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Biomedical subjects

G Pistone

Publications and source records attributed to G Pistone.

44 records · Page 3Linked to original sources

Electrophysiological alterations in hepatic encephalopathy detected by brain mapping.

Analogical electroencephalogram has been used to study electric alterations in the brain during liver encephalopathy. We adopted digital technique brain mapping to study the electric background activity in the brain and to evaluate the diagnostic and prognosis usefulness of this technique compared with the methods routinely used in this disease. We studied 18 patients with liver cirrhosis and varying degrees of liver encephalopathy and 7 healthy control subjects to assess correlation between the severity of encephalopathy and abnormal electric activity in the brain, and to detect the main differences between the brain mapping findings obtained in the two groups. The findings revealed an overall reduction in the rhythm, increased amplitude and anomalous distribution of the waveforms in the cirrhotic patients. Although similar results have already been reported, brain mapping furnished prompt and more easily visualised findings. Moreover, brain mapping facilitated detailed analysis of wave amplitude, frequency and topographic location indicating that this technique is a valid tool in diagnosing brain disorders.

Brain Mapping↗

The effects of reserpine on microcirculatory flow in rat flaps.

A model flap was developed in the rat which allowed us to quantitate microcirculatory blood flow within a flap, and to correlate the flow with the length of flap eventually surviving. A critical flow of 0.02 and 0.03 ml/min/gm (measured during the first 24 hours after flap elevation by radioactive microspheres) appears to be necessary for tissue survival. Reserpine, in a dose of 5 mg/kg, did not increase blood flow in the flap or the length of flap surviving in this model.

Animals↗

Lipid profile variations in a group of healthy elderly and centenarians.

Epidemiological and clinical studies have clearly shown a close relationship between plasma cholesterol concentrations and vascular risk. We focused our attention on the phenotypic-biohumoral conditions capable of influencing longevity in relation to different age classes. We evaluated the lipid profile in an elderly institutionalized population of 80 subjects (20 males and 60 females divided into age classes) in the town of Catania. Our results revealed a statistically significant reduction in total cholesterol, triglycerides and LDL-cholesterol concentrations as well as Apolipoprotein B100/Apolipoprotein A1, total cholesterol/HDL-cholesterol and LDL-cholesterol/HDL-cholesterol ratios, and a significant increase in HDL-cholesterol, Apolipoprotein A1, Apolipoprotein B100 and Lipoprotein (a) values. This changes are progressive with age. We believe that low total cholesterol, LDL-cholesterol and triglyceride concentrations, elevated HDL-cholesterol values, and low ratios protect subjects from ischemic and thrombotic events, thus favouring longevity. These changes are most evident and statistically significant in the most advanced decades of life, especially in centenarians, and may depend on diverse determinants, such as body composition, environmental factors, physical activity, diet and drugs.

Activities of Daily Living↗

[3-year-survival and quality of life after out-of-hospital heart arrest].

Although the long- and short-term aspects of the outcome of advanced cardiopulmonary resuscitation on patients have been studied to evaluate the percentage of survival up to the moment of discharge from hospital, little information has been published concerning the patients' long-term quality of life. In order to verify the efficiency of our group we retrospectively evaluated 468 subjects admitted to the Emergency Room of Rho Hospital (Milan, Italy) for out-of-hospital cardiac arrest that had occurred over a 90-month period. We studied the correlations between some variables: epidemiological (sex and age), objective (time required for advanced cardiopulmonary resuscitation and type of arrhythmias in the Emergency Room) and instrumental (left ventricular ejection fraction) and post-discharge survival. We also considered the state of health of the survivors by means of a questionnaire on their quality of life. Our data show that: a) 10.25% of the patients were discharged alive; b) younger men (< 65 years old) admitted with a ventricular fibrillation (p = 0.01) and those who had undergone advanced cardiopulmonary resuscitation for less than 25 min (p = 0.001) had a better survival rate at 3 years from discharge; c) 64% of the survivors have a satisfactory quality of life; d) younger age (p = 0.01) and cardiac left ventricular ejection fraction (> 40%) (p = 0.05) are positive predictors for future work capacity. In conclusion, we believe that the critical moment following advanced cardiopulmonary resuscitation is hospitalization because after discharge survival percentage abruptly increased from 10.25 to 65%.

Activities of Daily Living↗

A meta-analysis of interferon-alpha treatment of hepatitis D virus infection.

The severity of chronic hepatitis D infection and its unfavorable progress necessiate research into drugs and protocols capable of changing the natural history of the disease. Over the last few years interferon (IFN)-alpha has been the drug of choice in the management of this infection. We assessed its long-term efficacy by analyzing 5 controlled and 10 uncontrolled trials conducted between 1987 and 1994. The Mantel-Haenszel-Peto method was used in the former to perform statistical analysis. The odds ratio (0.16, confidence interval 0.058-0.476) confirmed the efficacy of IFN-alpha, even if the coefficient was not significant because of the limited number of spontaneous remissions in the trials. Although IFN treatment is fully beneficial in only a small number of patients with chronic hepatitis D infection, at present it is the only available agent.

Antiviral Agents↗

Interferon, cortisone, and antivirals in the treatment of chronic viral hepatitis: a review of 30 years of therapy.

Over the last 30 years many approaches have been adopted to treat chronic hepatitis. We conducted a meta-analysis to assess the efficacy of various types of treatments. We selected 4 studies of cortisone in chronic hepatitis B; 21 trials of interferon treatment, 6 in chronic hepatitis B, 10 in chronic hepatitis C, and 5 in chronic hepatitis D; and 5 of combined cortisone and interferon treatment in chronic hepatitis B. The Mantel-Haenszel-Peto method was applied to extrapolated data. We completed the study by analyzing four studies of cortisone treatment of chronic hepatitis C, two of cortisone plus interferon alpha (IFN-alpha) for chronic hepatitis C, and antiviral therapy for hepatitis B, C, and D. Trials administering cortisone for chronic hepatitis B had an overall OR of 0.29 (CI 0.12-0.73). No virologic remissions were observed in patients with hepatitis C receiving prednisone, even if those with features of autoimmunity achieved a biohumoral sustained response. Overall ORs in the trials were were as follows: IFN for chronic hepatitis B, 0.27 (CI 0.17-0.46); IFN for chronic hepatitis C, 0.3 (CI 0.21-0.44); IFN for chronic hepatitis D, 0.16 (CI 0.06-0.47); and cortisone plus interferon for chronic hepatitis B, 0.25 (CI 0.15-0.41). Sustained response rates of chronic hepatitis C ranged from 15-24.2%. The only encouraging results were obtained by antivirals. To date the lack of a specific antiviral drug makes it uncertain as to the preferred agent for this disease.

Anti-Inflammatory Agents↗

[The epidemiology and management of an acute asthmatic attack].

The mortality rate for acute asthma increased approximately 40% between 1982 and 1991 in the United States, while hospital admissions remained constant. In order to verify if inadequate therapy at home could increase hospitalization for this pathology, we evaluated retrospectively 94 subjects admitted to the Emergency Department of Rho Hospital, near Milan (Italy), for acute asthma in 1996. We studied the correlations between some epidemiological variables (sex and age) and the hospitalization of asthmatic patients and described the different therapeutic approaches at home and in the Emergency Department. Our data show that subjects > 40 years old, mostly females, were admitted more frequently than younger patients (38%) (p < 0.03). In comparison with the international guidelines we document the underuse of inhaled corticosteroids (69.7%) previous to the acute attack (p < 0.01). In conclusion, we believe that the correct early use of inhaled corticosteroids at home could prevent hospitalization for asthma, particularly in the elderly.

Adult↗