Search PubMed⌕ Search

Biomedical subjects

G Aprili

Publications and source records attributed to G Aprili.

34 records · Page 2Linked to original sources
PubMed1999

Preoperative autologous blood donation by 1073 elderly patients undergoing elective surgery: a safe and effective practice.

BACKGROUND: Preoperative autologous blood donation (PABD) aims at avoiding the risks associated with exposure to allogeneic blood. While its use is extremely common among adult patients in connection with elective surgery, it is still uncommon in elderly patients, because of a series of coexisting pathologies. STUDY DESIGN AND METHODS: A retrospective study was made of 1073 consecutive elderly patients at a city hospital from 1990 to 1996. Their responses to the PABD program were evaluated by analysis of the incidence of complications and the demand for allogeneic blood. RESULTS: The PABD program was interrupted in 79 (7.4%) of 1073 patients because of the onset of anemia, vasovagal reactions, lack of accessible superficial veins, or cardiovascular complications. Seven hundred eighty-four (73.1%) of 1073 patients were given autologous blood; 151 (14.1%) patients also required allogeneic blood. CONCLUSION: The onset of anemia (6.5%) was the main contraindication for continuing the PABD program: incidence increased with age. PABD in connection with elective surgery is both feasible and effective in a high percentage of elderly patients.

Aged↗
PubMed1998

Transmission of an anti-RhD alloantibody from donor to recipient after ABO-incompatible BMT.

We report a bone marrow transplant which was HLA matched, with major and minor ABO and minor RhD incompatibility (anti-RhD antibody) between the donor and recipient. When engraftment occurred, the recipient developed an anti-RhD antibody of donor origin detected by direct and indirect antiglobulin tests (DAT, IAT) and showed signs of mild hemolytic anemia. With the disappearance of the recipient RBCs, the DAT became negative and the hemolysis disappeared, while the anti-RhD alloantibody persisted in the patient's serum. This case emphasizes the importance of close immuno-hematological monitoring in patients undergoing allogeneic BMT with ABO-RhD incompatibility between recipient and donor.

ABO Blood-Group System↗
PubMed1998

Subcutaneous bolus injection of deferoxamine in adult patients affected by onco-hematologic diseases and iron overload.

BACKGROUND AND OBJECTIVE: Chelation therapy is often necessary for patients who undergo chronic transfusion therapy for myelodysplastic syndromes. In these patients, deferoxamine, the most widely used chelating agent, has been reported to be effective in reducing the iron burden and the transfusion requirement. Unfortunately, compliance with the drug, that is usually administered by slow subcutaneous infusion via a battery operated pump, is often poor, especially in elderly patients. DESIGN AND METHODS: To verify efficacy and tolerability of deferoxamine by subcutaneous bolus injection as compared to the conventional pump-driven slow infusion, eleven patients affected by oncohematologic diseases were given 2 g of deferoxamine diluted in 10 mL of distilled water over twelve hours by continuous infusion, or by bolus injection in two divided doses. RESULTS: Mean urinary excretion was comparable with the two methods, being 9,183 +/- 4,349 micrograms/48 h after two daily subcutaneous bolus injections and 8,291 +/- 3,970 micrograms/48 h with the slow infusion. The bolus injection was preferred by all eleven patients, who chose to continue chelation therapy by this method. INTERPRETATION AND CONCLUSIONS: The iron excretion induced by bolus injection is not statistically different from that induced by subcutaneous infusion. The side effects are acceptable. Subcutaneous bolus injection of deferoxamine is an acceptable alternative to slow, pump-driven infusion.

Adult↗
PubMed1981

Alternative pathway for complement activation triggered by human liver plasma membranes.

Liver plasma membranes (LPM) prepared from normal hepatocytes by centrifugation in sucrose discontinuous gradient, are capable of haemolysing PNH-like cells in the presence of complement or complement plus EGTA or MG2+ ions. In contrast, EDTA or Ca2+ ions inhibit the lysis. The total complement lytic activity is reduced by some 40% when fresh serum is incubated with LPM, whereas the total amount of C4 remains constant. The cross-immunoelectrophoresis studies of fresh serum incubated with LPM demonstrate the appearance of C3 breakdown products, which suggests the activation of the alternative complement pathway. In contrast, the sucrose test, which proceeds mainly through the classical complement pathway, is inhibited by LPM. The possible role of complement in liver disease is discussed.

Cell Membrane↗
PubMed1978

Activation of complement by stroma from normal and paroxysmal nocturnal haemoglobinuria red cells.

Stroma from normal, AET-treated and PNH red cells and their KC1-extracts (partially purified on Sephadex G-200) are able to trigger the activation of the alternative complement pathway. This fact has been demonstrated by: 1 - the lysis of PNH cells incubated in serum treated with stroma from normal or PHN-RBC or with their extracts; the addition of Mg2+ or Ca2+ or of their chelators (EDTA, EGTA) to the extract-treated serum enhances or abolishes the lysis 2 - the reduction of complement acitvity in fresh serum incubated for 60' with PNH-extract 3 - the appearance of C3 breakdown products in serum incubated with PNH-extract, demonstrated by crossed immunoelectrophoresis. In contrast, the same stroma (or extract) inhibits the sucrose lysis test, in which the lysis takes place through the classical complement pathway. No differences on the complement activation were observed between PNH and normal RBC stroma and between their chromatographic extracts. These findings may suggest the possible role of diurnal variation of Mg2+ and Ca2+ concentration in precipitating haemolytic attacks and the possibility that small amount of circulating red cell stroma might maintain the haemolysis on PNH RBC.

Acetylcholinesterase↗
PubMedDate not supplied

Clinical relevance of serum cryoglobulins in hemophilic patients with hepatitis C virus infection.

Twenty-four hemophilic patients positive for hepatitis C virus were evaluated for the presence of serum cryoglobulins and associated symptoms. Eight (33.3%) of them had serum cryoglobulins (type II mixed cryoglobulinemia in all cases). The average time lapse between infection and appearance of serum cryoglobulins was 14.4 years (range 7-22 years). Two (25%) out of the 8 patients presented symptoms: one had systemic vasculitis, the other mild purpura. Hemophiliacs are a particularly suitable model for studying cryoglobulinemia in patients with hepatitis C virus infection since the onset of the infection is known and there is a long-term follow-up period.

Adult↗
PubMedDate not supplied

Presence and significance of cold agglutinins in patients with HIV infection.

BACKGROUND: HIV-infected patients may contract a variety of other concurrent infections, including Mycoplasma pneumoniae, cytomegalovirus (CMV) and Epstein-Barr virus (EBV), that are known to be causes of transient cold agglutinins (CA). The aim of this study was to search for the prevalence, the persistence and the significance of CA in HIV antibody-positive patients. METHODS: Ninety patients belonging to different risk groups (drug addicts, homosexuals and hemophiliacs), including 15 with AIDS, 20 with ARC, 25 with PGL, 30 symptom-free individuals and 100 healthy blood donors were assessed for the presence of CA for at least six months. RESULTS: In 20 cases (22%) CA were found: 3, 7, 5 and 5 respectively, in each of the above mentioned HIV-positive groups, while the group used as control was CA-negative. There were no differences between CA-negative and CA-positive patients with regard to the presence of anemia, frequency of other infections, or development of lymphatic malignancy during the follow-up period. Serological specificity of CA included 14 of type anti-I, 5 of anti-i and 1 of anti-Pr specificity. CONCLUSIONS: It appears that CA production is another immune disorder of patients with HIV infection.

Agglutinins↗
PubMedDate not supplied

[Transfusional therapy of hemodialyzed patient with anti-Cartwright antibodies: case report and review of the literature].

BACKGROUND: Red cell Cartwright antigen (Yta) is very common in the general population therefore patients without red cell Cartwright antigen and with anti-Yta alloantibodies due to previous exposure to the antigen are rare. Report about clinical significance of Yta red cell alloantibodies in hemodialysis (HD) patients are scarce. CASE REPORT: We report a cirrhotic uremic patient with anti-Yta antibodies who received Yta positive red cells. No adverse reactions nor hemolysis were detected. CONCLUSIONS: We concluded that dialysis patients with anti-Yta antibodies could be safely transfused with blood from Cartwright positive donors.

Adult↗
PubMedDate not supplied

[Chemotaxis deficiency in patients with HIV infection].

Increased susceptibility to bacterial recurrent infection is characteristically associated with impaired B cells function but also with a defective PMN function. We studied PMN CT in 15 HIV positive drug addicts patients with persistent generalized lymphoadenopathy (PGL), in 15 symptom free HIV negative drug addicts (SFDA) and in 15 healthy blood donors to evaluate influence of HIV infection on PMN functions. CT of patients with PGL was reduced to 78% (p < 0.0001) and 75% (p < 0.00001) of CT in SFDA patients and healthy blood donors, respectively. We conclude that HIV infection causes defective PMNL CT and then it can increase susceptibility to bacterial recurrent infections in these patients.

AIDS-Related Complex↗