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Biomedical subjects

A Piana

Publications and source records attributed to A Piana.

At least 37 records · Page 2Linked to original sources

Amoxycillin resistance is one reason for failure of amoxycillin-omeprazole treatment of Helicobacter pylori infection.

BACKGROUND: The efficacy of omeprazole and amoxycillin dual therapy to treat Helicobacter pylori infection has been inconsistent, suggesting the presence of host or bacterial factors influencing treatment success. The aim of this study was to assess the role of pre-treatment amoxycillin resistance in the efficacy of omeprazole and amoxycillin dual therapy. METHODS: We studied 43 consecutive dyspeptic patients with H. pylori infection. Pre-treatment H. pylori infection was established by the combination of positive rapid urease test, culture and histology. Amoxycillin susceptibility testing was performed by an Epsilometer test (E-test) method and amoxycillin resistance was defined as minimum inhibitory concentration greater than 8 microg/mL. Patients received 20 mg omeprazole twice daily for 28 days and amoxycillin 1000 mg twice daily for 2 weeks. Adverse effects were documented using a questionnaire. H. pylori status was reassessed 6-8 weeks after the end of treatment by rapid urease testing and histological examination of gastric biopsies. RESULTS: Forty-two dyspeptic patients completed the study, and one patient dropped out. H. pylori infection was cured in 2 3 of 42 patients (55%). The cure rate was higher in patients harbouring amoxycillin-sensitive organisms than in those with resistant strains: 66% (19/29) vs. 31% (4/13), respectively (P = 0.049). No significant differences in cure rates were evident in relation to age, sex, smoking habits or compliance. CONCLUSIONS: The effectiveness of amoxycillin-omeprazole dual therapy was greatly reduced in the presence of pre-treatment amoxycillin-resistant H. pylori. The success rate in patients with amoxycillin-sensitive H. pylori was only 66%, suggesting the presence of additional factors affecting the efficacy of this therapy.

Adult↗

Hydrogen peroxide formation in platelets of patients with non-insulin-dependent diabetes mellitus.

A group of 29 patients with non-insulin-dependent diabetes mellitus (NIDDM) was compared with a group of 19 patients who had good glycemic control for platelet activity and hydrogen peroxide formation. NIDDM patients showed platelet hyperactivity in response to low ADP concentrations. In addition, stimulated platelets from untreated NIDDM patients produced more hydrogen peroxide than platelets of treated and normal subjects. Hydrogen peroxide accumulation was not related to modification of the enzymatic systems involved in its synthesis and break-down. The specific activities of NAD(P)H cytochrome C reductase, catalase, glutathione peroxidase and glutathione reductase were not different between patients and healthy subjects. It is likely that the platelet intracellular elevation of reactive oxygen free-radicals could play an important role in the vascular complications and thrombotic risk that is often present in NIDDM patients.

Journal Article↗

Hyperactivity and increased hydrogen peroxide formation in platelets of NIDDM patients.

Free radical activity may contribute to atherosclerotic lesions which in diabetic subjects may frequently lead to vascular complications. It is known that oxidative stress is associated to diabetes. Protein glycation and glucose oxidation could be possible source of free radicals. 28 non insulin dependent diabetic subjects (NIDDM) were examined. 20 healthy subjects matched for age, sex and for the presence of hypertension and hyperlipidemia were also studied. Hydrogen peroxide, measured by intracellular levels of the fluorescent 2,7-dichloro-fluorescein (DCF), was considered as indicative parameter of free radical production. The results showed that in resting platelets the basal level of hydrogen peroxide was significantly higher in diabetic subjects than in controls. Moreover, after stimulation with thrombin, collagen, phorbol myristate acetate (PMA) and platelet activating factor (PAF), platelets of diabetic subjects generated significantly higher amounts of hydrogen peroxide than controls. Moreover, platelet aggregation induced by adenosine 5'-diphosphate (ADP) and plasma beta TG levels were higher in diabetics than in controls. In diabetic patients platelet free radical production and functional activity are increased and therefore could play a role in the elevated thrombotic risk described in diabetes.

Adenosine Diphosphate↗

Reliability of hemorrhagic transformation diagnosis in acute ischemic stroke.

BACKGROUND AND PURPOSE: Diagnosis of hemorrhagic transformation (HT) could influence the prognosis and the management of acute ischemic stroke. The interobserver reliability of CT-scan HT classification is evaluated in the present study. METHODS: Fifty 5-day CT scans of patients enrolled in the Multicenter Acute Stroke Trial-Italy (MAST-I) were reviewed independently by two neuroradiologists and one neurologist with CT training. They evaluated the presence and type of intraparenchymal HT (hemorrhagic infarction types I, II, and III and intracerebral hemorrhage) (five-item scale), as well as the presence of intraventricular and/or subarachnoid bleeding according to standardized definitions. RESULTS: Agreement for exclusion of HT and intraventricular/ subarachnoid bleeding was good between the neuroradiologists (kappa = 0.70 and kappa = 0.72) and excellent between the neurologist and each neuroradiologist (kappa = 0.87 and kappa = 0.77, kappa = 0.83, and kappa = 0.81, respectively). The overall agreement for the five-item HT scale between the two neuroradiologists was good (kappa n = 0.65) because of discordance over the last three items. Better overall agreement was obtained with a three-item scale: no hemorrhage, petechial type I hemorrhagic infarction, and other HT (type II and type III hemorrhagic infarction and intracerebral hemorrhage) together (kappa w = 0.82 CONCLUSIONS: Exclusion of HT is a reliable CT diagnosis when made by neuroradiologists and also by a neurologist with CT training. Five- and three-item scales of HT types showed good to excellent reliability. The validity of the scale for predicting short- and long-term outcome should be evaluated in future studies.

Acute Disease↗

Increased hydrogen peroxide formation in platelets of patients affected with essential thrombocythaemia (ET).

The basal platelet level of reactive oxygen species and their enhancement following stimulation by different agonists were determined in a selected group of patients with essential thrombocythaemia (ET). Activated platelets had lower levels of superoxide anion and higher intracellular concentrations of hydrogen peroxide than controls. Higher levels of lipid peroxidation induced by N-ethylmaleimide were also observed. Measurement of the most important enzymes generating and scavenging these reactive oxygen species revealed increased specific activities of NADPH-cytochrome c reductase and superoxide dismutase and a decrease in platelet catalase activity in patients with ET. Since an abnormal production of oxygen radicals seems to be implicated in various pathological conditions and aging processes, the increased amount of hydrogen peroxide found in platelets of patients could be involved in some of the platelet alterations described in ET.

Blood Platelets↗

Platelets of patients affected with essential thrombocythemia are abnormal in plasma membrane and adenine nucleotide content.

The adenine nucleotides present in distinct cellular compartments of platelets of 27 patients affected with essential thrombocythemia have been measured. In order to quantify granule-bound nucleotides and adenylic cytoplasmic pool, platelets have been stimulated with thrombin or treated with increasing digitonin concentrations, respectively. Among patients, we have identified two groups: 12 patients (Group 1) had normal platelet level of ATP and ADP both in dense granules as well as in cytoplasmic pool. The other patients (Group 2) had granule ATP and ADP significantly lower and ATP/ADP ratio significantly higher than controls. In these patients an increase in hypoxanthine level, derived from metabolic ATP degradation occurring during stimulation, was observed. In addition, in the latter patients an increased resistance of plasma membrane to digitonin was shown, suggesting that membrane fluidity should be reduced owing to a modified cholesterol/phospholipid ratio.

Adenine Nucleotides↗

[Evaluation of various hemorheological parameters in nonagenarians: evidence of an increase of fibrinogen].

Cardiovascular disease is the most frequent cause of mortality in the elderly. A reduced microvascular blood flow associated with an increase in atherosclerosis might contribute to age related increases in the incidence of ischemic vascular disease. In order to evaluate the effect of age on some haemorheological parameters, blood and plasma viscosity and fibrinogen have been measured in 10 healthy elderly subjects, aged between 88 and 96 years, compared with 15 healthy young subjects (mean age 37 years). Elderly subjects showed a significant increase in plasma fibrinogen (p less than 0.0005) and a trend to an increase in plasma viscosity, whereas no difference was present in blood viscosity. These data confirm that aging is associated with a greater deal of thrombotic risk factors, the most important of which seems to be fibrinogen.

Adult↗

[Evaluation of various hemorheologic parameters in diabetes mellitus].

It has been speculated that changes in intrinsic blood flow properties may contribute to the evolution of vascular complications in diabetes mellitus. To verify this hypothesis we measured hematocrit, fibrinogen, plasma and blood viscosity in 30 diabetic patients and in 25 healthy volunteers. Diabetics showed blood and plasma viscosity and fibrinogenemia higher than healthy subjects, although only plasma viscosity and fibrinogenemia were statistically significant (p less than 0.001). Moreover the diabetic patients with the highest HbAlc values had a significant increase in plasma viscosity compared with the patients with lower HbAlc values (p less than 0.001), despite a similar fibrinogenemia. This study confirms the presence of hemorheological changes in diabetes mellitus and shows a correlation between plasma viscosity and metabolic control.

Adult↗

[Hemorheological and coagulation aspects in plasmacytoma].

We reported the main rheological and coagulative features in seven patients affected with monoclonal gammapathy: four of them presented IgA class paraprotein, two IgM class paraprotein and one IgG class paraprotein. All presented increased plasma and serum viscosity. The four patients affected with IgA monoclonal paraproteinaemia underwent one plasma volume plasmapheresis. This procedure has been demonstrated to be useful and effective in reducing both plasma and serum viscosity.

Adult↗

Platelet glucose metabolism in type I diabetic subjects.

In a group of 35 type I diabetics, platelet glycolytic and glycogenolytic flux have been measured. In type I diabetic platelets glucose uptake was significantly reduced. The quite normal lactate production was obtained by a faster utilization of stored glycogen in these patients. Specific activity of glycolytic enzymes was normal, in particular the levels and kinetic properties of soluble and membrane bound hexokinase. The rate of glucose flux through the hexose monophosphate shunt, measured either in resting or in arachidonic acid-stimulated platelets, was normal in diabetics. Kinetics of glucose transport across plasma membrane have also been determined. Km was significantly increased in diabetic patients. No changes was shown in Vmax. Modifications present in membrane organization of patients could involve glucose transport protein.

Adult↗

Effect of diabetes mellitus on selected acid hydrolase activities in human platelets.

Platelets were isolated from blood donated by 57 diabetic subjects, 41 insulin-dependent and 16 non insulin-dependent, ranging in age from 19 to 78 years, and by 54 healthy non-diabetic subjects ranging from 19 to 63 years of age. The platelets were ruptured by sonication and resultant preparations assayed for their levels of activity of seven acid glycohydrolases. Platelets from diabetic subjects contained only 50% of the alpha-L-fucosidase activity and about 60% of the acid phosphatase, beta-D-galactosidase, and beta-D-glucosidase activities of platelets from non-diabetic individuals; the differences were statistically significant. N-acetyl-beta-D-glucosaminidase activity in platelets from diabetic subjects was reduced by about 15% from normal levels while beta-D-glucuronidase and alpha-D-mannosidase activities were similar to those from non-diabetic individuals. A comparison of the data from older insulin-dependent diabetic and normal subjects with a similar age distribution yielded identical results for the two groups in all enzymes tested except fucosidase. Platelets of non insulin-dependent diabetics and those from non-diabetic subjects of a similar age distribution appear to possess similar levels of these acid hydrolases. There was no difference in levels of these platelet acid hydrolases between males and females in either the diabetic or non-diabetic group. Within the diabetic group, there was no difference in these platelet acid hydrolase activities between subjects with retinopathy and without retinopathy. There was no correlation of the enzyme activity levels of platelets from diabetic subjects with concentration of glycosylated haemoglobin, serum triglycerides or serum cholesterol.

Acid Phosphatase↗

Lactate overproduction in platelets of subjects affected with myeloproliferative disorders.

In platelets of patients affected with myeloproliferative disorders, glycolytic and glycogenolytic flux have been examined. Results of studies on glucose uptake, glycogen breakdown and lactate formation have been reported. No difference in glucose uptake between controls and patients was observed, but in patients a higher lactate formation was always noted in the presence or absence of exogenous glucose, in correlation with a higher glycogen breakdown rate. Results could be explained by modified regulation mechanisms on glycogen phosphorylase.

Adult↗

Some aspects of platelet glucose metabolism in thrombocytosis due to myeloproliferative disorders.

Some aspects of the glucose metabolism were investigated in platelets of 11 healthy donors and 11 patients suffering from thrombocytosis due to myeloproliferative disorders. Out of all the glycolytic compounds measured in resting platelets, dihydroxyacetonephosphate and fructose 1,6 bisphosphate were significantly higher in cells of subjects with thrombocytosis. No difference was observed in the basic net flux of glucose through the hexose monophosphate shunt. Addition of arachidonic acid to platelets of patients with thrombocytosis had a very poor effect in stimulation of the hexose monophosphate shunt, whereas high values of activation were obtained in control platelets. Lactate production determined by collagen was found significantly higher in all patients. These data observed in platelets of patients could be explained by a decreased pool of metabolic adenine nucleotides.

Adult↗

Platelet membrane fatty acids in thrombocytosis due to myeloproliferative disorders.

The fatty acid composition of platelet membranes has been analysed in patients with thrombocytosis due to myeloproliferative disorders, who had not taken any drugs. A significant increase in palmitic and oleic acid, together with a decrease in stearic, linoleic and arachidonic acids was observed. The fatty acid pattern of platelet membranes was also analysed in patients during treatment with ASA (acetylsalicylic acid). ASA ingestion completely normalizes the platelet content of palmitic acid and partially that of stearic and arachidonic acid, whereas it has no effect on the level of linoleic acid and raises that of oleic acid. The altered pattern of fatty acids observed in patients may interfere with platelet function by decreasing membrane fluidity. Treatment of patients with ASA seems to act on platelet membranes by partially normalizing the fatty acid composition.

Adult↗

Platelet glyoxalases in thrombocytosis.

In platelets of patients suffering from thrombocytosis due to myeloproliferative disorders, glyoxalase I activity is significantly higher than in controls (P less than 0.01), while glyoxalase II levels are the same (P less than 0.3). The cellular concentration of glutathione is also increased in patients. Km values for methylglyoxal (glyoxalase I) and S-lactoylglutathione (glyoxalase II) are identical both in normal and pathological subjects, as are the thermostability of the two enzymes. The higher activity observed for glyoxalase I in patients could be related to a specific role of this enzyme in platelets.

Adult↗

Platelet lysosomal enzymes are normal in myeloproliferative disorders.

In platelets of subjects affected with myeloproliferative disorders the following lysosomal enzymes were studied: alpha-mannosidase, alpha-fucosidase, beta-galactosidase, beta-glucosidase, beta-glucuronidase, beta-N-acetylglucosaminidase and acid phosphatase. For each enzyme the specific activity, the optimum of pH and buffer, Km and saturating substrate concentrations, as well as thermostability were determined. Control and patient enzymes showed no difference.

Blood Platelets↗

[A method for the assay of fibrinopeptide in plasma].

Fibrinopeptide A (FPA) levels have been assayed in 10 normal subjects using a radioimmunoassay (RIA-mat FPA Mallinckrodt). Mean values were 0,97 +/- 0,46 ng/ml. The variation coefficient of the test was 4,82%. The method is well standardized and seems to be useful in the diagnosis of venous thrombosis and in the control of heparin treatment. It seems to be also useful in the evidentiation of an activation af the coagulation system in some diseases (cardiovascular diseases, diabetes etc.)

Fibrinogen↗