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Biomedical subjects

D Prisco

Publications and source records attributed to D Prisco.

138 records · Page 8Linked to original sources
PubMedDate not supplied

Homocysteine-lowering therapy and carotid intima-media thickness in renal transplant recipients.

The aim of this study was to document, in hyperhomocysteinemic renal transplant recipients, the effect of vitamin supplementation on carotid intima-media thickness (cIMT). Fifty-six hyperhomocysteinemic stable renal transplant recipients were randomly assigned to either vitamin supplementation (group A) or placebo treatment (group B). All patients underwent high-resolution B mode ultrasound to measure IMT of common carotid arteries before and after 6 months of vitamin supplementation. In group A, cIMT significantly decreased after treatment, whereas no significant changes were observed in group B. In conclusion, our results demonstrate a beneficial effect of the treatment of hyperhomocysteinemia by vitamin supplementation on an early sign of atherosclerosis in a group of renal transplant recipients.

Carotid Arteries↗
PubMedDate not supplied

Effect of low-dose heparin treatment on fibrinolysis in patients with previous myocardial infarction.

The present study was designed to investigate whether medium-term, low-dose heparin treatment is able to affect the fibrinolytic system. In a randomized cross-over study 10 asymptomatic patients with previous (1-6 years) myocardial infarction underwent two sequential 15-day treatments, respectively, on heparin and on placebo (saline solution), preceded and separated by 10-day wash-out periods. Heparin (as calcium heparin, 12,500 IU in 0.5 ml) and saline (0.5 ml) were subcutaneously administered once a day at 8 a.m. Blood samples for fibrinolysis studies were withdrawn on the first and 15th day of each period immediately before and 4 h after heparin or saline administration before and after 10 min venous occlusion (VO) respectively. Four hours after the first heparin administration tissue plasminogen activator antigen (t-PA ag) levels significantly increased with respect to saline administration (p < 0.01 and p < 0.05, respectively). After 15-day heparin treatment a decrease in euglobulin lysis time (p < 0.05) and an increase in t-PA activity (act) (p < 0.05) and in t-PA ag (p < 0.01) in comparison with placebo were observed before VO. No statistically significant changes in plasminogen activator inhibitor-1 (PAI-1) levels were found. The variations of fibrinolytic system activity induced by heparin treatment were more marked when evaluated after VO. These results indicate that medium-term low-dose heparin treatment increases t-PA ag formation and/or release with consequent t-PA act increase.

Adult↗
PubMedDate not supplied

Clottable to immunological fibrinogen ratio in plasma from control subjects and hyperfibrinogenemic patients.

The measurement of fibrinogen (Fg) plasma levels is one of the more frequently performed tests in clinical practice, usually by clotting assay. However, for the diagnosis of dysfibrinogenemia the use of an immunological assay is necessary to compare total and clottable protein. Little information is available on the range of the ratio clottable (C) Fg/immunological (I) Fg levels in normal population. This study aimed at evaluating the CFg/IFg ratio in 70 control subjects (age range 17-74 years-group A), in 57 acute patients (age range 17-79 years-group B) and in 14 pregnant women (age range 27-41 years, pregnancy weeks 30-40-group C), as a physiologic model of hyperfibrinogenemia. CFg was assayed on citrated plasma by the Clauss clotting method and IFg was assayed by radial immunodiffusion technique. In the three groups, CFg/IFg ratios were not significantly different (respectively group A 0.98 +/- 0.17, group B 1.02 +/- 0.18 and group C 1.01 +/- 0.11), whereas both CFg (310 +/- 45 mg/dl) and IFg (326 +/- 70 mg/dl) levels were lower (p < 0.001) in control subjects than in patients (CFg 556 +/- 92 mg/dl; IFg 561 +/- 121 mg/dl) and in pregnant women (CFg 530 +/- 65 mg/dl; IFg 530 +/- 77 mg/dl). The analysis of the relationship between CFg and IFg in the three groups (group A: y = 11.53 + 1.01x, r = 0.64, p < 0.001; group B: y = 68.72 + 0.88x, r = 0.67, p < 0.0001; group C: y = 71.59 + 0.87x, r = 0.73, p < 0.01) indicates that a good correlation exists (p < 0.001) for values of fibrinogenemia ranging from 180 to over 700 mg/dl. A reference range of CFg/IFg (mean +/- 2 SD in group A) was 0.64-1.32. These data could be of practical importance for a rapid screening of dysfibrinogenemias.

Adolescent↗
PubMedDate not supplied

[Retinal vein occlusions: diseases for the internist?].

Retinal vein occlusion is a relatively common disease, usually associated with the presence of diseases related to internal medicine. Central retinal vein occlusion is the most frequently-occurring and clinically relevant type. In addition to the well-known classic risk factors, new hemostasis-related ones have been investigated in patients affected by central retinal vein occlusion. While data concerning a number of parameters remain contradictory, high levels of type 1 plasminogen activator inhibitor (PAI-1) and lipoprotein(a) and hyper-homocystinemia appear to play a significant role in the pathogenesis of this disease. Although based on a limited number of studies, this new knowledge could eventually provide important indications regarding prognosis and therapeutic strategies.

Hemostasis↗
PubMedDate not supplied

Activated protein C resistance is a risk factor for central retinal vein occlusion.

Central retinal vein occlusion is one of the most common retinal vascular disorders. Few and contrasting data are available on the prevalence of hemostatic risk factors in patients with central retinal vein occlusion. The aim of this study was to investigate the most common hemostasis-related inherited risk factors for venous thrombosis in a group of 53 central retinal vein occlusion patients (median age 59 years, range 18-77 years) and in 53 comparable control subjects (median age 57 years, range 22-84 years). No difference was found in antithrombin III, protein C and protein S plasma levels between patients and controls. At univariate analysis, activated protein C resistance (odds ratio 5.8) and factor V Leiden (odds ratio 4.4) were significantly associated with central retinal vein occlusion whereas G20210A polymorphism of the prothrombin gene was not. After adjustment for sex, age, and the other classic vascular risk factors (hypertension, diabetes, hypercholesterolemia, smoking) activated protein C resistance remained the only independent risk factor for central retinal vein occlusion (odds ratio 11.5). These data indicate that activated protein C resistance may play a role in the pathophysiology of central retinal vein occlusion.

Activated Protein C Resistance↗
PubMedDate not supplied

[D-dimer in the year 2000: current data and new perspectives].

D-dimer is a product of cross-linked fibrin degradation by the fibrinolytic system. It has been shown to be highly sensitive and moderately specific for venous thromboembolic disease. Thus, the most common clinical use of D-dimer relates to its negative predictive value for deep vein thrombosis and pulmonary embolism. Diagnosis, however, should not be based solely on this parameter, and an integrated strategy that combines clinical approach (pre-test probability), a non-invasive test (ultrasonography or lung scan) and D-dimer assay is highly recommended. Over the last years a number of studies have demonstrated that D-dimer may also enable the prediction of the complications of atherothrombosis inasmuch as the data available suggest a significant association of D-dimer with the risk of coronary artery disease independent of classic risk factors. Moreover, elevated plasma D-dimer seems to be a marker of a systemic prothrombotic state, and anticoagulation can normalize its levels. However, further studies are needed to assess whether or not this parameters is of clinical value to predict or prevent arterial thrombotic events in the single patient.

Algorithms↗
PubMedDate not supplied

Human prostacyclin platelet receptors and platelet lipid composition.

To assess the role of the cellular lipid environment in the expression of prostacyclin (PGI2) membrane receptors, PGI2 binding sites together with cholesterol and phospholipid content in platelets from 17 healthy subjects were investigated. Membrane receptors were investigated by a direct radioligand binding method using [3H]PGI2 as radiolabeled ligand. Significant negative correlations between PGI2 high-affinity receptors and platelet cholesterol content (r = -0.787, P less than 0.001) and platelet cholesterol/phospholipid ratio (r = -0.946, P less than 0.001) were observed; on the contrary phospholipid content was positively correlated with the number of high-affinity receptors (r = 0.610, P less than 0.01). These results indicate that physiological changes in platelet lipid composition can affect membrane receptor number.

Adult↗
PubMedDate not supplied

[Therapeutic ranges of oral anticoagulant therapy in different diseases. Guidelines of the Federation of Centers of Surveillance of Patients on Anticoagulation. Ad hoc Study Group].

The "ad hoc" Study Group of the Federation of Italian Anticoagulation Clinics has proposed a series of guidelines for oral anticoagulant therapy in different pathological states for which this treatment is indicated. These indications are based on the scientific literature available through March 1996. While there is wide consensus for some indications, opinions diverge regarding others. Finally, there are a number of indications which are potentially useful but are not supported by adequate studies. For the applications of guidelines in individual cases, however, careful clinical evaluation is necessary.

Administration, Oral↗
PubMedDate not supplied

Clinical application of fibrinolysis laboratory tests: a review.

The aim of this paper is to review fibrinolysis laboratory tests of potential clinical usefulness. Since the activation of the fibrinolytic system may be responsible for several relevant pathological scenarios, it is crucial to know whether and to what extent fibrinolysis laboratory tests are useful for the diagnosis and therapy of individual patients. The plasma fibrinolytic system may be altered by deficiencies and/or abnormalities of some of its components. Few doubts remain concerning the possible role of fibrinolysis alterations in the pathophysiology of some hemorrhagic and thrombotic disorders. In hemorrhagic patients, laboratory tests may demonstrate the existence of increased plasmin activity and the presence of specific congenital defects leading to primary hyperfibrinolysis. Alterations of the fibrinolytic system should be looked for only in selected patients who have a history of venous thrombosis and negative results of initial screening tests.

Blood Coagulation Tests↗
PubMedDate not supplied

Endothelins: an overview of recent achievements.

The aim of this study is to review the recent developments in research on the pathophysiological role of endothelins in the reproductive system and lungs, as well as in systemic disorders such as sepsis, acute respiratory distress syndrome and multiple organ failure. The international literature of the last 9 years, as available on MEDLINE, was duly scanned. Only relevant, original and update studies were selected for the purpose of this survey. The results of the most significant studies in humans are summarized. The potential roles of endothelins in systemic diseases are currently under investigation. A possible role of these peptides is suggested in the pathophysiology of heart failure and in the mechanism of post-ischemic renal failure. Studies have been conducted also on other systems, namely the reproductive system, the endocrine system and the lungs as well as on a number of tissue disorders such as sepsis, acute respiratory distress syndrome multiple organ failure, preeclampsia and related abnormalities. Full understanding of the role and action of this group of regulatory mediators in tissues should enable complete insight into the pathophysiological mechanisms of localized diseases as well as of multiple organ diseases. As a result, adequate therapy may be established.

Cardiovascular Diseases↗