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Biomedical subjects

D Giordano

Publications and source records attributed to D Giordano.

At least 55 records · Page 3Linked to original sources
PubMed1990

[The Bentall technique for the treatment of aortic aneurysms and acute aortic dissections: our experience with 24 cases].

Authors report their experience between 1981 and 1989 in the surgical treatment of 24 patients, aged 11 to 68 years, with chronic aneurysm of the ascending aorta (14 cases) or acute aortic dissection (10 cases), 7 of them being in cardiogenic shock with cardiac tamponade. In 7 patients the classic Bentall technique was employed, in 7 a modified Bentall technique and in 10 cases reimplantation of the coronary arteries was performed. In 2 cases a coronary artery by-pass, by saphenous vein graft, was placed on the right coronary artery, which was involved in the dissection. Valved dacron conduits were always employed. Two patients died after the operation whereas no late deaths were recorded in a follow-up interval ranging from 3 months to 7 years. The modifications of the classic surgical technique described in 1968 by Bentall-De Bono are of primary importance in diminishing the operative mortality and the incidence of early and late complications in these patients, whose disease nonetheless remains a surgical challenge.

Acute Disease↗
PubMed1989

Idarubicin in combination with intermediate-dose cytarabine in the treatment of refractory or relapsed acute leukemias.

13 patients with refractory or relapsed acute lymphoblastic leukemia (ALL) and 7 patients with acute myeloid leukemia (AML) were treated with a regimen that included idarubicin 12 mg/m2 intravenously daily for 3 d plus cytarabine 2 g/m2 by infusion over 3 hours daily for 3 d. There were 10 remissions (ALL:7; AML:3) in the 15 relapsed patients and 4 (ALL:3) in the 5 patients with primary refractory disease. Severe myelosuppression was observed in all patients. Toxicity of this regimen caused nausea and vomiting, stomatitis, infections and/or liver enzymes increase. Cardiac toxicity was not observed. 2 patients died in aplasia of Gram-negative septicemia and brain hemorrhage. In conclusion, the combination of idarubicin and intermediate-dose cytarabine (IDARA-C) seems to be highly effective and sufficiently well-tolerated for the treatment of refractory and relapsed acute leukemias.

Adolescent↗
PubMed1989

Different priming on human neutrophil respiratory burst by lipopolysaccharides from phase I and phase II Coxiella burnetii.

Human neutrophils produce small amounts of superoxide anion when stimulated with the chemotactic peptide FMLP; preincubating neutrophils with low concentrations of lipopolysaccharides (LPS) markedly increases this response, an effect referred to as priming. In this work LPS from Coxiella burnetii either phase I (virulent) or phase II (avirulent) were examined for their ability to induce priming. Results clearly show that only LPS from phase II microorganism was able to increase the release from neutrophils upon subsequent stimulation with FMLP. This effect was abolished by preincubation of LPS with polymyxin B. This finding may account for the ability of Coxiella burnetii phase I to escape intracellular phagocyte killing during persistent infections.

Coxiella↗
PubMed1989

Increased procoagulant activity of peripheral blood monocytes in human and experimental obstructive jaundice.

We studied the procoagulant activity of peripheral blood monocytes in 41 patients with severe obstructive jaundice and in 27 nonjaundiced control patients using a one-stage clotting assay. Mononuclear cells from jaundiced patients, tested immediately after isolation, expressed low levels of procoagulant activity, which were, however, significantly higher than in cells from controls (p less than 0.01). In addition, after incubation in short-term cultures with and without endotoxin, these cells generated more procoagulant activity than did the control ones (p less than 0.001). No significant difference in procoagulant activity was found between patients with and without malignancy in either group. The relief of biliary obstruction resulted in the reduction of both serum bilirubin levels and monocyte procoagulant activity. Endotoxin-induced monocyte procoagulant activity was about threefold higher in the jaundiced patients who died than in the survivors (p less than 0.001). In rabbits made icteric by bile duct ligation and separation (15 days), the endotoxin-induced monocyte procoagulant activity was markedly increased as compared with sham-operated animals (p less than 0.005). In all instances, procoagulant activity was identified as tissue factor. The increased capacity of mononuclear phagocytes to produce procoagulant activity might help explain the activation of blood coagulation in severe obstructive jaundice.

Adult↗
PubMed1988

Autologous unpurged bone marrow transplantation for acute non-lymphoblastic leukaemia in first complete remission.

Twenty-five patients with acute non-lymphoblastic leukemia (ANLL) in first complete remission underwent autologous bone marrow transplantation (ABMT) between March 1984 and March 1988. The high-dose therapy employed included cyclophosphamide followed by total body irradiation (10 Gy), administered as a single dose. The median time from complete remission to ABMT was 5 months (range 2-9 months). Thirteen (52%) patients remain in complete remission 10-51 months (median 25 months) after ABMT and 14-60 months (median 32 months) after achieving complete remission. Causes of death were recurrent leukemia (five patients), parenchymal toxicities (acute respiratory distress syndrome, veno-occlusive disease) (three patients), cerebral haemorrhage (one patient), cerebral aspergillosis (one patient) and viral hepatitis (one patient). Six patients relapsed at a median of 5 months after ABMT (range 4-10 months). In conclusion, this study has resulted in survival data comparable to those of other institutions and the best reported outcomes of conventional chemotherapy.

Adolescent↗
PubMed1987

Idarubicin in combination with etoposide and cytarabine in adult untreated acute non lymphoblastic leukemia.

Thirty-one unselected patients with untreated acute non lymphoblastic leukemia (ANLL) ranging in age from 15 to 76 years received two courses of a new high-dose induction regimen consisting of idarubicin, etoposide and cytarabine. Patients who entered complete remission (CR) were then allocated to post-remission intensification (PRI). Patients under 40 years of age with a HLA-compatible donor were given bone marrow transplantation (BMT); those without an HLA identical donor received either autologous BMT (ABMT) or no subsequent therapy. Twenty-five out of 31 patients (80.6%) achieved CR (93.3% in young and 68.7% in old patients) and 14 (56%) after the first cycle. Six patients (five out six greater than 40 years) died of cerebral hemorrhage and/or infection during the induction phase and four additional patients (three elderly) died on the PRI for the same cause without recurrent disease. Eleven out 25 patients are disease-free survivors 2-34 months (median 10 months) after achievement of CR. In conclusion, this intensive chemotherapy regimen is effective both in young and older patients but the post-remission intensification is too aggressive in elderly patients.

Acute Disease↗
PubMed1987

Screening haemodialysis patients for infection with human immune deficiency virus (HIV).

A group of 484 patients having regular haemodialysis was tested for the presence of antibodies to the human immunodeficiency virus (HIV). With a commercial enzyme-linked immunoassay kit, the serum of 17 appeared positive. When these 17 samples were retested by a different method, however, none was found to contain antibodies to the virus. Furthermore, evaluation of the clinical state of these 17 patients for the presence of any prodromal symptoms associated with the acquired immune deficiency syndrome was negative. It is therefore suggested that patients having regular haemodialysis are presently at low risk of contracting infection by HIV. By contrast, 81% of these patients had antibodies to cytomegalovirus.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Beneficial effects of atrial natriuretic factor on cisplatin-induced acute renal failure in the rat.

The organometal cisplatin has potent antitumor properties. However, its use is sometimes complicated by significant nephrotoxicity. This is characterized by tubular necrosis and impairment of the glomerular filtration rate (GFR). On the other hand, it has been demonstrated that atrial natriuretic factor (ANF) increases GFR in normal euvolemic rats. In the present study, we have therefore tested if this new potent natriuretic compound could restore some of the renal parameters affected by cisplatin. To investigate this issue, acute renal failure was induced in 9 rats by intraperitoneal injection of cisplatin 10 mg/kg body weight (b.w.). Renal function was studied 72 h later using the 3H-inulin clearance method and was compared with the renal function of 5 normal euvolemic rats. The cisplatin-treated rats showed high blood urea nitrogen levels, a 74% reduction of whole kidney GFR (0.308 +/- 0.047 vs. 1.17 +/- 0.08 ml/min/100 g b.w.) and a significant increase in the fractional excretion of urine, sodium and potassium. After 2 control clearances, synthetic ANF was administered intravenously as a prime (12 micrograms/kg b.w.) and then as a constant infusion (1 microgram/kg/min) to 6 cisplatin-treated rats. This promptly doubled the GFR (0.603 +/- 0.113 ml/min/100 g b.w.) and induced a significant increase in the excretion rate of urine, sodium and potassium. These results demonstrate that the administration of ANF has a beneficial effect on the experimental model of acute renal failure induced by cisplatin.

Acute Kidney Injury↗
PubMed1986

Procoagulant activity of human alveolar macrophages: different expression in patients with lung cancer.

Mononuclear phagocytes, an integral part of the lymphoreticular infiltrate of many malignant tissues, might contribute to tumor-associated fibrin deposition through the production of procoagulant activity (PCA). We have studied the PCA of human alveolar macrophages in 28 patients with primary lung cancer and in 9 control subjects. Alveolar macrophages (greater than 97% esterase positive) were isolated form bronchoalveolar lavage fluids by adherence onto plastic. PCA was evaluated by a one-stage clotting assay immediately after isolation (basal PCA) and after incubation (4 hr at 37 degrees C) in the absence and in the presence of endotoxin. Cells from control subjects had low basal PCA (3.9 +/- 1.0 units/5 X 10(4) cells) but, upon exposure to endotoxin, they displayed a 5- to 16-fold increase in PCA. In patients, different patterns of PCA were observed. In the 8 patients in whom lavage had been carried out on the contralateral side to the neoplasm, alveolar macrophages behaved essentially like those from controls. In contrast, in the 20 patients in whom macrophage populations close to the site of the tumor were examined, PCA was abnormal in many respects. In 12 of these, alveolar macrophages had basal PCA comparable to or somewhat lower than control cells, but exhibited a poor procoagulant response when incubated in vitro in the presence of endotoxin. Alveolar macrophages from the remaining 8 patients expressed far higher levels of basal PCA than control cells (25.1 +/- 5.9 units as compared to 3.9 +/- 1.0 units/5 X 10(4) cells). These cells retained their ability to respond to endotoxin in vitro with a 3-fold increase in PCA. In all instances, alveolar macrophage PCA had the characteristics of tissue factor. These data suggest that the presence of primary lung cancer may modulate the expression of PCA in alveolar macrophages close to the tumor site. PCA might be useful to better characterize the functional state of macrophages near the tumor.

Adult↗
PubMed1986

A further study on the prevalence of multiple sclerosis in Sicily: Caltanissetta city.

The prevalence of probable multiple sclerosis (MS) in Caltanissetta city, Sicily, is at least 51 per 100,000. If possible multiple sclerosis patients are included, it is 54 per 100,000. This value is similar to that found in other cities in Sicily: Enna, Monreale and Agrigento. The high prevalence of multiple sclerosis in Caltanissetta confirms the previous data on Sicily and emphasises the importance of small population studies in the epidemiology of MS.

Adolescent↗
PubMed1986

Cytochrome b and FAD content in polymorphonuclear leucocytes in a family with X-linked chronic granulomatous disease.

Chronic granulomatous disease (CGD), an immunodeficiency syndrome characterized by extreme susceptibility to bacterial infections, is due to a defect of the respiratory burst in human phagocytes. NADPH oxidase, the enzyme that catalyzes the reduction of oxygen and the release of oxidative radicals, was studied in polymorphonuclear leucocytes (PMNs) in a family affected by an x-linked inheritance form at high penetrance of the disease. The contents of cytochrome b, suggested as the terminal component of the oxidase electron transport chain, and FAD, the hypothetical proximal component of the chain, were determined in patients and in carriers. Cytochrome b showed the typical behaviour of x-linked CGD: total absence in patients, intermediate values in carriers. FAD content evaluated on plasma membranes was less decreased than cytochrome b. Carriers also showed a decrease of this flavoprotein. Cytochrome b and FAD contents were compared to NBT test and superoxide production: a clear correlation was observed for the cytochrome b, but FAD plasma membrane evaluation could also be an interesting tool for the metabolic characterization of the disease in patients and in carriers.

Adult↗
PubMed1985

In vitro cisplatin effects on phagocyte functions.

The effects of cis-diamminedichloroplatinum (II) (cisplatin), a drug used in cancer chemotherapy, on the oxidative metabolism, endocytosis, chemotaxis and exocytosis of guinea-pig polymorphonuclear leukocytes were studied. All these functions were negatively influenced, but the same effect (50% inhibition) was observed at different drug concentrations (3 X 10(-5) M for chemotaxis, 10(-4) M for O2 consumption by FMLP and beta-glucuronidase release, 10(-3) M for O2 consumption by PMA and for zymosan engulfment). The effects of the drug can be explained by its ability to bind to membrane proteins, essentially to -SH groups.

Animals↗
PubMed1985

4-Demethoxydaunorubicin (Idarubicin) in refractory or relapsed acute leukemias. A pilot study.

Twenty-five adults with previously treated acute leukemia were treated with 4-demethoxydaunorubicin (Idarubicin) with a daily dose of 8 mg/m2 for 3 days intravenously. Complete remission was achieved in 3 of 18 patients with acute nonlymphoblastic leukemia (ANLL) and 2 of 6 with lymphoblastic leukemia. Complete remissions were observed in two of eight ANLL patients refractory to cytarabine, anthracycline, and m-Amsa (amsacrine), indicating a lack of cross-resistance between these drugs and Idarubicin. The median duration of remission was 8 weeks. The main major toxicity of Idarubicin therapy, severe myelosuppression, cannot be considered a toxic effect because it was desired in this case list. Our preliminary results indicate that Idarubicin has significant activity against refractory adult acute leukemia.

Acute Disease↗