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Biomedical subjects

A Magrini

Publications and source records attributed to A Magrini.

At least 37 records · Page 2Linked to original sources

Thyroid autoimmunity and its association with non-organ-specific antibodies and subclinical alterations of thyroid function in women with a history of pregnancy loss or preeclampsia.

Following the observation that non-organ-specific antibodies are related with pregnancy loss and preeclampsia, the role of organ-specific antibodies is currently being extensively investigated. The aim of this study was on the one hand to evaluate the incidence of antithyroid antibodies in a study group of 69 women with a history of early pregnancy loss (subgroup 1), foetal death (subgroup 2) or preeclampsia (subgroup 3) and in a control group, on the other hand to assess the possible association of these autoantibodies with non-organ-specific antibodies and subclinical alterations of thyroid function in the study group. Antithyroid antibodies were present in 26/69 (37.7%) women of the study group (37.9% in subgroup 1; 40.9% in subgroup 2; 33.3% in subgroup 3) and in 10/69 (14.5%) of controls, the difference being statistically significant. A significant difference in the distribution of antibodies to thyroglobulin and thyroid peroxidase was found in subgroup 2. In the study group, the incidence of antiphospholipid antibodies was not significantly different in women positive (26.9%) and negative (34.9%) for antithyroid antibodies. Also, the overall incidence of subclinical alterations of thyroid function in the study group was significantly different in women positive (53.8%) and negative (16.2%) for thyroid autoimmunity (P<0.02). The results of this study seem to confirm the association between thyroid autoimmunity and obstetric complications and suggest the usefulness of undertaking prospective studies in order to evaluate the reproductive outcome of women with a history of recurrent abortion, foetal death or preeclampsia and positivity for antithyroid antibodies.

Abortion, Habitual↗

Incidence and risk factors associated with cardiac arrhythmias during rehabilitation after coronary artery bypass surgery.

OBJECTIVE: To evaluate the clinical relevance of cardiac arrhythmias during rehabilitation after coronary artery bypass graft (CABG) surgery. DESIGN: Survey of consecutive patients admitted to an inpatient cardiac rehabilitation center. SETTING: A rehabilitation center acting as a reference for cardiology clinics lacking this facility. The program was performed in the inpatient setting. PATIENTS: Two hundred sixty patients undergoing elective CABG surgery for angina. INTERVENTIONS: Four-week cardiac rehabilitation program. A 24-hour electrocardiographic examination was performed during the first 2 days and, subsequently, on a daily basis. MAIN OUTCOME MEASURES: Incidence and type of cardiac arrhythmias during rehabilitation; identification of factors associated with an increased risk of cardiac arrhythmias. RESULTS: Cardiac arrhythmias were recorded in 33.5% of the patients and were more frequent in patients with hypertension (47%), diabetes (42.4%), and hyperlipidemia (36.5%), compared with patients free from these diseases (15.5%) (p < .05). Arrhythmias were also recorded in patients older than 70 years (49%), compared with those younger (29.2%) (p < .01), and in patients who discontinued amiodarone (64.3%) compared with those who did not interrupt the drug (16%) (p < .005). Arrhythmias precluded rehabilitation in 5% of the patients and caused death in one patient. CONCLUSION: Surveillance for the development of cardiac arrhythmias during cardiac rehabilitation after CABG surgery may allow the early detection and treatment of arrhythmias in a substantial number of patients.

Aged↗

[Acute pericarditis in pregnancy. Report of a case].

In this study the authors describe a case of acute pericarditis occurring at 26 weeks' gestation in a woman affected by Wolff-Parkinson-White Syndrome and with a history of Hodgkin's Lymphoma and autoimmune hypothyroidism. The patient was first admitted to the 4th Medical Pathology Unit of the University of Florence, where moderate pericardic effusion with no evidence of heart tamponade was documented by ultrasound scan. Subsequently the patient was cared for on outpatient basis at the Centre of Perinatal Medicine of the Department of Obstetrics and Gynaecology of the University of Florence. Since all examinations and tests aimed at defining the etiology of pericardial effusion were negative, an idiopathic acute pericarditis was diagnosed. The patient was given prednisone at a dose of 75 mg per day; owing to episodes of paroxystic atrial fibrillation, propaphenon was also administered intravenously to treat acute episodes and orally as prophylaxis. The patient underwent close control of both heart function (by means of ultrasound scans of the heart and dynamic EKG) and pregnancy (blood tests, ultrasound scans and Doppler velocimetry). At 36.5 weeks' gestation a healthy fetus was spontaneously delivered. Three months after delivery, the patient underwent an ultrasound scan that demonstrated the complete reabsorption of the effusion.

Acute Disease↗

Substrate specificity of catechol oxidase from Lycopus europaeus and characterization of the bioproducts of enzymic caffeic acid oxidation.

The substrate specificity of catechol oxidase from Lycopus europaeus towards phenols is examined. The enzyme catalyzes the oxidation of o-diphenols to o-quinones without hydroxylating monophenols, the additional activity of tyrosinase. Substrates containing a -COOH group are inhibitors for catechol oxidase. The products of enzymic oxidation of caffeic acid were analyzed and isolated by HPLC with diode array detection. The neolignans of the 2,3-dihydro-1,4-benzodioxin type (3, 6-8), 6,7-dihydroxy-1-(3,4-dihydroxyphenyl)-2,3-dicarboxy-1,2-dihydro naphthaline (1) 6,7-dihydroxy-1-(3,4-dihydroxyphenyl)-3-carboxynaphthaline (5) and 2,6-bis-(3',4'-dihydroxyphenyl)-1-carboxy-3-oxacyclo-(3,0)-pent an-2-on-1-ene (4) were formed. A reaction mechanism for the formation of (1, 4 and 5) is discussed.

Caffeic Acids↗

Serum HCV RNA titer does not predict the severity of liver damage in HCV carriers with normal aminotransferase levels.

AIMS/BACKGROUND: Many HCV RNA positive subjects with normal aminotransferase levels have significant liver damage despite normal liver biochemistry. In these patients it is not possible to discriminate between "healthy" carriers and subjects with chronic liver damage, unless liver biopsy is performed. The aim of this study was to evaluate the usefulness of HCV RNA quantitation as a non invasive tool to predict the severity of liver injury in a group of HCV carriers with normal amino-transferase levels. METHODS: 59 HCV RNA positive subjects (20 males) with persistently normal ALT levels were studied. All patients underwent HCV RNA quantitation and percutaneous liver biopsy. RESULTS: No correlation was found between serum HCV RNA titers and grading, while viraemia did correlate with staging. Patients were categorized into four subgroups, according to arbitrary serum HCV RNA cut-offs. Grading was not different between the four groups. Staging was significantly higher among subjects with viraemia > 1000 x 10(3) copies/mL than in patients with HCV RNA titers < 1000 x 10(3) copies/mL. CONCLUSIONS: In HCV carriers with normal aminotransferase levels viraemia does not predict the grade of HCV-related chronic liver disease (CLD), although subjects with higher HCV RNA levels seem to have more severe fibrosis. Although these data suggest that patients with higher viraemia might have more intense architectural changes and more severe progression of liver disease than those with lower levels of HCV replication, the weak and imprecise correlation leads us to conclude that HCV RNA quantitation is not a useful indicator in clinical practice in the selection of patients for liver biopsy.

Adult↗

[Alterations in postural control: the use of spectral analysis in stability measurement].

UNLABELLED: Static posturography studies the frequency at which the center of gravity in the human body oscillates. There is no universal agreement as to the importance of this index or whether it is specific in identifying alterations in the postural control systems (vestibular, proprioceptive and visual). Nevertheless, some hypotheses appear generally accepted: a) visual information dominates; b) proprioception affects anterior-posterior oscillation; c) relatively low frequency body oscillation is affected by vestibular input while higher frequency oscillations are controlled by proprioceptive information. In order to check these hypotheses, four groups of patients underwent spectral analysis of bodily oscillations recorded with static posturography. The four groups of patients were similar in terms of age and broken down as follows: Group A-peripheral diabetic neuropathy (10 cases); Group B-diabetic neuropathy-free patients (10 cases); Group C-pure peripheral vestibulopathy (10 cases); Group D-normal subjects (20 cases). Analysis was performed dividing the frequency spectrum (FFT) into three groups: gr. I) 0.01-0.7 Hz; gr. II) 0.7-1 Hz; gr. III) > 1 Hz. Analysis of the spectra for Group A showed a significant increase in high frequency bodily oscillation (gr. III) with the eyes open in the anterior-posterior direction (M = 8.6 +/- 5.5; p < 0.05) and in the lateral direction (M = 4.0 +/- 2.0; p < 0.05); an increase was also found in both directions with the eyes closed (M = OCX II: 7.4 +/- 1.5; p < 0.05) (M = OCX III: 5.6 +/- 1.6; p < 0.01) (M = OCY II: 16.8 +/- 5.0; p < 0.05) (M = OCY II: 9.2 +/- 4.4; p < 0.05). In Group B the increase was limited to high frequency anterior-posterior oscillations (gr. III) at open eyes (M = 3.6 +/- 1.6; p < 0.05) and at closed eyes (M = 4.4 +/- 1.5; p < 0.05). In Group C there was an increase in high frequency lateral oscillations (gr. III) at open eyes (M = 4.2 +/- 0.5; p < 0.01) and panfrequency oscillations at closed eyes (M = OCX I: 47.7 +/- 5.6; p < 0.01) (M = OCX II: 23.2 +/- 4.9; p < 0.01) (M = OCX III: 7.2 +/- 2.3; p < 0.05). CONCLUSIONS: The diabetic proprioceptive deficit appears to lead to multiplanar destabilization at the medium-to-high frequency range. The labyrinthine deficit, on the other hand, appears to cause lateral destabilization at all frequencies. The method of analysis used appears to provide useful parameters with which to evaluate static posture since they can specifically identify alterations in orthostatic bodily control of various origins.

Adult↗

Clinical, histological, and virological features of hepatitis C virus carriers with persistently normal or abnormal alanine transaminase levels.

This study was aimed to evaluate demographic, clinical, histological, and virological characteristics of 46 hepatitis C virus (HCV) carriers with persistently normal alanine transaminase (ALT) levels and to compare the results with those obtained in a group of 52 HCV-RNA-positive patients with elevated ALT levels. Subjects with normal ALT were more often females (P < .001), were more likely to be asymptomatic (P < .001), and have a lower incidence of risk factors for HCV transmission (P < .01). All patients with normal ALT had significant histological liver damage. The mean grading and staging did not differ between patients with normal and those with raised ALT concentrations. Moderate to severe hepatitis was more frequently found among subjects with normal than with elevated ALT. HCV genotype 2a was far more common in subjects with normal (43%) than with abnormal ALT levels (6%; P < .002), genotype 1b being more frequent in these latter (50% vs. 17%; P < .001). Patients with normal ALT levels had similar serum HCV-RNA titers than subjects with raised ALT. Neither HCV genotype distribution nor viral load correlated with the severity of liver damage. We conclude that significant liver disease may occur irrespective of clinical symptoms, ALT levels, HCV genotypes, and viral load.

Adult↗

Contribution of central neuropathy to postural instability in IDDM patients with peripheral neuropathy.

OBJECTIVE: To evaluate the contribution of central neuropathy on postural impairment observed in diabetic patients with peripheral neuropathy. RESEARCH DESIGN AND METHODS: Central sensory and motor nervous propagation, nerve conduction velocity, and static posturography were assessed in the following age-matched subjects: 7 IDDM patients with peripheral neuropathy (group DN), 18 IDDM patients without peripheral neuropathy (group D), and 31 control subjects (group C). Somatosensory-evoked potentials (SEPs) during tibial nerve stimulation were recorded, and the spine-to-scalp sensory central conduction time (SCCT) was evaluated. Motor-evoked potentials (MEPs) were recorded from leg muscles during magnetic transcranial brain stimulation, and the scalp-to-spine motor central conduction time (MCCT) was evaluated. The following posturographic parameters were calculated from the statokinesigram: trace length, trace surface, velocity of body sway with its standard deviation, and VFY (a parameter derived from the velocity variance and the anteroposterior mean position of the body). RESULTS: SCCT was significantly higher in the DN group than in the C and D groups (P < 0.001). MCCT was similar in all groups. Posturographic parameters were all significantly impaired in the DN group (P < 0.01). While posturographic parameters showed a direct relationship with some parameters of peripheral nerve conduction, no correlations were observed with SEP and MEP central conduction time. These results were also confirmed by logistic regression, which indicates peripheral neuropathy as the only implicating factor in postural instability (odds ratio 0.22, 95% CI 0.07-0.75) after data reduction by means of factor analysis. CONCLUSIONS: Although diabetic patients with peripheral neuropathy show a delay in central sensory conduction, postural instability may be fully explained by the presence of peripheral neuropathy.

Adult↗

Leucocyte rheological properties are altered in patients with diffuse atherosclerosis.

To evaluate whether atherosclerosis may be associated with altered leucocyte rheology, we assessed leucocyte count (by Coulter counter), aggregation (by means of the leukergy test) and expression of adhesion molecules integrin LFA-1 and CD 44 (by means of immunofluorescence staining and flow cytometry) in 9 patients with carotid plus lower limb artery atherosclerosis (group A), 14 patients with carotid atherosclerosis only (group B) and 23 controls without atherosclerosis (group C). The level of LFA-1 (calculated as mean fluorescence channels-MFCs) on neutrophils, lymphocytes and monocytes was significantly higher (p < 0.05) in group A and B patients than in controls (group A-mean +/- SE: 383.77 +/- 9.42 vs 295.45 +/- 5.76; 474.22 +/- 8.86 vs 388.35 +/- 7.84; 457.66 +/- 12.03 vs 396.25 +/- 4.37. Group B: 322.42 +/- 6.36 vs 295.45 +/- 5.76; 421.42 +/- 7.21 vs 388.35 +/- 7.84; 415.71 +/- 7.73 vs 396.25 +/- 4.37, respectively); furthermore, the MFC of LFA-1 on neutrophils was significantly different (p < 0.05) between group A and B patients. The percentage of aggregated leucocytes was significantly higher (p < 0.05) in group A patients (4.46 +/- 1.07) than those in groups B (1.75 +/- 0.38) and C (1.43 +/- 0.25), whereas no significant difference was detected between groups B and C. Leucocyte number and expression of CD44 were not significantly different among the 3 groups. In conclusion, changes in leucocyte rheology are present in patients with atherosclerosis and may contribute to chronic ischaemia.

Aged↗

[Changes in posture in whiplash evaluated by static posturography].

Analyzing vestibular-spinal reflex by recording changes in the pressure center over time, static posturography provides precise, repeatable information regarding a person's posture and subsequent postural strategy. Moreover, using the detected postural pattern, this can presage likely genesis of problems in equilibrium. The purpose of the present work was to evaluate posturographic findings in subjects with chronic or persistent whiplash (WL)-induced disequilibrium in order to determine any clear postural pattern able to indicate the likely genesis of the disorder. Fifty young subjects were selected for the study: 28 (6 females) affected with equilibrium problems resulting from WL-type cervical strain and 22 (5 females) normal, age compatible controls (C) (mean age of the groups: WL = 37 +/- 14.3; C = 32.4 +/- 6.7; p = n.s.). The results obtained were statistically processed with a personal computer and specific software (Windows-SPSS). In the analysis of the means (T-test and ANOVA analysis of variance) p < 0.05 was considered significant. In the WL group there was an increase in the antero-posterior axis oscillation frequency as compared to the control group. This is indicated by the FFTY parameter in tests performed both with eyes open and closed. Likewise, in both tests, there was a decrease in the LFS value, a parameter correlating length with surface. The surface was increased in the WL group as compared to group C although this increase was significant only when the test was performed with eyes closed. In addition, the average velocity and standard deviation of velocity increased in the WL group but this was only statistically significant when the eyes were open. The results obtained in the present study show that whiplash victims show an increase in antero-posterior oscillation frequency at the pressure center, as found in the open and closed-eye tests. This suggests that in WL subjects there is an evident disturbance of the fine postural system, leading to an increase in the surface parameters, tracing length and a decrease in LFS function. The onset of this partial postural decompensation can be seen in: a) decrease in fine static postural control which is reflected in an increase in body surface oscillation; b) an increase in energy consumption to maintain orthostatism as revealed in the decreased LFS. In conclusion, it appears reasonable to assume that cervical proprioceptive alterations play a preeminent role in the genesis of whiplash-induced chronic postural instability. This would result in an attempt to vary the physiology from an ankle to a hip strategy; incomplete manifestation of this new posture would cause the feeling of instability mentioned by the patients and documented by posturography.

Adult↗

Hospital prevalence of asymptomatic primary biliary cirrhosis: 4-year study based on analysis of 4468 consecutive in-patients.

To assess the hospital prevalence of asymptomatic primary biliary cirrhosis (PBC), routine determination of serum alkaline phosphatase (AP), liver function tests (albumin, bilirubin, prothrombin time) and serum liver biochemistry (aminotransferases, gamma-glutamyltranspeptidase) were performed in 4468 consecutive in-patients (2332 men, 2136 women; mean age 57 years, range 16-94 years) admitted to our medical department from April 1991 to May 1995. In patients with an increase of serum AP levels, antimitochondrial antibody (AMA) testing, ultrasonography or CT scan, HIDA biliary scintiscan, bone scintiscan and endoscopic retrograde cholangio-pancreatography (ERCP) were performed to exclude any disorders other than PBC. Fourteen out of the 4468 patients (0.3%) showed an asymptomatic increase of AP levels (i.e., detected by chance at the entry and not earlier investigated). In 12 of 14 cases the increase of AP was not related to PBC. Asymptomatic PBC was found in 2 of 4468 patients (0.04%). When only the "risk group" (women over 40 years) is considered, the prevalence rate increases to 0.12% (2/1644 women). Our data, while not assessing the true prevalence of asymptomatic PBC in the general population, suggest that symptomless PBC is much more common than has been thus far supposed.

Adolescent↗

Postural rearrangement in IDDM patients with peripheral neuropathy.

OBJECTIVE: To evaluate the influence of diabetic peripheral neuropathy on postural strategy. RESEARCH DESIGN AND METHODS: Static posturography and nerve conduction velocity were performed in the following age-matched subjects: 10 IDDM patients with peripheral neuropathy, 23 IDDM patients without peripheral neuropathy, and 21 control subjects. All subjects with signs or symptoms of postural instability were excluded from the study. The following posturographic parameters were drawn: 1) velocity of body sway, expressed as mean velocity and average of the SDs, 2) VFY, the parameter derived from the velocity variance and the anteroposterior mean position of the body (this parameter monitors the postural strategy pursued by the subject), and 3) fast Fourier transformation on the x (FFTX) and y (FFTY) planes, spectral analysis of the frequencies of body oscillation on frontal (x) and anteroposterior (y) planes. RESULTS: Mean velocity and its SD were higher in IDDM patients with peripheral neuropathy than in control subjects and IDDM patients without peripheral neuropathy (P < 0.001). VFY was increased in IDDM patients with peripheral neuropathy versus control subjects and IDDM patients without peripheral neuropathy (P < 0.01). A direct relationship was found between parameters of posturography and some parameters of nerve conduction tests. CONCLUSIONS: Diabetic patients with peripheral neuropathy demonstrate a shift from physiological ankle control to hip postural control as monitored by specific posturography analysis.

Adult↗

Body sway in diabetic neuropathy.

OBJECTIVE: To evaluate the influence of peripheral neuropathy on body sway assessed by posturography. RESEARCH DESIGN AND METHODS: The age-matched study subjects included 10 insulin-dependent diabetes mellitus (IDDM) patients with peripheral neuropathy (DN), 23 IDDM patients without peripheral neuropathy (D) according to the San Antonio Consensus Conference guidelines, and 21 control subjects (C). All subjects with symptoms and/or clinical signs of postural instability were excluded from the study. RESULTS: The trace surface was significantly larger in the DN than in the C and D groups (P < 0.05), and the trace length was longer in the DN than in the C and D groups (P < 0.01). Mean velocity was faster in the DN than in the other two groups (P < 0.001). A direct relationship was found between the parameters of posturography and some parameters of the nerve conduction velocity. CONCLUSIONS: Diabetic patients with peripheral neuropathy demonstrate a relative deficit in their ability to maintain posture. Posturography allows an early disclosure of the failure of postural control.

Adult↗