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Biomedical subjects

C Rostagno

Publications and source records attributed to C Rostagno.

52 records · Page 3Linked to original sources
PubMed1990

Effects of long-term gestodene-containing oral contraceptive administration on hemostasis.

The purpose of this study was to evaluate the behavior of the hemostatic system during treatment with gestodene-containing oral contraceptives in monophasic (SHD 356, n = 15) and triphasic (SHD 415, n = 15) formulations. No changes in platelet (beta-thromboglobulin, platelet aggregate ratio, and megathrombocyte) and routine clotting assays were observed. Factor VIIc/factor VIIag ratio and fibrinopeptide A values showed a significant (p less than 0.005) increase after three cycles of both treatments. A slight, significant increase (p less than 0.01) in antithrombin III activity was observed during triphasic treatment. Protein C was unchanged. Fibrinolytic activity and plasminogen levels were significantly increased (p less than 0.05 and p less than 0.001). After 6 and 9 months, the factor VIIc/factor VIIag ratio was still significantly enhanced, whereas fibrinopeptide A values significantly (p less than 0.05) decreased, even if they were higher (p less than 0.05) than basal values. The persistence of factor VII activation without enhanced thrombin formation after long-term use of oral contraceptives suggests that at that time the activity of antithrombotic mechanisms counteracts the prothrombotic tendency, thus helping to minimize unwanted side effects on hemostasis during long-term drug administration.

Adolescent↗
PubMed1988

Increased protein C and fibrinopeptide A concentration in patients with angina.

Protein C and fibrinopeptide A (FpA) levels in plasma were measured in 30 controls and in two groups of patients with angina. The first group was formed by 27 patients suffering from spontaneous ischemic attacks (active angina). The second one was formed by patients who had previously suffered from angina, but were free from myocardial ischemic attacks for at least one month (inactive angina). Protein C (measured by electroimmunoassay) and FpA (radioimmunoassay) were higher than controls in both groups but were significantly higher in patients with active angina than in patients with inactive angina. A clear trend toward a linear correlation existed between protein C and FpA levels, though it did not reach the statistical significance. These results confirm a significant involvement of blood clotting system in ischemic heart disease and specially in active angina.

Adult↗
PubMed1984

Protein C antigen is not an acute phase reactant and is often high in ischemic heart disease and diabetes.

Protein C, an antithrombotic protein, was measured immunologically in 299 patients with clinical conditions associated with a high frequency of venous or arterial thromboembolism. The mean protein C antigen (PC:Ag) level was high for 48 patients with ischemic heart disease and, to a lesser extent, for 95 diabetics. In 28 patients with thrombotic strokes, 48 patients with proximal deep-vein thrombosis and in 80 patients with localized or metastatic tumors, mean PC:Ag was normal. Comparison of the pattern of changes of PC:Ag levels with those of fibrinogen, orosomucoid and prothrombin in 21 patients during the postoperative period and in 20 patients with active rheumatoid arthritis ruled out the possibility that high PC:Ag is non-specific, acute-phase reaction to inflammation, tissue injury or neoplastic growth. Therefore, high PC:Ag might be specifically related to the thrombotic tendency of these patients, but the mechanism of such a relationship remains to be clarified.

Adolescent↗
PubMedDate not supplied

Early out-of-hospital lidocaine administration decreases the incidence of primary ventricular fibrillation in acute myocardial infarction.

This study was designed to assess the effectiveness of early prehospital intravenous administration of lidocaine in preventing primary ventricular fibrillation (PVF) in patients with suspected acute myocardial infarction (AMI). Sixty patients with suspected AMI, seen by the Mobile Coronary Care Unit (MCCU) of Florence, were randomly allocated at home to treatment with lidocaine (bolus i.v. of 1 mg/kg, followed by an infusion of 4 mg/min) or placebo (infusion of saline at a rate of 1 mL/min), respectively. The lidocaine group (27 patients) and the control group (33 patients) were not significantly different in age, clinical condition, or time of randomization. The diagnosis of AMI was confirmed in all 60 patients during the hospital stay. Ventricular fibrillation (VF) occurred in 5 patients in the control group in comparison to none in the lidocaine group (P < 0.05). Three patients experienced VF at home and were successfully resuscitated by an MCCU cardiologist. In another two patients, VF occurred during the first 4 hours after onset of symptoms. No major side effects were observed after the infusion of lidocaine. Our findings support the effectiveness of the prophylactic administration of lidocaine in preventing PVF in the prehospital phase of AMI and suggest that the drug can be safely administered in this setting by prehospital personnel.

Aged↗
PubMedDate not supplied

[Anticoagulant therapy in patients with dilated cardiomyopathy].

Heart failure due to dilated cardiomyopathy is associated with a significant increase in risk of thromboembolism. The incidence can be estimated, on the average, at 2.0-2.5 events per 100 patients per year. At this time, in the absence of randomized trials, limited evidence exists to support the use of anticoagulant treatment for patients with heart failure due to dilated cardiomyopathy in sinus rhythm, even if these subjects appear to be at higher risk than those with ischemic cardiomyopathy and comparable degree of left ventricular dysfunction. Women with left ventricular ejection fraction < 25% constitute a remarkable exception to this rule, and anticoagulation is strongly indicated for them. Unless there are contraindications, anticoagulant treatment is mandatory for patients with heart failure and atrial fibrillation. As studies on preventive treatment in atrial fibrillation have indicated, a target International Normalized Ratio between 2.0 and 3.0 seems appropriate. Patients with intraventricular thrombi present a difficult therapeutic challenge inasmuch as no strong evidence exists that anticoagulant treatment significantly decreases the risk of embolization particularly in patients with flat thrombus. Therapy should thus probably be limited to patients with pedunculated or floating thrombus.

Anticoagulants↗
PubMedDate not supplied

[The effects of training on skeletal and cardiac muscle mass in professional soccer players].

Ongoing physical exercise is able to increase skeletal and cardiac muscle mass. Echocardiography and body impedance analysis permit non-invasive evaluation of these two parameters. The aim of this study was to evaluate the effects of training and detraining on the heart and skeletal muscles of professional soccer players. Twenty-one professional athletes (average age 24 +/- 3.5 years) were evaluated during five different phases of their athletic training and compared with 21 age- and height-matched healthy, non-obese sedentary subjects. All subjects underwent measurement of body mass distribution by means of bioelectrical impedance analysis and of left ventricular mass by means of echocardiography. The control group had lower values of lean and cellular body mass, as well as lower left ventricular mass than the professional athletes. Over the 13-month study period, the athletes showed no substantial modifications in fat and muscle mass parameters. Instead, left ventricular mass values increased during the playing season, evidencing physiological hypertrophy after 6 months of competitive activity. No subsequent increases were observed over the next 2 months, and after detraining, left ventricular mass returned to baseline values. We thus conclude that exercise training brings about changes in cardiac mass without producing parallel changes in skeletal muscular mass.

Adolescent↗
PubMedDate not supplied

Increased thrombin generation in normal pregnancy.

The aim of this longitudinal study was to evaluate whether an increased thrombin generation takes place in normal pregnancy by determining fibronopeptide A plasma concentration in 24 women at three stages of gestation. The activity of the main blood clotting inhibitors, antithrombin III and protein C., and platelet agregability were also investigated. Our study showed a significant rise of fibrinopeptide A plasma levels already manifest at the first trimester. Antithrombin III activity was found to slightly but significantly decrease during pregnancy, whereas protein C levels showed a moderate, significant increase. A slight platelet activation was observed in the second and third trimester. These findings indicate that during pregnancy a new equilibrium of blood clotting system arises, shifted to a hypercoagulable state which leads to the increased risk of thromboembolism observed in pregnancy.

Adult↗
PubMedDate not supplied

[Hemostatic-vascular interactions in the pathogenesis and the treatment of adult respiratory distress syndrome].

The complex pathophysiologic alterations occurring in adult respiratory distress syndrome (ARDS) result from the interaction of various humoral and cellular mediators. In this review we examine the events that lead to acute pulmonary injury as discussed in the recent literature as well as the correlations among humoral systems and cell activation involved in the pathogenesis of ARDS. We also consider the mechanisms inducing the appearance of adhesive molecules (ELAM-1 and ICAM-1) on the surface of endothelial cells, the importance of complement and clotting activation, and the role of monocyte-macrophages, platelets and neutrophils. The complexity of alterations among the different mediators involved in the pathogenesis of ARDS is underscored by experimental results demonstrating how the pharmacologic blockade of each system cannot completely prevent the development of lung damage. Understanding of the complex processes involved in the pathogenesis of ARDS provides new prospects for its treatment, such as inhalational nitric oxide and aerosolised prostacyclin. The most promising approach involves the use of monoclonal antibodies which may enable the selective inhibition of different mediators and endotoxins.

Humans↗
PubMedDate not supplied

Differences in some circadian patterns of cardiac arrhythmia, myocardial infarctions and other adverse vascular events.

BACKGROUND: Results from unpublished data on the incidence of adverse vascular events and from several published studies are reevaluated chronobiologically. METHODS AND RESULTS: Cosinor methods indicate 1. a circadian variation in the incidence of paroxysmal supraventricular tachycardia (PST), of broadly classified ventricular arrhythmia (VAr), and of atrial fibrillation (AF); 2. a statistically significant difference in the timing of the circadian rhythm of PST and VAr versus that of AF; and 3. a further difference in the timing of these rhythms from that in the incidence of myocardial infarctions (MI). Electrocardiographic records for spans longer than 24h show the extent of day-to-day variability in circadian characteristics of the given patient and indicate the presence of even lower-frequency components, notably along the scale of a week, that may underlie weekly and half-weekly patterns of morbidity and mortality. CONCLUSION: Beyond alterations in the about 1-Hz periodicity of the heart, predictable changes along the scales of the day and the week may constitute a clue to the etiopathology of a given condition and provide a basis for treatment timing. The assessment of unfavorable changes in the lower frequency components may provide a lead time long enough to prompt the institution of preventive, rather than curative, intervention.

Animals↗
PubMedDate not supplied

[Rational bases for the therapy of supraventricular tachycardias and their management].

Supraventricular arrhythmias are frequently encountered in clinical practice. Despite their common anatomical origin above the division of His' bundle into bundle branches, these arrhythmias have profoundly different electrophysiological mechanisms, clinical significances and responses to treatment. Although 12-lead surface ECG usually enables correct identification, facilitating treatment choice in the emergency room, electrophysiologic testing to determine the site of origin and the pathway of the arrhythmia may be necessary for the management of definitive treatment. Drug therapy is efficient for conversion to sinus treatment in 80-90% of patients with new onset arrhythmias. Class Ic antiarrhythmics (propafenone and flecainide) are particularly useful for atrial fibrillation, while adenosine and verapamil are the drugs of choice for reentry tachycardias. Atrial flutter is a noteworthy exception, and DC shock is often required to terminate the arrhythmia. The results of antiarrhythmic therapy for long term prevention of recurrences are often disappointing. Recent surgical and technological developments, in particular transcatheter ablation procedures, now allow definitive resolution of most reentrant arrhythmias, including preexcitation syndrome. This report discusses current concepts regarding the management of supraventricular arrhythmias.

Anti-Arrhythmia Agents↗
PubMedDate not supplied

[Meningeal carcinomatosis from pulmonary adenocarcinoma: two clinical cases with review of the literature].

The case of a 68-year-old woman with lung adenocarcinoma complicated by apparently isolated widespread meningeal metastasis is described. Meningeal carcinomatosis is a rare complication of solid neoplasms. In fact, it occurs in less than 2% of lung carcinoma which is the most frequent cause of this syndrome. Although computed tomography and nuclear magnetic resonance may aid the diagnosis of this condition, only the cytological demonstration of neoplastic cells in the cerebrospinal fluid directly establishes it. In this patient, the onset of symptoms due to meningeal carcinomatosis complicated the course of a diagnosed lung adenocarcinoma with the acute onset of a confusional state and extended meningeal dissemination without clinical or instrumental findings of metastasis in other areas of the body. Acute confusional state is seldom the initial symptom of meningeal carcinomatosis. Nevertheless, in the neoplastic patient, this possibility must be taken into account after the most common causes of acute confusion have been excluded. Even when modern diagnostic imaging techniques are utilized, diagnosis must be confirmed by cytological examination of the cerebrospinal fluid.

Adenocarcinoma↗