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Biomedical subjects

A Notarbartolo

Publications and source records attributed to A Notarbartolo.

170 records · Page 10Linked to original sources
PubMedDate not supplied

Lipid and apoprotein behaviour after oral fat load in hypertriglyceridaemia.

Post-prandial profiles of plasma lipids and apoproteins have been studied in 13 hypertriglyceridaemic patients and in 24 normolipidaemic subjects who acted as controls. Triglyceride curves were different in the two groups: type IV patients reached the peak later than the controls (7-h vs 4 1/2-h) and cleared plasma triglycerides more slowly. The magnitude of post-prandial response was found to be higher in hypertriglyceridaemic patients. Positive correlations were also found between triglycerides response and fasting levels of triglycerides, apo B, apo C-II, apo C-III and apo E levels and negative correlations (not significant) with HDL-C levels in both hypertriglyceridemics and controls. In normolipidaemic subjects the triglyceride increase area was also correlated with age, BMI and total cholesterol, while in type IV patients with apo A-I and apo A-II levels. These data confirm that the magnitude of post-prandial phase is influenced by fasting levels of triglycerides-rich lipoproteins and that HDL are important determinants in the control of the post-prandial response. The most relevant finding in this study was the difference of the post-prandial profile of apoproteins C-II, C-III and E. These apoproteins significantly decreased nine hours after meal in the controls, while in hypertriglyceridaemics these apoproteins showed a rise over time. On the contrary apo A-I, apo A-II and apo B curves presented a similar profile in both groups. Possible mechanisms have been discussed, but further studies are necessary to understand the metabolic defects responsible for this behaviour in hypertriglyceridaemia.

Adult↗
PubMedDate not supplied

[Diet and psychological therapy in a group of severely obese patients].

The authors evaluated the usefulness of the psychological therapy in addition to usual diet treatment. Fifty subjects with severe obesity, have been randomly assigned to two different treatment groups: a) diet; b) diet plus psychotherapy. At the end of the study only the patients treated with diet plus psychotherapy showed any highly significant body weight reduction and a better diet adherence.

Adult↗
PubMedDate not supplied

[Incidence of anti-HCV positivity in a Sicilian population with liver diseases].

The discovery of virus C as an etiological agent of chronic liver disease (CLD) has modified previously-held concepts concerning the etiology of this disease. In a study of 581 consecutive patients with CLD, we confirmed that virus C was the sole agent responsible for it in 64.2% of all cases. Moreover, virus C was characteristically associated with virus B, alcohol consumption, and autoimmunity. When the various CLD were separated into subgroups, i.e., chronic persistent hepatitis (CPH), chronic active hepatitis (CAH), and liver cirrhosis (LC), virus C continued to be the main etiological agent, varying from 60.5% to 68.3%: this suggested constant evolution from milder to more severe forms of liver disease. Virus B alone was found less frequently, probably thanks to the virtual elimination of post-transfusion hepatitis B and the anti-B virus vaccination which is now widely administered. Frequency was 15.2% in the CPH group but lower in the LC and CAH groups (7.4% and 6.3% respectively), suggesting that evolution from the milder to the more severe forms of liver disease may not occur. Finally, we confirmed a statistically significant difference in mean age between hepatitis C virus positive men and women (p < 0.0001): in men, frequency was higher in the 20- to 50-year-old group; in women it was higher in the 50+year-old group.

Adult↗
PubMedDate not supplied

[Evidence-based medicine: the emerging of a new model of clinical practice. Italian Group for Evidence-Based Medicine (GIMBE)].

The introduction of the Diagnosis-Related Groups System to finance Italian hospitals has troubled not only health policy makers but also single physicians, who find themselves in the position of "resource managers" lacking adequate competence to evaluate the effectiveness of medical interventions. Given the limited economic resources and the failure of exclusively managerial-organizational-based solutions, the use of work-related methodologies able to identify and enable diagnostic and therapeutic interventions of documented efficacy for all patients has become a necessity. Evidence-based medicine is an emerging paradigm of clinical practice: promoted by the formulation of specific problems, it is implemented by the collection, interpretation and integration of research-derived evidence. This new model, which facilitates the transfer of progress made in research to clinical practice thanks to the promotion of diagnostic and therapeutic interventions of documented efficacy, can improve the effectiveness and efficiency of health care. The authors review the cultural events that have encouraged the development of this new paradigm of clinical practice, describe its methods, advantages and limits and point out differences from traditional models.

Evidence-Based Medicine↗
PubMedDate not supplied

[Levels of scientific evidence and strength of clinical recommendations. From trials to guidelines. The Italian Group on Medicine Based on Evidence--(GIMBE)].

Evidence-based medicine is a new paradigm of clinical practice that promotes the collection, interpretation and integration of valid, important and applicable to patients research-derived evidence, and it can improve the efficiency and the effectiveness of health care. Nevertheless research often fails to get in clinical practice, also because the traditional tools used by physicians to solve clinical problems are less reliable as the volume/complexity of medical information and biomedical technology have grown exponentially. New tools are emerging to help physicians: the systematic reviews of randomized controlled trials and the clinical practice guidelines that summarize a great volume of medical knowledge to improve health care. Practice guidelines, with a systematic review or meta-analysis pertaining to a definite health problem, summarize the evidence of clinical trials in clinical recommendation. These combine the strength and heterogeneity of the primary studies with magnitude and precision of the treatment effects as it relates to the minimal clinical benefit. The recommendation may suggest therapeutic intervention when the baseline risk is high or otherwise when the baseline risk is low. The Authors discuss principles of evidence-based medicine, measures of treatment effectiveness, systematic reviews and methods used by experts to graduate the strength of clinical recommendations in producing practice guidelines.

Humans↗