Search PubMed⌕ Search

Biomedical subjects

C Finelli

Publications and source records attributed to C Finelli.

45 records · Page 3Linked to original sources
PubMed1983

[Polycythemic hyperviscosity syndromes].

Packed red cell volume (VPRC) and total blood volume chiefly affect oxygen transport to tissues and produce the syndrome of polycythemic hyperviscosity. Several studies have demonstrated that a raised VPRC increases the blood viscosity and, under a measured pressure, decreases the flow rate in a capillary tube. Reduced flow results in a less effective tissue perfusion. The oxygen transport at different values of VPRC is shown by an inverted arc-like curve: at normal VPRC levels the oxygen transport is optimal. Hypervolemia affects oxygen transport to tissues: at the same VPRC values, hypervolemic patients have a better oxygen transport. In polycythemia vera (PV), hypervolemia may partially reduce the damage due to the increased blood viscosity. However, in some local areas where fixed vessel diameter (from arteriosclerosis) limits the increased blood flow, hyperviscosity may result in a local tissue ischemia. A relative iron deficiency with associated microcytosis due to venesection frequently occurs in PV. It is also associated with a delayed red blood cell filtration which may contribute to hyperviscosity. When thrombocytosis is present, the risk of thrombotic complications is furthermore increased. We report symptoms and signs at the onset in a series of 80 patients affected by PV. All patients have a minimum follow-up of 4 years. We also report the course of the illness, the treatment effectiveness (venesection, dibromomannitol) on clinical symptoms, the survival curve with analysis of prognostic factors at the onset and the causes of death.

Aged↗
PubMedDate not supplied

The validity of informant reports in assessing the severity of dementia: evidence from the CAMDEX interview.

The evaluation of a patient's mental state, overall clinical profile and behavioural disturbance in the process of diagnosing dementia requires at least two sources of information: the patient and the informant. Since the severity of the dementia may interfere with the subjective perception of these disorders, it is important to evaluate the consistency between these two sources of information and the clinical and psychometric evaluation made by the physician. Accordingly, in this study five behavioural areas, derived from the semi-structured interview schedule provided by the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX, i.e., Sleep, Depressed Mood, Everyday Activity, Memory and Global Mental Functioning) have been tested on the patient and his/her informant. Eighty dementia patients (mean age = 74 years) and their informants participated in the study. The dementia group was subdivided into two levels of severity according to DSM-IIIR criteria: 41 with mild dementia and 39 with moderate dementia, respectively, matched for age and schooling. The rating of impairment was found to increase along with the severity of dementia in all the above-mentioned areas, except for sleep. However, the source of information per se significantly influenced the evaluation of memory functioning. Moreover, the significant interaction between the two factors considered indicates that memory functioning is evaluated quite differently by the patients and the informants, as only in the assessment made by the latter group did the impairment increase in parallel with severity of dementia. Finally, whereas none of the subjective measures recorded in the patients were significantly correlated with their test scores, the correlations between the informant memory appraisals and patient test results proved to be significant. The present findings confirm the validity of informant reports in assessing cognitive and memory disorders in early-stage dementia, as well as in distinguishing patients with mild from those with moderate dementia.

Aged↗
PubMedDate not supplied

Effect of in vivo treatment with rh GM-CSF on in vitro growth of haematopoietic progenitors in patients with myelodysplastic syndromes.

BACKGROUND: Recombinant (r) human (h) granulocyte/macrophage colony stimulating factor (rh GM-CSF) has been shown to increase the number of peripheral blood (PB) neutrophils, eosinophils and monocytes in myelodysplastic syndromes (MDS). The aims of this study were: 1) to evaluate the effect of rh GM-CSF therapy on the in vitro growth of granulocyte-erythroid-macrophage-megakaryocyte colonies (CFU-GEMM), erythroid colonies (BFU-E), and granulocyte-macrophage colonies (CFU-GM) in patients with MDS; 2) to assess in these patients, while they are being treated in vivo with rh GM-CSF, the possible additive effect of rh IL-3 and rh G-CSF on the in vitro growth of haematopoietic progenitors. METHODS: The in vitro growth of CFU-GEMM, BFU-E and CFU-GM was studies in 10 myelodysplastic (MDS) patients, before and after in vivo administration of rh GM-CSF. RESULTS: After rh GM-CSF administration, the number of CFU-GM increased in all standard risk MDS patients. In 2 out of 5 cases, this effect was more pronounced and persisted up to 30 days after the end of rh GM-CSF treatment. On the other hand, the number of CFU-GEMM and BFU-E was substantially unchanged. When rh GM-CSF, rh G-CSF and rh IL-3 were added in vitro alone or in combination as the source of colony stimulating activity, no significant increase of the CFU-GM colony number was noticed. CONCLUSIONS: Rh GM-CSF therapy appears useful for increasing the number of peripheral blood granulocytes and of marrow CFU-GM in standard-risk MDS patients. High-risk MDS patients are far less responsive to rh GM-CSF treatment, probably reflecting a more aggressive and/or advanced disease.

Colony-Forming Units Assay↗