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Biomedical subjects

F Fabris

Publications and source records attributed to F Fabris.

At least 253 records · Page 14Linked to original sources
PubMedDate not supplied

Platelet-specific proteins in patients with transient ischemic attacks. (Effects of anti-platelet drugs).

Levels of beta-thromboglobulin and platelet factor 4 in 46 patients with transient ischemic attacks and the influence of treatment with dipyridamole or aspirin plus dipyridamole were evaluated. Patients not receiving therapy showed levels of beta-thromboglobulin significantly higher than controls. However, patients taking only dipyridamole showed values of beta-thromboglobulin significantly lower than untreated patients or those taking aspirin plus dipyridamole. No significant difference was observed with regard to platelet factor 4 between the patients.

Adult↗
PubMedDate not supplied

The Italian version of the Alzheimer's Disease Assessment Scale (ADAS): psychometric and normative characteristics from a normal aged population.

The Alzheimer's Disease Assesment Scale (ADAS) was specifically proposed for the clinical assessment of patients suffering from dementia and is used in different countries. The Italian version of ADAS is presented in this paper together with the description of criteria used in transforming the American edition in the Italian edition. Psychometric and normative data are illustrated and discussed. A sample of 95 healthy volunteers of both sexes ranging in age from 50 to 79 years were recruited from the general population in different parts of Italy and from different social and educational levels. Their performance on the ADAS was analysed by sex, age, and educational level. Results indicated a specific influence of subjects' educational level on the Cognitive Subscale Total Score of ADAS and the need for an adequate correction was evidenced. The two objective measures of memory which constitute, together with the Cognitive Subscale Total Score, the cognitive subscale of ADAS were sensitive to both age and educational level, requiring corrections. The factor structure of the cognitive subscale of ADAS confirms the validity of distinguishing between the clinical-functional scores, which are summarized by the Cognitive Subscale Total Score (CSTS), from those of the objective memory tasks, which are kept separate and used to quantify specific memory characteristics. The main components of the CSTS were 3 factors. The first factor was

Journal Article↗
PubMedDate not supplied

Health and functional status in elderly patients living in nursing homes.

Socio-economic background, functional status, multiple pathology and medical conditions requiring care have been evaluated in 506 elderly subjects living in nursing homes in Turin (Italy). In the sample 78.8% are women, mean age 84.2 years, only 21.2% are men, mean age 76.3 years. Particularly in the oldest age classes women are more represented than men. Most subjects (94.3%) require help in at least one Activity of Daily Living (ADL). Part of the sample (21.2%) comes from home, 13.2% from acute wards, 9.1% from long term care wards, 6.3% from mental hospitals, 26.3% from residential homes. Education level is rather low. Before retirement, many men were workmen (38.3%), while many women were housewives (46.6%). Multiple pathology is very common: 23.7% of patients suffer from 4 pathologies, more than 5 diseases are present in 18.8%, while only 4.7% of subjects have less than two pathologies. Half of the sample (52.6%) is affected by dementia, 37.6% by cardiovascular diseases, 29.1% by chronic obstructive lung disease and 25.5% by stroke. Bone fractures are present in 22.1% of the subjects. Severe impairments in strength and/or motility in at least two limbs affect 43.7% of patients, double incontinence 49.2%, severe disturbances in speech and communication 35.4%. The prevalence of care needs is higher in women compared with men. More females than males need aid in walking, help in eating, diapers, pressure sores prevention and bedposts.

Journal Article↗
PubMedDate not supplied

Splenomegaly as the first manifestation of thyroid cancer metastases.

We report the case of a 65-year-old man who developed a symptomatic splenomegaly due to spleen metastasis from thyroid follicular carcinoma. In 1982, at the age of 53, the patient had undergone a thyroid lobectomy for a cold node, followed one year later by a second intervention for a microfollicular adenoma. He was subsequently administered thyroid suppressive therapy with no further follow-up. The diagnosis of spleen metastases from thyroid cancer was first suspected on the basis of history, high serum thyroglobulin (Tg) levels, and the presence of pulmonary 99Tc uptake. The patient underwent a splenectomy, during which vast infiltration involving the diaphragm, spleen, stomach, colon and pancreas, was found. Histological and immunohistochemical results showed that the spleen and diaphragm metastases derived from thyroid follicular carcinoma. Radioiodine uptake by the pulmonary metastases confirmed the thyroid source. Retrospective re-evaluation of the thyroid tissue removed in 1983 revealed a histological pattern consistent with follicular carcinoma, which could not be unequivocally attributed to the widely or minimally invasive form. To our knowledge this is the first report of splenomegaly as the first manifestation of thyroid cancer metastases. In this paper cases of splenomegaly due to metastatic spread are reviewed and the management of the present case is discussed.

Adenocarcinoma, Follicular↗
PubMedDate not supplied

[Sleep disorders in the aged].

OBJECTIVES: The aim of the study was the assessment of prevalence and risk factors of sleep disorders in the elderly. METHODS: The study sample consisted of a group of institutionalized elderly, from two university affiliated community nursing homes in Turin. The following subjects were excluded: a) those aged less than 65 years; b) had length of stay less than thirty days; c) were not able to communicate because of severe aphasia or severe hearing loss and d) had cognitive impairment based on the Short Portable Mental Status Questionnaire (SPMSQ ) > 5. A total of 88 subjects (65-102 ys; 24 male and 64 female) have been studied. Comorbidity was measured using the Acute Physiology and Chronic Health Evaluation scale (APACHE), disability using the index of Activity Daily Living (ADL), depressive symptoms using the Geriatric Depression Scale (GDS); sleep quality was determined using the Pittsburgh Sleep Quality Index (PSQI) and the subjective health by the Self-Rated Health (SRH) was also evaluated. RESULTS: Using the PSQI questionnaire, 70 subjects (79.5%) were identified as "poor sleepers" (PSQI > 5). They complained of difficulties in getting sleep (85.7%) and frequent awakening (75.7%). The most common causes of sleep disturbances were nycturia (51.4%), cough (38.6%) and pain (32.9%). Insomnia correlated with depressive symptoms, poor physical activity, number of medications and bad self-rated health. CONCLUSION: Sleep disorders probably are due to physical, psychological or ambient factors. The identification and correction of treatable causes of insomnia are relevant for improving the quality of sleep and health in the elderly.

APACHE↗
PubMedDate not supplied

[The effectiveness of foot reflexotherapy on chronic pain associated with a herniated disk].

Foot reflexology is both a diagnostic technique and therapy. It is an alternative therapy which is considered useful in pain management. Its effectiveness as a therapy has been studied at the Mestre hospital where a clinical study has been undertaken to determine the effectiveness of reflexology in the reduction of pain. A group of 40 persons suffering almost exclusively from a lumbar-sacral disc hernia received three treatments of reflexology massage for a week. The results found that 25 persons (62.5%) reported a reduction in pain, (rating at 0.75 on a scale of 0-4). These results however did not take into consideration the relationship between the effectiveness of foot reflexology and variables such as the persons physicality (Body Mass Index), or their psychological or social status.

Body Mass Index↗
PubMedDate not supplied

Validation of blood collection procedures for the determination of circulating vascular endothelial growth factor (VEGF) in different blood compartments.

AIMS OF THE STUDY: Studies on circulating VEGF have reported mixed results, possibly due to a lack of standardization of the pre-analytical phase. The aim of our investigation was to standardize the sampling procedure for the determination of VEGF in different blood fractions. BASIC PROCEDURES: We evaluated various clotting times for obtaining serum in 30 subjects, as well as different procedures for the preparation of plasma Edinburgh anticoagulant mixture (EDTA, PGE1, theophylline) and CTAD. VEGF was also assayed in lysed whole blood. In vitro platelet activation was monitored by measuring the levels of PF4. VEGF and PF4 were measured using commercially available enzyme-linked immunoassays. MAIN FINDINGS: Clotting time increased the release of VEGF, which reached a plateau between 2 and 4 hours. The percent increase of VEGF at 2 hours ranged from 118% to 4,515% (median 327%) compared to samples centrifuged within 10 min from withdrawal. VEGF was not different and PF4 was very low or undetectable in Edinburgh plasma and CTAD plasma, while it was significantly higher in sodium citrate plasma. VEGF in CTAD plasma was not correlated with platelet count or leukocytes. Serum VEGF did not correlate with the leukocyte number, but it correlated significantly with the platelet count. PRINCIPAL CONCLUSIONS: The procedures for sample collection described above are highly standardized and easy to perform in a routine setting. We therefore suggest systematic evaluation of VEGF in CTAD plasma, in serum (clotting for 2 hours at room temperature) and in whole blood, until prospective controlled clinical studies will have clarified in which blood compartment(s) VEGF provides clinically relevant information.

Biomarkers, Tumor↗
PubMedDate not supplied

Identification of anti-platelet autoantibodies by western blot in 45 patients with idiopathic thrombocytopenic purpura (ITP).

BACKGROUND: In sera and platelet eluates of ITP patients, antigen specificity was widely studied by means of sensitive methods including immunoprecipitation, monoclonal antibody immobilization, and immunoblot. These studies indicated that GPIIb-IIIa were the main epitopes of ITP autoantibodies. METHODS: We studied the specificity of antiplatelet autoantibodies in 45 patients with acute and chronic ITP. Patient sera were tested by Western blot on separated platelet proteins in non-reducing conditions; antibody binding was identified using biotinconjugated anti-human IgG and avidin-peroxidase. RESULTS: Two main nonspecific bands of 200 and 125 kD were visible using normal serum; the first referred to platelet IgG, and the second was due to a naturally occurring antibody towards an internal protein. Twenty-five sera (55%) stained one (n = 11), two (n = 7), three (n = 3) or four (n = 4) specific bands. In patients with chronic ITP there was a prevalence of multiple bands. The relative molecular weights of the recognized antigens were in the range of 140-160, 80-100, 50-70 and 40 kd. The 80-100 epitope was recognized as a membrane protein in only 40% of sera, and it was partially characterized as GPIIIa in 4 patients. The other stained epitopes were absorbed by platelet lysate and then identified as internal proteins. CONCLUSIONS: This finding might be related to sensitization to antigens exposed by platelets during immune damage, and may pose an important problem in the identification with the immunoblot technique of target antigens responsible for immune sequestration.

Adult↗
PubMedDate not supplied

Long-term treatment of refractory HIV-related immune thrombocytopenia in a patient with haemophilia A.

Haemophilia A patient developed symptomatic immune thrombocytopenia 5 years after HIV seroconversion without any progression of the viral disease. He displayed major bleeding with less than 30 x 10(9) platelets/l. No increase in platelet count was obtained using steroids, azidothymidine and alpha-interferon, while the patient was responsive only to high-dose intravenous immunoglobulins (IVGG). The patient remained responsive to IVGG for 1 year, and the repeated infusions of immunoglobulins were effective in safely maintaining the platelet count, with peak counts above 100 x 10(9)/l. On the contrary, after a single course of six plasma exchanges the patient became symptomatic and completely refractory to IVGG during the next month. In conclusion, IVGG could be effectively used in a long-term regimen in haemophiliacs with refractory HIV-ITP to avoid the risk of haemorrhages and to delay splenectomy.

Adult↗
PubMedDate not supplied

Sex and age as prognostic factors in essential thrombocythemia.

BACKGROUND: The major causes of morbidity and mortality in essential thrombocythemia (ET) are bleeding and thrombotic accidents, but a prognostic pattern for these complications has not yet been discovered. MATERIALS AND METHODS: In this study we report data from a large cohort of patients with thrombocytosis, distinguished for sex and age, in order to define their thrombotic risk. The prevalence of vascular complications recognized in 86 patients with essential thrombocythemia was studied. In addition, 91 patients with polycythemia vera (PV), 20 with myelofibrosis (MF) and 63 with secondary thrombocytosis (ST) were evaluated. RESULTS: 6.3% of ET subjects younger than 40 (4.6% of males and 7.0% of females), 11.8% of patients between 40 and 65 years old (14.9% of males and 9% of females), and 16.8% of subjects over 65 (14.6% of males and 17.8% of females) showed thrombotic accidents. In the PV and MF groups thromboses occurred more frequently than in the ET groups for all ages and for both sexes. On the contrary, ST subjects showed fewer thromboses than ET patients, but their incidence rose with patient age; moreover the prevalence of males in this group was limited. In ET patients, particularly in females, the incidence of thrombosis was low under 40 years of age, but rapidly increased later. CONCLUSIONS: ET females over 40 must be followed with particular attention in order to prevent thrombotic complications.

Adult↗
PubMedDate not supplied

Medical treatment of portal hypertension.

Prevention of the first variceal haemorrhage should start when the patients have developed medium sized to large varices. Non-selective beta-blockers are the first-line treatment; band ligation is roughly equivalent to beta-blockers and is the first choice for patients with contraindications or intolerance to beta-blockers. Treatment of acute bleeding should aim at controlling bleeding and preventing early rebleeding and complications, especially infections. Combined endoscopic and pharmacological treatment with vasoactive drugs can control bleeding in up to 90% of patients. All patients who survive a variceal bleed should be treated with beta-blockers or band ligation to prevent rebleeding. All patients in whom bleeding cannot be controlled or who continue to rebleed can be treated with salvage TIPS or, in selected cases, with surgical shunts. Liver transplantation should be considered for patients with severe liver insufficiency in which first-line treatments fail.

Acute Disease↗
PubMedDate not supplied

The use of fluorescence flow cytometry in the characterization of Bernard-Soulier syndrome and Glanzmann's thrombasthenia.

We have used flow cytometry analysis of fluorescence to study the binding of murine monoclonal antibodies to platelets. Anti-platelet glycoproteins Ib (AP1), the complex IIb-IIIa (LJP9) and the FITC-conjugated second antibody were added directly to the sample of platelet rich plasma without washing. The analysis was performed in normals and in patients affected by the Bernard-Soulier syndrome and Glanzmann's thrombasthenia and compared to the direct binding of radioiodinated monoclonas. Comparable results were obtained. A symmetric profile of fluorescence for both glycoproteins Ib and IIb-IIIa was observed in normals and in the patient group, which indicates homogeneous distribution of these glycoproteins on the platelet surface. The develop technique allows identification of homozygous and heterozygous carriers of the platelet disorders studied and quantification of the defect, which seems to be due to a homogeneous decrease of specific glycoproteins in all platelet populations.

Adult↗