Biomedical subjects
Publications and source records attributed to A Lillo.
Congenital arteriovenous fistulas (AVF) without associated vascular malformations are uncommon. Only a very few cases of AVF have been reported in the neck. We describe our findings in a patient with AVF treated by a combined vascular and endovascular approach.
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The mevalonate-independent biosynthetic pathway to isopentenyl diphosphate and dimethylallyl diphosphate, the universal precursors to the isoprenoids, operates in eubacteria, including Escherichia coli, in algae, and in the plastids of higher plants. A search of the Sanger Centre Streptomyces coelicolor genome database revealed open reading frames with ca. 40--50% identity at the deduced amino acid level to the first three E. coli enzymes of this pathway, corresponding to deoxyxylulose phosphate synthase, deoxyxylulose phosphate reductoisomerase and 2-C-methyl erythritol 4-phosphate cytidylyltransferase. The S. coelicolor genes have been cloned and expressed in E. coli, and the recombinant proteins characterized physically and kinetically. The presence of the corresponding enzyme activities in extracts of S. coelicolor CH999 further supports the operation of the mevalonate-independent pathway in this organism.
OBJECTIVES: To evaluate the presence of premature atherosclerotic lesions of epiaortic vessels in HIV-1-infected protease inhibitor-(PI) treated patients compared with PI-naive patients and healthy individuals. DESIGN: One-hundred and two HIV-1-positive patients, including 55 treated with PI for at least 12 months and 47 either naive or treated with PI-sparing regimens, were subjected to epiaortic vessel ultrasonography. These data were compared with those obtained from 104 healthy individuals. METHODS: Intima characteristics, pulsation and resistance indexes, and minimal, peak and mean speed were evaluated using a colour power doppler. Atherosclerotic plaques were described. Independent risk factors and values for glycaemia, cholesterolaemia and triglyceridaemia were considered. Statistical analysis included the chi-square test, Mantel-Haenszel test, odds ratio and logistic regression analysis. RESULTS: Of the PI-treated patients, 29 out of 55 (52.7%) presented acquired lesions of the vascular wall at ultrasonography, whereas similar lesions were found in seven out of 47 (14.9%) PI-naive patients. Of the 104 healthy individuals, seven cases (6.7%) of intimal medial thickness were noted. A slightly significant correlation was found between carotid lesions and age, male sex and hypercholesterolaemia, whereas cigarette smoking, hypertriglyceridaemia and Centers for Disease Control and Prevention stage significantly increased the risk of vascular lesions (P= 0.022, P= 0.017 and P= 0.079 respectively). However, the highest significance regarded use of PI (P= 0.011). These results were confirmed by logistic regression analysis. CONCLUSIONS: These data demonstrate a higher than expected prevalence of premature carotid lesions in the PI-treated compared with PI-naive patients. If confirmed, a periodic ultrasonographic study of the vascular wall should be included in the follow-up of HIV infected patients.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.
Plasma lipids were tested in 59 patients with symptomatic peripheral vascular disease (PVD) (confirmed by angiographic and, in many cases, operative examinations) and compared with the lipid balance in 47 nonarteriopathic subjects constituting the control group. Of all the elements considered, only the hypertriglyceridemia and the fall in the HDL cholesterol/total cholesterol ratio showed a statistically significant difference between the two groups. In particular, there was a significant difference between the two groups. In particular, there was a significant difference in the triglyceridemia present in the arteriopathic patients, as evidenced by the double check afforded by the frequency test (PVD: 25/59; control: 8/47; p less than 0.01) and the averages test (PVD: 201 +/- 131; control: 138 +/- 98; p less than 0.01).
Repair of descending thoracic aneurysm or thoracoabdominal involves transient ischaemia of many organs with high risk of complications. The elderly patient may be more at risk depending on the presence or absence of significant comorbidity factors. Careful preoperative evaluation and patient selection considerably reduce the risk of operative mortality and morbidity. We review the management of thoracic and thoracoabdominal aneurysms in the elderly and briefly describe our surgical approach in order to minimize operative risk and improve surgical results.
The elderly population has the highest risk for developing stroke and the annual death rate is some 394/100,000 population. Moreover, the elderly are the fastest growing segment in our society. In carefully selected patients carotid endarterectomy may provide to prophylaxis against stroke. With a careful selection, acceptable low operative motality and morbidity rates may be achieved, comparable to the 4.3% and the 2.3% of the Veterans Affair and ACAS studies, in which the patients' mean ages were 64.1 and 67 years respectively.
The constant increase in the median age over 80 requires more and more care from vascular surgeons to obtain better results in the treatment of aortic degenerative diseases. In the last years a remarkable improvement in the procedures of endovascular surgery of abdominal aortic aneurysms has been reached. Actually different prostheses are available for the treatment of aortic aneurysms. The early results of these procedures are similar to the traditional surgical techniques, but at the moment long term results are not yet available. The Authors underline the importance of a long term follow up to allow a correct evaluation of physiopathological modifications in the aortic circulation.
The authors compare the results obtained from the strain gauge plethysmography on 79 patients affected by vibrating machines angiopathology with a group of 20 others non exposed to vibrations. The results, analyzed according to the microcirculation vision, lead the authors to suppose that the damage caused by vibrating instruments is revealed at the capillary bed trophic exchange level.