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Biomedical subjects

E Mancini

Publications and source records attributed to E Mancini.

At least 55 records · Page 3Linked to original sources

Continuous on-line optical absorbance recording of blood volume changes during hemodialysis.

Conventional techniques that measure blood volume changes during hemodialysis are invasive, hard to reproduce, and provide only intermittent evaluations. To overcome these drawbacks, we have developed an optoelectronic instrument that estimates intradialytic blood volume percentage changes by the optical absorbance of blood. This device is based on the absorption of light transmitted through blood, which is directly related to the hemoglobin concentration. A personal computer interfaced to the device provides a continuous on-line graphic display of the hemoglobin levels and the percentage changes in blood volume. The noninvasive measurement of dialysis blood volume changes by an optical method may be helpful in detecting the appearance of severe hypovolemia that can be dangerous in critically ill patients.

Absorption↗

[Perioperative pain and stress: a comparison between video laparoscopic cholecystectomy and "open" cholecystectomy].

Pain and endocrine-metabolic response to surgical stress, during surgery and in the early postoperative period, was compared in two groups of patients affected by gallstones and randomly assigned to Laparoscopic Cholecystectomy or Open Cholecystectomy. Pain was assessed by the VAS method also taking into account the need of analgesic administration in the postoperative period. The so called "stress hormones" (Prolactin (PRL), Cortisol (CORT), Human Growth Hormone (HGH)) and glycaemia were monitored during surgery and in the first postoperative 24 hours. The minimal invasive technique of laparoscopic cholecystectomy accounted for a very limited analgesic administration. In the intraoperative period laparoscopic cholecystectomy plasma hormone levels overlapped the open cholecystectomy ones, while in the postoperative period a constant increase in PRL and CORT levels was registered in the open cholecystectomy group demonstrating a prolonged stressful condition. The end results of this study show that laparoscopic cholecystectomy has major advantages than open cholecystectomy in the treatment of gallstones as far as pain and endocrine-metabolic response are concerned.

Anesthesia, General↗

Effect of alpha-gliadin-derived peptides from bread and durum wheat on K562(S) cells.

Previous studies suggested that the proteins and peptides that are responsible for coeliac small intestinal lesions, are also able to agglutinate K562(S) cells. On the contrary, peptides from whole gliadins from durum (tetraploid) wheat do not agglutinate these cells. Bread wheat alpha-gliadins have been identified as a major toxic fraction in coeliac disease. In the present research, alpha-gliadins were purified from durum and bread wheat cultivars. alpha-gliadin peptides from bread wheat were active in agglutinating K562(S) cells, whereas alpha-gliadin from durum wheat failed to induce any agglutinating activity. These results suggest that the lack of toxicity of gliadin from durum wheat cultivars is not related to a low content of alpha-gliadins but is mainly due to intrinsic structural differences from bread wheat gliadins.

Agglutination Tests↗

Amines protect in vitro the celiac small intestine from the damaging activity of gliadin peptides.

Proteins and peptides responsible for the celiac small intestinal lesion inhibit both the enterocyte recovery of in vitro cultured flat celiac mucosa and the in vitro development of fetal rat intestine. They also agglutinate K 562 (S) cells. Using these three in vitro systems (cultured human celiac and rat fetal intestine and cell agglutination), it is shown that several small-molecular-weight amines, mostly the polyamines spermidine and spermine, prevent and reverse K 562 (S) cell agglutination induced by gliadin peptides, whereas they do not prevent cell agglutination induced by concanavalin A and wheat germ agglutinin. Some of these amines also protected in vitro developing fetal rat intestine and flat celiac mucosa from the damaging effect of gliadin peptides. This protective effect may be related to the trophic activity exerted by amines on the intestine and/or the effect of amines on the functions of intestinal brush border or intracellular membranes involved in the intestinal handling of gliadins.

Abdomen↗

Mannan and oligomers of N-acetylglucosamine protect intestinal mucosa of celiac patients with active disease from in vitro toxicity of gliadin peptides.

Wheat flour and other cereals toxic for celiac patients contain an alcohol-soluble protein fraction that, under experimental conditions simulating in vivo protein digestion, yields peptides that agglutinate undifferentiated K 562(S) cells. In contrast, cereals well tolerated in celiac disease (i.e., rice and maize) do not. Furthermore, purified A-gliadin peptides that damage in vitro-cultured flat celiac mucosa are powerful agglutinins for K 562(S) cells, whereas A-gliadin peptides that do not show any adverse in vitro effect on celiac intestine lack agglutinating activity. Mannan, acetylglucosamine, and its oligomers (N,N'-diacetylchitobiose and N,N',N"-triacetylchitotriose) were able to prevent and reverse cell agglutination induced by peptides from all the toxic cereals. Moreover, mannan and N,N',N"-triacetylchitotriose exhibited a protective effect on intestinal mucosa specimens of patients with active celiac disease cultured with wheat protein-derived peptides. These data are consistent with the hypothesis that the agglutinating and toxic peptides are bound by carbohydrates.

Acetylglucosamine↗

A haemodynamic study of hypotension during haemodialysis using electrical bioimpedance cardiography.

Continuous recording of beat-to-beat changes in haemodynamic parameters such as arterial pressure, heart rate, stroke volume, cardiac output, and total peripheral resistance, was done in 52 uraemic patients. The study was performed during the haemodialysis session, using a system combining a personal computer, an arterial pressure recorder, and an electrical bioimpedance cardiography monitor. Forty-six episodes of dialysis-induced hypotension occurred in 26 patients. Systolic arterial pressure and total peripheral resistance decreased by -39.3 +/- 2% and -36.3 +/- 4% respectively during acute hypotension; in contrast, there was an increase in cardiac output (+13.9 +/- 6.7%), while heart rate and stroke volume did not change significantly. It was possible to distinguish two types of collapse on the basis of heart rate behaviour: the classic 'tachycardiac' collapse with heart rate increase and stroke volume decrease, and the so-called 'bradycardiac' collapse with a paradoxical reduction in heart rate and an increase in stroke volume. 'Bradycardiac' collapses were observed in 54% of the cases. The administration of atropine in one patient resulted in an immediate increase in heart rate. The development of bradycardia and hypotension during haemodialysis seems to be related to a sudden parasympathetic vagal overactivity and could be attributed to the Bezold-Jarish reflex.

Adult↗

Hypertension in primary glomerulonephritis without renal insufficiency.

Hypertension is frequently present in glomerulonephritis without renal insufficiency but its pathogenesis is poorly understood. Eighty-five patients with glomerulonephritis and normal renal function, including 55 hypertensive patients, and 24 normal subjects were studied to obtain data on the mechanisms responsible for hypertension. Plasma renin activity (PRA), plasma noradrenaline, total exchangeable sodium, and urinary prostaglandin E (PGE) were determined. Moreover, the autonomic nervous system was explored with the following tests: tilt test, diving reflex, lying down, and deep-breathing tests. In 15 of the 30 normotensive patients with glomerulonephritis, PRA was measured after the administration of propranolol and then indomethacin. No significant differences were found in the mean values of PRA, plasma noradrenaline, total exchangeable sodium, urinary PGE, and autonomic nervous system behaviour between glomerulonephritis patients with and without hypertension or between hypertensive glomerulonephritis patients and control subjects. In many of the normotensive glomerulonephritis patients we found an elevated PRA that was normalised by propranolol but not by indomethacin. In summary, hypertension in glomerulonephritis is not associated with abnormalities in the sodium balance, with renin-angiotensin or with autonomic nervous system abnormalities. A renin hypersecretion seems to be present only in some normotensive patients with glomerulonephritis.

Adolescent↗

[Comparison of two-dimensional echocardiography, angiocardioscintigraphy and cineventriculography in the study of left ventricular wall motion in ischemic cardiopathy].

Thirty-two patients with non acute myocardial infarction (inferior in twenty, anterior in ten, anterior and inferior in two) were studied with contrast left ventriculography, two-dimensional echocardiography and radionuclide angiography to assess left ventricular wall motion. We adopted the CASS criteria for the standard left ventriculography, and the Mayo Clinic classification for the echocardiographic study. Radionuclide angiography studies were obtained in left anterior oblique view; the images were evaluated with the use of Walsh-Hadamard transform; the left ventricle was divided in basal and apical septal, apical, posterolateral, posterobasal and two central segments. We tried to correlate the findings of the three techniques both for single segments and larger regions made of contiguous segments. Left ventricular angiography and two-dimensional echocardiography showed a fair concordance for both anterobasal and posterolateral left ventricular wall, whereas for the septal, apical and posterolateral regions contrast and radionuclide angiography had the best correlation. Compared to left ventricular angiography two-dimensional echocardiography shows better sensitivity than radionuclide angiography; the latter is more specific in defining left ventricular wall motion. The two non invasive techniques are therefore helpful in the evaluation of wall motion and their role is complementary.

Cineradiography↗

Personality aspects in multiple sclerosis.

To test the claim that peculiar personality bias is detectable in multiple sclerosis (MS) we used the Szondi test to investigate the psychodynamic aspects of 110 MS patients in comparison with 200 healthy subjects. MS patients appeared to have a greater need for love in a passive form than normal people, rigid defense mechanisms, difficulty in resolving their inner conflicts either by sublimation or by internalization of satisfactory new emotional experiences, feelings of autoaggressiveness, and many symptoms of depression. Some of these aspects correlate with the severity of the disease, others seem to date back to early childhood as peculiar personality patterns. An investigation of childhood events in 110 controls confirmed that MS patients had had many more unhappy experiences in childhood than might commonly be expected. Further, the oft-reported psychiatric troubles preceding MS clinical onset suggest that at least in some MS patients there are specific gaps in personality structure dating back to early phases of their development.

Adolescent↗

Agglutinating activity of gliadin-derived peptides from bread wheat: implications for coeliac disease pathogenesis.

The PT-digest of bread wheat gliadin was very active in agglutinating undifferentiated human K562(S) cells. This activity was quantitatively, but not qualitatively, similar to that of Con A or WGA. Moreover, Con A-induced cell agglutination was inhibited by mannan and mannose, WGA-induced agglutination by NAG only, and cell agglutination induced by bread wheat gliadin peptides was inhibited by each of these three saccharides. Not only was mannan the most active saccharide in preventing cell agglutination induced by bread wheat gliadin peptides, but it was also able to dissociate agglutinated cells. As compared to the PT- digest of whole bread wheat gliadin, the digest obtained from purified A-gliadin was tenfold more active. The PT-digest of durum wheat gliadin did not show any agglutinating activity.

Agglutination Tests↗

Intensive care complications in liver and multivisceral transplantation.

The complications concerning liver and intestinal transplant surgery have relevance for the field of intensive care because they share some characteristics with those following complex long-term surgery. Thus, in this article we shall try to describe complications that are specific to liver and multivisceral transplants. A review of the existing literature on this topic reveals a large number of studies dedicated to early as well as late surgical complications, and immunosuppressive treatment, while there are far fewer contributions describing complications exclusively concerning intensive care. We shall thus attempt to focus on certain aspects where, besides the literature data, we have personal experience. In particular we want to underline the implications of failure in the functional recovery of the graft; alterations in water, electrolyte, and glycemic balance; as well as neurological, respiratory, renal, nutritional, and infective complications.

Critical Care↗