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Biomedical subjects

C Marini

Publications and source records attributed to C Marini.

At least 145 records · Page 8Linked to original sources
PubMedDate not supplied

Sumatriptan and cerebral blood flow velocity changes during migraine attacks.

Transcranial Doppler studies on the effects of sumatriptan on cerebral hemodynamics have shown conflicting results. We evaluated blood flow velocity changes in 21 patients suffering from migraine with (n = 4) or without aura (n = 17) during a spontaneous attack, before and after treatment with sumatriptan. Flow velocity in the internal and external carotid, middle cerebral, and basilar arteries was measured by means of transcranial Doppler. During the attack, measurements were taken before subcutaneous sumatriptan injection, then after 30 minutes, 2 hours, and 24 hours. An additional measurement was taken 1 week later, in a headache-free state. We found a significant reduction of flow velocity during the attack in the middle cerebral artery on both sides (P < 0.05). After sumatriptan administration, flow velocity increased in the internal carotid artery on both sides (P < 0.05) and in the middle cerebral artery on the headache side (P = 0.0001), but not in the external carotid and basilar arteries (P > 0.05). Flow velocity changes may reflect the vasodilation present at the onset of the migraine attack followed by vasoconstriction in the internal carotid and middle cerebral arteries after sumatriptan treatment. Since vasoconstriction occurs in responders and nonresponders to treatment, it is unlikely to be the primary mechanism by which sumatriptan relieves headache.

Adolescent↗
PubMedDate not supplied

Different vascular risk factor profiles among cortical infarcts, small deep infarcts, and primary intracerebral haemorrhage point to different types of underlying vasculopathy. A study from the L'Aquila Stroke Registry.

The type of small-vessel disease in small deep (lacunar) infarcts (SDIs) remains contentious as opposed to that in primary intracerebral haemorrhage (PICH), which is lipohyalinosis in most cases. Therefore, we compared risk factor profiles as indicators of underlying vessel pathology, between patients with SDI and patients with PICH, and those with a non-cardio-embolic infarct involving the cortex (CORTI). Multivariate regression analysis showed the diabetes mellitus [odds ratio (OR) 0.56; 95% confidence interval (CI) 0.34-0.90] and hypercholesterolaemia (OR 0.63; 95% CI 0.40-0.99) were more strongly associated with CORTI than with SDI. Carotid stenosis was associated with SDI in comparison with PICH (OR 7.5; 95% CI 1.02-54.94). Compared with PICH, CORTI was more strongly associated with diabetes mellitus (OR 3.27; 95% CI 1.38-7.76), carotid stenosis (OR 24.42; 95% CI 4.99-119.45), and hypercholesterolaemia (OR 3.12; 95% CI 1.47-6.65), whereas hypertension was associated with PICH (OR 0.37; 95% CI 0.18-0.79). These data support the hypothesis that small-vessel atheromatosis rather than small-vessel lipohyalinosis underlies lacunar infarcts in most cases.

Aged↗
PubMedDate not supplied

Cerebrovascular reactivity evaluated by transcranial Doppler: reproducibility of different methods.

Transcranial Doppler is routinely used to assess the cerebrovascular reactivity, despite scarce information on its reproducibility. We evaluated the reproducibility of cerebrovascular reactivity measurements by this method utilizing different vasodilatory and vasoconstrictor stimuli. The cerebrovascular reactivity was measured in 45 healthy volunteers during hypercapnia induced by inhalation of a mixture of 5% CO2 and 95% O2, breath holding and rebreathing, and during hypocapnia induced by voluntary hyperventilation. Three sets of measurements were performed at times 0, 1, and 24 h to assess the within-observer short- and long-term reproducibility. The reproducibility was analyzed using the intraclass correlation coefficient. For the CO2 inhalation method, a good short-term (rI = 0.55; 95% CI = 0.39-0.68) and a good long-term (rI = 0.43; 95% CI = 0.25-0.59) reproducibility was found. For the breath-holding method a good short-term agreement was found (rI = 0.41; 95% CI = 0.22-0. 57), while the long-term reproducibility was poor (rI = 0.17; 95% CI = -0.03-0.36). Rebreathing showed a fair (rI = 0.31; 95% CI = 0.11-0. 48) short-term and a poor (rI = 0.17; 95% CI = -0.03-0.36) long-term reproducibility. For voluntary hyperventilation, the short-term reproducibility was good (rI = 0.53; 95% CI = 0.36-0.66), and the long- term reproducibility was fair (rI = 0.31; 95% CI = 0.11-0.48). In our study, CO2 inhalation and voluntary hyperventilation had the highest reproducibility and should be preferred when assessing cerebral vasoreactivity, especially in follow-up studies.

Adult↗
PubMedDate not supplied

Effects of interferon beta, cyclophosphamide and azathioprine on cytokine profile in patients with multiple sclerosis.

We assessed the in vitro effects of interferon beta-1b (IFNbeta-1b), cyclophosphamide (CY), and azathioprine (AZA) alone and of the combination of IFNbeta-1b with CY or AZA on the production of Th1 and Th2 cytokines in 10 patients with multiple sclerosis. Cytokine levels were determined at baseline and after stimulation with IFNbeta-1b, CY, and AZA alone or with the combination of IFNbeta-1b with CY or AZA. The combination of IFNbeta-1b with CY resulted in a statistically significant decrease in the production of interleukin-2 (IL-2) (P=0.003) and tumor necrosis factor alpha (TNF-alpha) (P=0.03). An additive effect on the production of interferon gamma (IFN-gamma) (P=0.2) and interleukin-10 (IL-10) (P=0.6), and a positive interaction on the production of interleukin-4 (IL-4) (P=0.08) were observed although the findings were not statistically significant. The combination of IFNbeta-1b with AZA resulted in a significant negative effect on the production of IL-2 (P=0.006), whereas TNF-alpha (P=0.02), IFN-gamma (P=0.03), IL-4 (P=0.2), and IL-10 (P=0.3) were not statistically impacted. Our data show that CY was able to improve the effects of IFNbeta-1b on the ratio of Th1/Th2 cytokines.

Adult↗
PubMedDate not supplied

A comparison of predictive outcomes of APACHE II and SAPS II in a surgical intensive care unit.

The Acute Physiologic Score and Chronic Health Evaluation (APACHE) II and the Simplified Acute Physiologic Scale (SAPS) II are two of the more commonly employed predictors of outcome and performance in the intensive care unit setting. However, controversy persists about whether the scores generated by these systems have similar predictive value. This study compared the predicted mortalities derived from APACHE II and SAPS II and contrasted them to the actual mortality in a surgical intensive care unit (SICU). Data for 1665 patients admitted to the SICU between July 1994 and August 1997 were entered into an SICU computerized database. From recorded demographic, hemodynamic, and laboratory data, APACHE II and SAPS II scores were obtained with corresponding predicted mortalities. Patients were stratified by age into categories of less than and greater than 65 years old. Predicted mortalities by APACHE II and SAPS II were compared for each group. An additional analysis included a comparison of survivors and nonsurvivors. There was no significant difference in predicted mortality between APACHE II and SAPS II in any of the groups. Actual mortality was 30 of 486 (6.2%) in patients less than 65 years of age and 73 of 1179 (6.2%) in patients 65 years of age or greater. The APACHE II and SAPS II predicted mortalities (mean +/- SD) for patients less than 65 years of age were 10.5% +/- 10.6% and 10.9% +/- 13.3%, respectively (P > .05). The APACHE II and SAPS II predicted mortalities in patients 65 years of age or greater were 19.1% +/- 17.8% and 18.7% +/- 21.0%, respectively (P > .05). Similarly, when patients were stratified by survival status, no significant difference was present between groups. However, in individual patients, a difference between APACHE II and SAPS II scores was often present. We conclude that although disparities between APACHE II and SAPS II predicted mortalities in individual patients may be significant, APACHE II and SAPS II have similar predictive value in a large SICU patient population. However, both APACHE II and SAPS II systems overestimate mortality in SICU patients. Based on our results, we conclude that either system can be used to measure quality of care in the SICU; however, neither system can be reliably applied to a single patient.

APACHE↗
PubMedDate not supplied

Echocontrast agents in neurosonology.

Temporal hyperostosis is the major limitation of transtemporal insonation of the basal cerebral arteries in transcranial Doppler sonography. New contrast agents capable of traversing the pulmonary bed offer new prospects for overcoming this limitation. Echocontrast agents improve the diagnostic potentiality of ultrasound techniques, increasing the diagnostic accuracy of these methods in cerebrovascular diseases, vascular malformations, venous pathologies and tumors, and may contribute to reducing the need for more invasive and expensive examinations.

Cerebral Arteries↗
PubMedDate not supplied

Contrast-enhanced transcranial Doppler sonography in patients with acute cerebrovascular diseases.

The aim of the study was to evaluate the diagnostic potential of galactose-based microbubble suspension (Levovist) in patients with acute cerebrovascular disease and inadequate transtemporal acoustic window, when examined by transcranial Doppler (TCD). We studied 10 patients with either transient ischemic attack (no. = 3) or stroke (no. = 7). Inadequate transtemporal acoustic window was unilateral in 3 patients and bilateral in the remaining 7 patients. Signals from middle, anterior, and posterior cerebral arteries (MCA, ACA, PCA) were recorded after injecting Levovist 300 mg/ml. Six patients needed 3 injections of Levovist, 1 patient two, and 3 patients one. Mean +/- SD duration of optimal signal enhancement was 175.2 +/- 53.2 s, range 70-290 s. Doppler waveform analysis was possible in 14 (82.3%) MCA, 11 (65%) ACA, and 9 (53%) PCA. Levovist improved the reliability of TCD in patients with acute cerebrovascular disease and insufficient transtemporal insonation.

Aged↗
PubMedDate not supplied

Efficacy and safety of an infectious bursal disease virus intermediate vaccine in ovo.

The study was divided into two experiments. In the first experiment, the efficacy of in ovo intermediate vaccine against infectious bursal disease virus (IBDV) was determined by challenge at 21 days of age with virulent IBDV in specific-pathogen-free (SPF) and commercial chickens. This vaccine was able to induce active immunity and to protect SPF chickens to challenge; protection was not complete in commercial chickens, as testified by bursal lesions, bursal index after challenge, and vaccine immunoresponse. In order to detect field and vaccinal viruses, immunoperoxidase staining, enzyme-linked immunosorbent assay, capture, and reverse transcriptase-polymerase chain reaction (RT-PCR) were tested; the RT-PCR was more effective at detecting both kind of viruses. In the second experiment, the immunosuppressive effect of in ovo vaccination was determined by evaluating the immunoresponse against Newcastle disease virus (NDV) vaccination effected at 10 days in both SPF and commercial chickens vaccinated in ovo. The in ovo vaccine causes a reduction of NDV immunoresponse, as testified by lowest geometric mean titer in group I (SPF chickens vaccinated against IBDV in ovo and against NDV at 11 days). In commercial chickens, immunoresponse to NDV vaccination was not influenced by in ovo vaccination.

Age Factors↗
PubMedDate not supplied

Laser welding and irradiation in alcohol preserved homografts.

This experiment examined the effect of laser welding and irradiation on the patency rate of microvascular anastomoses done with alcohol preserved homografts. The carotid arteries from Sprague-Dawley rats were freshly harvested and preserved in 70% ethyl alcohol for at least 3 weeks. The homografts were interposed into the carotid arteries with one of the following techniques: Group I, grafts were anastomosed with three stay sutures and laser welding (carbon dioxide laser, 90 mW); Group II, anastomoses were completed with eight to nine interrupted sutures (10-0 nylon); or Group III, the same technique used in Group II, but followed by laser irradiation (90 mW for 1 min) of the grafts. These results showed that patency at 2 weeks was 73% in Group I, 71% in Group II, and 82% in Group III, respectively. The patency at 12 weeks was 67% in Group I and unchanged in Groups II and III. In conclusion, laser irradiation and laser welding did not increase the patency rate of microvascular anastomoses done with alcohol preserved homografts. Thrombotic occlusion in microvascular homografts usually occurs before the second week postoperatively.

Anastomosis, Surgical↗
PubMedDate not supplied

Erythrocyte membrane fluidity in subjects affected with reversible ischemic attacks (RIA).

It is well recognized that in subjects with cerebrovascular disease (CVD), changes in hemorheological properties may occur in about 50% of the patients. This paper concerns a study on microhemorheological perturbations of the erythrocyte membranes in a group of 20 RIA's patients, treated with Pentoxifylline. At the admission of the subjects to the study a trend to an increased whole blood viscosity and erythrocyte aggregation was associated to alterations of membrane fluidity analyzed by means of the fluorescent probes in the patients with respect to the controls. At the end of pharmacological treatment and wash-out, our data indicate a clear modification in erythrocyte membrane which results improved. Our results underline how the improvement of the erythrocyte membrane fluidity, induced by pentoxifylline, is a basic factor of blood flow in the microcirculation.

Erythrocyte Membrane↗
PubMedDate not supplied

[Influence of 2 different milk formulas on renal tubular function in full- and pre-term newborn infants].

74 neonates (39 premature and 35 full term) were fed during first week of life on two available formulas: one was adapted and the other a powdered sweetened half skimmed milk. Urinary osmolarity was higher in neonates fed half skimmed milk. The study of blood parameters of renal function showed an higher urea nitrogen and a lower base excess in neonate fed half skimmed milk and in particular in prematures. Renal tubular function studied by means of volume/minute (V/m') of the clearance of free water (CH2O), of the clearance of osmotically active substances (COsm), and of the maximum tubular reabsorption of water (TcH2O), showed an increased clearance of osmotically active substances in both premature and full term neonates fed half skimmed milk and tubular reabsorption of water (TCH2O) in prematures. Such parameters of renal tubular function seem to be sensible indices for evaluating renal solute load of diet.

Blood Chemical Analysis↗
PubMedDate not supplied

[Anti-toxoplasma antibody titers and immunoglobulins].

285 sera from parturient patients have been tested for the presence of anti-toxoplasma antibodies by the direct Agglutination test and for Immunoglobulins by the immunochemical turbidimetric determination. 17 sera showed a significant increase in the titre of anti-toxoplasma antibodies; 5 of these 17 presented a simultaneous IgM level increase, subsequently confirmed by a 2 Mercaptoethanol pretreatment, this fact suggesting the presence of active infectious disease. The authors think it can be useful in the diagnostic assessment of active toxoplasmic infectious disease the simultaneous screening of sera by the two described methods: the direct Agglutination test and the immunochemical turbidimetric determination.

Agglutination Tests↗