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Biomedical subjects

F Mannino

Publications and source records attributed to F Mannino.

At least 19 recordsLinked to original sources
PubMed2002

Induction and recovery phases of methacholine-induced bronchoconstriction using FEV1 according to the degree of bronchial hyperresponsiveness.

Forty-eight patients suffering from intermittent bronchial asthma underwent methacholine challenge test. Response was stronger in 29 patients and less pronounced in 19. The two groups had the same characteristics except for the cumulative methacholine dose which was lower in severe hyperresponsiveness. The patients were studied both in the phase of induced bronchospasm and in the subsequent phase of spontaneous recovery. Dose-response curves to methacholine were analyzed as FEV1% decline/methacholine dose for the induction phase of bronchoconstriction and as FEV1% increase*methacholine dose/time after PD20FEV1 for the recovery phase. The phase of induced bronchospasm as well as spontaneous recovery had a linear pattern in severe hyperresponsiveness; in patients with moderate response, induced bronchoconstriction had a curvilinear pattern whereas spontaneous recovery had a linear pattern. This latter group had to break down an amount of methacholine that was fivefold greater than the former, therefore the mechanism of local homeostasis recovery may be more efficient in moderate hyperresponsiveness. However, in both groups recovery after the bronchospasm was not complete after 60 min (p < 0.01 versus baseline). Furthermore, recovery was faster in the first 15 min than in the remaining time. In conclusion the behavior of methacholine-induced bronchospasm and its spontaneous recovery in both severe and moderate hyperresponsiveness seem to be different although several and not well-established mechanisms may be responsible for this phenomenon.

Administration, Inhalation↗
PubMed2001

Dopamine receptors in human platelets.

The expression of dopamine receptors by human platelets was investigated by Western blot analysis and immunocytochemical techniques using antibodies raised against dopamine D1-D5 receptor protein. The influence of dopamine D1-like and D2-like receptor agonists on adrenaline-induced platelet aggregation was also investigated. Western blot analysis revealed that platelet membranes bind anti-dopamine D3 or D5 receptor protein antibodies, but not anti-D1, D2 or D4 receptor protein antibodies. Cytospin centrifuged human platelets exposed to anti-dopamine D3 or D5 receptor protein antibodies developed a specific immune staining, whereas no positive staining was noticeable in platelets exposed to other antibodies tested. Both the D1-like receptor agonist 1-phenyl2,3,4,5-tetrahydro-(1H)-3-benzazepine-7,8-diol hydrochloride (SKF 38393) and the D2-like receptor agonist 7-hydroxy-N,N-di-n-propyl-2-aminotetralin (7-OH-DPAT) dose-dependently inhibited adrenaline-induced platelet aggregation. These effects were decreased respectively by the D-like and D2-like receptor antagonists R(+)-2,3,4,5-tetrahydro-3-methyl-5-phenyl-1H-3-benzazepin-7-ol hydrochloride (SCH 23390) and (-)sulpiride. The above findings indicate that human platelets express dopamine D3 and D5 receptors probably involved in the regulation of platelet function.

Adult↗
PubMed2001

[Significant increase of incidence of cypress pollen allergy in the city of Rome].

In the second semester of 1999, 246 patients, living in a Roman urban area, were subjected to a prick-test screening. 194 (78.9%) of the patients showed a positive answer toward almost one of the tested allergens, whereas the other 51 persons (21.1%) turned out to be negative. Of the patients with a positive cutireaction, 59 (24% of total survey and 30.4% of allergic subjects), with an average age of 29.6 (SD = 12.78) showed sensitization toward cypressus. The results were compared with a case-study of 900 atopic subjects, recruited by the same Center between 1994-96 and living in the same Roman area. In this last group we only found 84 pts (9.3%) with a positive prick-test toward Cypressus, with an average age of 35.2 (DS = 13.48). This analysis wants to stress the increasing incidence of allergy toward cypressus among atopic subjects, switching from 9.3% to 30.4%, in the same urban area, during these last three years.

Allergens↗
PubMed2000

Immune response to blood transfusion invery-low-birthweight infants.

BACKGROUND: Allogeneic blood transfusion is common in the treatment of neonatal anemia of prematurity or anemia due to multiple phlebotomies. The immune response of neonates to passenger leukocytes from allogeneic red cells was investigated. STUDY DESIGN AND METHODS: Fourteen infants (4 male, 10 female) prospectively were randomly assigned to receive either white cell-reduced (Group 1) or non-white-cell reduced (Group 2) irradiated blood. Blood samples were taken before and at various time intervals after transfusion (Days 1, 5-7,and 10-14). Cord blood from 11 healthy term infants was used for comparison. The following surface markers were used to assess immune modulation by flow cytometry: CD45RA/CD45RO, CD4/CD8, CD25/CD28, CD3/DR, CD14/B7, and CD3/CD56+CD16. Donor cell microchimerism was studied using semi-quantitative polymerase chain reaction Y-chromosome detection in female infants who received male donor blood. Donor and recipient HLA class II typing was performed with polymerase chain reaction with sequence specific primers. RESULTS: The lymphocyte counts in both groups were significantly increased after transfusion, and there was a significant increase in lymphocytes expressing CD45RA, CD3-/CD16+CD56, CD80, and CD3-/DR on Day 14. The premature infants' pretransfusion natural killer cell population (CD3-/CD16+CD56) was significantly lower than that of term infants, but it reached a similar level by Days 10-14. CD8 subpopulations were increased but not CD4+ cells. Two female infants (of 6) had circulating Y chromosomes 1 day after transfusion, and most of the infants effectively cleared the donor cells within 24 hours of transfusion. Two Group 2 infants who by chance received presumably HLA-haploidentical donor blood developed necrotizing enterocolitis. CONCLUSION: Blood transfusion alters immune cell antigen expression in premature neonates and may initially be immunostimulatory and later immunosuppressive.

Anemia, Neonatal↗
PubMed2000

Three-dimensional ultrasonographic imaging of the neonatal brain in high-risk neonates: preliminary study.

The aim of this investigation was to compare the utility of three-dimensional ultrasonography versus two-dimensional ultrasonography in imaging the neonatal brain. Thirty patients in the neonatal intensive care unit underwent two-dimensional and three-dimensional ultrasonography. The resultant two- and three-dimensional images recorded on film and three-dimensional volumes (reviewed on a workstation) were evaluated independently. Comparable numbers of normal and abnormal studies were diagnosed by each modality. Axial images were considered useful in approximately 50% of three-dimensional cases. Image quality, overall and in the far-field, was rated higher on two-dimensional images. Three-dimensional sonographic acquisition time in the neonatal intensive care unit (1.7 min+/-0.7 standard deviation) was significantly shorter than that for two-dimensional sonography (9.0+/-4.5 min). The total time for evaluation on the three-dimensional workstation (4.4+/-1.1 min) was significantly less than that for two-dimensional images on film (10.6+/-4.7 min). In conclusion, three-dimensional ultrasonography is a promising, diagnostically accurate, and efficient imaging tool for evaluation of the neonatal brain; however, visualization must improve before it can replace two-dimensional ultrasonography.

Brain↗
PubMed1999

Radioligand binding assay of M1-M5 muscarinic cholinergic receptor subtypes in human peripheral blood lymphocytes.

Analysis of lymphocyte muscarinic cholinergic receptors using quantitative techniques such as radioligand binding assay is made difficult due to the low density of these sites and the lack of subtype-specific selectivity of most available muscarinic ligands. In this study, a combined kinetic and equilibrium labeling technique recently developed for brain tissue was used for labeling the five muscarinic cholinergic receptor subtypes in intact human peripheral blood lymphocytes. No specific muscarinic M1 receptor binding was detectable in human peripheral blood lymphocytes using [3H]-pirenzepine as a ligand. Labeling of M2-M5 muscarinic receptors using [3H]N-methyl-scopolamine (NMS) by occluding various receptor subtypes with muscarinic antagonist and mamba venom resulted in the labeling of M2-M5 receptors in brain as well as in human peripheral blood lymphocytes. The relative density of different receptor subtypes was M3 > M5 > M4 > M2. The development of a reproducible technique for assaying muscarinic cholinergic receptor subtypes expressed by human peripheral blood lymphocytes may contribute to clarify their role in lymphocyte function.

Adult↗
PubMed1999

Aerosol characterization of three corticosteroid metered dose inhalers with volumatic holding chambers and metered dose inhalers alone at two inspiratory flow rates.

Inhaled corticosteroids are first-choice drugs in the treatment of chronic asthma. A metered dose inhaler (MDI) equipped with a spacer device is easier to use for patients with a poor inhalatory technique; it favors a reduction in the size of the particles delivered to the patient and thus a reduction in the incidence of local and systemic side effects of these drugs. The aim of this study was to determine the particle characteristics of fluticasone propionate (FP), flunisolide (FLUN), and beclomethasone dipropionate (BDP), each administered at a rate of 250 micrograms per puff and at inspiratory flow rates of 30 and 60 L/min in vitro, to estimate the particle characteristics of these drugs aspirated via an MDI alone and via a large-volume holding chamber (Volumatic). Compared with the MDI alone, at 30 L/min, the Volumatic (Glaxo Wellcome, Ware, UK) significantly reduced the mass median aerodynamic diameter (MMAD) and increased the fine particles (< 5 microns and < 2 microns) generated by all three drugs. At 60 L/min, the MMAD increased and the generation of fine particles decreased with both devices. These data suggest that the inspiratory flow applied by means of the devices may be a determinant for the deposition of the drug in the lower airways in that by increasing the inspiratory flow, the MMAD increases and the percentage of fine particles decreases, probably because of the reaggregation favored by the higher flows.

Aerosols↗
PubMed1999

[Dermatofibrosarcoma protuberans: authors' experience].

Dermatofibrosarcoma protuberans is an uncommon slow-growing cutaneous neoplasm. Surgical excision is an effective therapeutic approach although a significant number of local recurrences has been documented in the literature. In the present paper the Authors report 3 cases of dermatofibrosarcoma protuberans. All cases have been surgically treated with a wide local excision extended up to 3 cm from the tumor borders. No local recurrence has been reported. The Authors conclude that the surgical technique employed could reduce the local recurrence rate of dermatofibrosarcoma protuberans.

Abdomen↗
PubMed1998

Peripheral blood lymphocyte muscarinic cholinergic receptors in airway hyperresponsiveness: a marker of cholinergic dysfunction?

1. Muscarinic cholinergic receptors were assayed in human peripheral blood lymphocytes of healthy control and airway hyperresponsive subjects using a radioligand binding assay technique and the muscarinic cholinergic receptor antagonist [3H]-quinuclidinyl benzilate (QNB) as a radioligand. Subjects investigated were divided in four different groups based on threshold responses to methacholine inhaled as challenge test. 2. [3H]-QNB was bound to human peripheral blood lymphocytes in a manner consistent with the labelling of muscarinic cholinergic receptors. Dissociation constant (Kd) values of [3H]-QNB binding were similar in the different groups examined, whereas maximum density of binding sites (Bmax) was increased in airway hyperresponsive subjects in comparison with healthy controls. 3. The above findings indicate that the density of muscarinic cholinergic receptors is increased in peripheral blood lymphocytes of airway hyperresponsive subjects. 4. This suggests that airway hyperresponsiveness is associated with cholinergic hyperreactivity and is probably a systemic cholinergic dysfunction since it is accompanied by changes in the density of muscarinic cholinergic receptors expressed by peripheral blood lymphocytes.

Adult↗
PubMed1998

[Tobramycin aerosol: could the delivery system influence the particle size and deposition in the lower airways?].

UNLABELLED: Aerosolized tobramycin represents an efficient alternative to the systemic administration, especially in patients with cystic fibrosis and bronchiectasis affected with Pseudomonas aeruginosa infections. Aim of this study was, using a Time Of Flight Aerosol Beam Spectrometer (API Aerosizer Mach2), to compare the granulometric characteristics of tobramycin aerosolized in 1 sec by three nebulizers and, using mathematic models, to value the particles and drug deposition in the lower airways, particularly at: P level, which includes bronchiolar and alveolar tract; TB level, which includes tracheobronchial tract; ET level, which includes the extrathoracic tract; the amount of particles (Dp) and drug (Dd) dispersed. RESULTS: Nebula Nuovo: Mass Median Aerodynamic Diameter (MMAD): 3,722 microns; Geometric Standard Deviation (GSD): 2,382; Particles deposited-P: 42.86%; TB: 4.99%; ET: 8.7%; Dp: 43.45%; Tobramycin deposited-P: 36.84%; TB: 11.52; ET: 26.36%; Dd: 25.28. Pari IS2: MMAD: 3,179 microns; GSD: 1,367; Particles deposited--P: 41.99%; TB: 8.67%; ET: 17.26%; Dp: 32.07%; Tobramycin deposited-P: 33.19%; TB: 14.37%; ET: 34.12%; Dd: 18.3%. Artsana with Sidestream ampulla-MMAD: 3,083 microns; GSD: 2,313; Particles deposited-P: 43.96%; TB: 7.11%; ET: 6.23%; Dp: 42.68%; Tobramycin deposited-P: 43.63%; TB: 8.1%; ET: 15.3%; Dd: 32.97%. CONCLUSIONS: Differences in nebulizers performance influence therapeutic effects and tobramicyn deposition in the lower airways.

Aerosols↗
PubMed1998

[The immediate reconstruction of the breast after a mastectomy for carcinoma. Our experience].

The authors surgically treated 281 consecutive women with breast cancer by breast conservation techniques (45.2%) or by mastectomy (38.8%), during a four-year period. Forty-five of these 281 patients (16%) were treated in the same period of time by mastectomy and immediate reconstruction (IR) of the breast. IR of the breast was performed by inserting a submuscular tissue expander at the same time of mastectomy (first stage of reconstruction). A second operation allowed the replacement of the expander with a prosthesis (second stage of reconstruction) and the simultaneous symmetrization of the contralateral breast (not always performed, however). In some cases nipple-areola complex was eventually reconstructed with a delayed surgical procedure (third stage of reconstruction). In the present paper the authors analyze the results and outline the advantages of IR. This easy and safe technique slightly increased the average operative time of a mastectomy, did not interfere with routine oncological follow-up, did definitely reduce patient's psychological trauma following mastectomy. The authors conclude that IR of the breast undoubtedly plays a major role in the so called "onco-plastic"" surgical management of breast cancer.

Adult↗
PubMed1997

[Study of spontaneous resolution of bronchial spasm after methacholine challenge. Comparison of patients with different degree of hyperreactivity].

The study was designed to assess the spontaneous recovery of bronchial spasm induced by methacholine in bronchial challenge tests and to examine the mechanisms and the modalities involved as well as the influence of dosage. The phenomenon was analysed in 32 hyperreactive patients diagnosed as asthmatics by measuring FEV1 as soon as maximum bronchial constriction (PD20) had been achieved and after 5, 10, 15, 30 and 60 minutes. The data obtained were subjected to variance analysis. Results show: 1) as regards duration of spontaneous recovery, that FEV1 returned to pre-challenge levels after 60 minutes in both the severely and moderately hyperreactive patients; 2) as regards onset of regression, that onset depended on the level of sensitivity, occurring after 30 minutes in the severely affected, after 15 minutes in the mild cases; 3) as regards recovery intensity, that in the moderated cases the recovery was more pronounced in the first 15 minutes than subsequently. Data show that the onset and intensity of the spontaneous recovery change according to the degree of sensitivity. That might reflect a greater affinity and/or bonding of methacholine in the muscarinic receptors of the severely affected, but the possibility of a difference in mediator metabolization speed cannot be excluded. In conclusion, research into the recovery of bronchial spasm may contribute to a better understanding of bronchial hypersensitivity and provide new information of value on the diagnosis, pathogenesis and treatment of the condition.

Adult↗
PubMed1996

Muscarinic cholinergic receptor subtypes in human peripheral blood lymphocytes.

The subtypes of muscarinic cholinergic receptors were studied in human peripheral blood lymphocytes with radioligand binding techniques and the non-selective muscarinic cholinergic receptor antagonist [3H]quinuclidinyl benzylate (QNB) as a ligand. [3H]QNB was bound to human peripheral lymphocytes in a manner consistent with the labelling of muscarinic cholinergic receptors. The dissociation constant (Kd) value was 0.60 +/- 0.08 nM and the maximum density of binding sites (Bmax) was 2.33 +/- 0.03 fmol/2.2 x 10(6) cells. The binding was time-, temperature- and concentration-dependent, belonging to a single class of high affinity sites. Analysis of the pharmacological profile of [3H]QNB binding in the presence of compounds specific for the different muscarinic receptor subtypes suggests that human peripheral blood lymphocytes express mainly muscarinic cholinergic M2 and M3 receptor subtypes and to a lesser extent muscarinic M4 receptors. The characterization of the subtypes of muscarinic cholinergic recognition sites expressed by human peripheral blood lymphocytes may represent a tool for investigating the possible relationships between immune and cholinergic systems in normal and pathologic conditions.

Adult↗
PubMed1996

Probability of particle and salbutamol deposition in the respiratory tract: comparison between MDI and Autohaler.

The aim of this study was to assess the granulometric characteristics and the deposition probabilities of particles and drug, in the respiratory tract, following one puff of salbutamol delivered by a metered-dose inhaler (MDI) and a breath-actuated metered-dose inhaler (BAI-Autohaler). Particle analysis, achieved using an API Aerosizer Mach2, showed that the two devices have similar granulometric characteristics; recording the following data for the mass median aerodynamic diameter (MMAD) and for the geometric standard deviation (GSD): MDI (MMAD 2.29 microns. GSD 1.46); BAI (MMAD 2.41 microns, GSD 1.48). Data on the percentage of drug carried by the single particles suggest a higher probability of deposition of salbutamol delivered by Autohaler in the pulmonary and tracheobronchial tracts (approximately 61 vs 48% for the conventional MDI) and a reduced deposition in the orolaryngeal tract (17 vs 26% for the conventional MDI), with a consequently lower risk of having collateral effects caused by systemic absorption of the drug and an improved effectiveness at the site of action.

Administration, Inhalation↗
PubMed1991

An interesting case presentation: ultrasound diagnosis of primary atrial thrombosis associated with brain infarctions.

A premature infant with nonbacterial endocardial thrombosis and embolization of the cerebral circulation is presented. The patient was born at 32 weeks with a birthweight of 1480 g. Pregnancy was complicated by toxemia and placental infarctions. Echocardiographic examination by 12 hours after birth revealed a large mass in the right atrium compatible with endocardial thrombus. Follow-up echocardiograms showed a small mass in the left atrium and a decrease of the right atrial mass by day 7. Echoencephologram studies were normal on day 1. An echodense area in the subcortical white matter was seen by day 2. Other echodensities were detected by day 10. Computerized tomography studies showed areas of decreased attenuation in both hemispheres. Lung perfusion scan and renal-liver ultrasound studies were normal. All these cerebral and cardiac lesions were asymptomatic. Real-time ultrasonography is useful to diagnose asymptomatic endocardial thrombosis and its cerebral complications in premature infants.

Cerebral Infarction↗
PubMed1988

Neonatal complications of postterm gestation.

Postterm gestation infants represent about 10% of the newborn population and, as compared to term gestation infants, have an increased incidence of perinatal and neonatal problems. Most postterm infants are normal appearing, although changes in the skin and a loss of subcutaneous fat occur in some. A smaller number experience the onset of fetal wasting late in gestation and appear dysmature (postmature) at birth. The incidence of infants with dysmaturity increases as postterm gestation continues; however, the prevalence of dysmaturity is greater in term infants. The most significant neonatal problems in the postterm gestation infant are the result of fetal distress and perinatal asphyxia. Those infants affected most severely may have hypoxic encephalopathy, seizures and meconium aspiration syndrome. Other problems are birth trauma (due to the large size of some postterm infants) and polycythemia. Anencephaly is associated with postterm gestation. The later intellectual development of postterm gestation infants appears normal except for those with perinatal asphyxia or severe neonatal problems. The long-term somatic growth is normal, even in dysmature-appearing infants. Postterm infants are at increased risk for perinatal asphyxia; however, with careful obstetric management, most neonatal problems can be prevented.

Child Behavior↗