressive properties in higher eukaryotes which are mediated through interaction with specific receptor proteins (FKBPs or RBPs, for FK506- and Rm-binding proteins, respectively). These proteins possess peptidyl-prolyl cis-trans isomerase (PPIase) activity in vitro which is inhibited by the binding of Rm and FK506. We previously isolated a gene encoding an RBP from Saccharomyces cerevisiae, and demonstrated that null mutations in this gene (called RBP1) result in a recessive Rm-resistant (RmR) phenotype. We now have cloned the Candida albicans RBP1 gene via complementation of the RmR phenotype in S. cerevisiae. The predicted C. albicans RBP exhibits 61%, 52% and 49% amino acid (aa) sequence identity with RBPs (FKBPs) from S. cerevisiae, Neurospora crassa and human cells (FKBP-12), respectively. Furthermore, several of the aa residues identified as being important for drug binding in human FKBP-12 are conserved within the C. albicans RBP.

Amino Acid Sequence↗
PubMed1992

Preservation of continence after ileoanal anastomosis by the coordination of ileal pouch and anal canal motor activity.

Nocturnal incontinence may occur after ileoanal anastomosis and may be related to loss of an effective anal canal pressure barrier during sleep; how pressure and contractions in the proximal bowel influence this barrier is unknown. Our aim was to evaluate the relationship between anal canal pressure and contractions and contractile activity of the pouch in continent subjects after ileal pouch-anal anastomosis (IPAA) and of the rectum in normal controls. A fully ambulatory system for 24-hour pressure recording was used. A flexible transducer catheter was introduced endoscopically so that sensors were at 2, 3, 8, 12, 16, and 24 cm from the anal orifice in 12 healthy controls (7 men, 5 women, mean age: 35 years) and 7 fully continent IPAA patients (4 men, 3 women, mean age: 34 years) more than 12 months postoperatively. Twenty-four hour spontaneous motor activity was stored in a 2.5 megabyte (MB) digital portable recorder. Mean anal canal pressure was calculated, and rectal motor complexes and ileal pouch large pressure waves were characterized. During sleep, resting anal canal pressures were similar in the two groups (72 +/- 12 mm Hg in controls versus 66 +/- 9 mm Hg in IPAA patients [mean +/- standard deviation (SD)], p = NS), but anal canal pressure showed cyclic relaxations (periodicity: 95 +/- 11 min in controls, 54 +/- 18 min in IPAA patients, p less than 0.05), during which the mean pressure trough was 15 +/- 4 mm Hg in controls and 14 +/- 5 mm Hg in IPAA patients (p = NS). In the control patients, during sleep, a mean of six rectal motor complexes were identified (range: 3 to 9). In patients with IPAA, during sleep, a mean of eight large pressure waves per hour were identified (range: 2 to 20). Importantly, in both controls and patients, rectal motor complexes or large pressure waves were always accompanied by rapid return of anal canal pressure from trough to basal values and increased contractile activity. We concluded that, in healthy patients and in continent patients after IPAA, motor activity of the rectum and of the ileal pouch was associated with changes in pressure and contractile activity of the anal canal so that rectal- and neorectal-anal canal pressure gradient, and, in turn, fecal continence were preserved.

Adult↗
PubMed1992

Epidemiology of diabetes mellitus in southern Italy: a case-finding method based on drug prescriptions.

The study evaluates whether data concerning drug prescriptions available from the National Health System (NHS) can be used to provide an estimate of the prevalence and pattern of treatment of diabetes in a well defined health district in southern Italy. In Italy virtually all drug prescriptions are obtained through the NHS. For a period of three consecutive months all prescriptions of insulin, hypoglycemic agents and strips for blood and urine testing were monitored in a well defined area near Naples. 2958 cases were thus identified giving a prevalence of drug treated diabetes mellitus of 2.01%; prevalence was higher in females than in males (2.68 vs 1.35%) and increased with age from 0.05% in the age group below 9 years to 13.67 in the age group over 70 years. This case-finding procedure was validated by cross-check with independent sources of cases. To evaluate the sensitivity of the method a list of 820 "known" cases of drug treated diabetes mellitus was obtained from a random sample of local general practitioners (GPs) and diabetic clinics: 73.5% of these cases were also detected through the analysis of drug prescriptions. To evaluate the probability of misclassification a random subsample of 602 cases identified through prescriptions was submitted to the GPs working in the study area, for 517 the diagnosis of diabetes was confirmed, thus yielding a positive predictive value of 85.9%. After correction for sensitivity and probability of misclassification the prevalence of drug treated diabetes in our population was 2.52%. The pattern of prescriptions in this population is also given.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

NIDDM associated with mutation in tyrosine kinase domain of insulin receptor gene.

A population of 103 patients with non-insulin-dependent diabetes mellitus (NIDDM) was screened for mutations in the tyrosine kinase domain of the insulin receptor gene. Patient genomic DNAs corresponding to exons 17-21 of the insulin receptor gene have been amplified by polymerase chain reaction and analyzed by denaturing gradient gel electrophoresis (DGGE). One patient was identified with an altered pattern of mobility of exon 20 in the DGGE assay. Direct sequence of amplified DNA showed a single nucleotide substitution in the codon 1152 (CGG-- greater than CAG), resulting in the replacement of Arg with Gln. Two bands appeared in the sequence of exon 20 of the insulin receptor (nucleotide position 3584), indicating that this patient was heterozygous for the mutation. Insulin binding to intact erythrocytes from the patient was in the normal range. Although autophosphorylation of the purified insulin receptor also seemed normal, its kinase activity toward the exogenous substrate poly Glu:Tyr (4:1) was undetectable. This mutation may impair insulin receptor kinase and contribute to insulin resistance in this patient.

Alleles↗