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Biomedical subjects

G Pugliese

Publications and source records attributed to G Pugliese.

123 records · Page 7Linked to original sources

Recommendations for reducing risks of infection associated with suction collection procedures.

It is recognized that risks are incurred when health care workers contact various body fluids. The handling of suction collection equipment poses a risk because it is one way workers may come in contact with these fluids. Minimizing the risks associated with suction procedures can be accomplished if appropriate policies and procedures can be developed in health care facilities.

Cross Infection↗

Serum levels of thyrotropin, thyroxine, 3,3',5-triiodothyronine and 3,3',5'-triiodothyronine (reverse T3) in the first six days of life.

Serum concentrations of thyrotropin (TSH), thyroxine (T4), 3,3',5-triiodothyronine (T3), and 3,3',5'-triiodothyronine (rT3) were determined in blood samples from 140 full-term healthy newborns, 110 appropriate weight and 30 large-for-gestational age, aged 1 to 6 days, delivered vaginally and breast-fed. Serum TSH levels decreased progressively from the 1st to the 4th day; serum T4 levels increased, with a peak on the 2nd day, and then progressively decreased until the 6th day; serum T3 levels increased to a maximum value on the 2nd day and then decreased to a minimum on the 5th day; serum rT3 levels increased during the 1st day and the level remained constant from the 2nd to the 4th day and later decreased slightly. The decrease of T3 was more pronounced than that of T4, while rT3 remained at high levels until the 4th day. Dividing the data into narrower intervals of time, it was possible to show that the maximum value of TSH was followed first by a net increase in serum T3, then in T4, and lastly in rT3 ant T3 levels. These data indicate that the rapid increase after birth of serum T3 levels is prevalently TSH-dependent; the following increase in serum levels of T3 and the increase in rT3 are prevalently T4-dependent. This study provides data concerning physiological changes in TSH and thyroid hormones in serum from a large number of infants, during the first week of life. They should be useful for the understanding of thyroid function in early postnatal life.

Age Factors↗

The circulating insulin-like growth factor system in children with coeliac disease: an additional marker for disease activity.

BACKGROUND: Chronic undernutrition resulting from coeliac disease (CD) could be associated with changes in the circulating insulin-like growth factor (IGF) system, which may participate in the pathogenesis of growth retardation occurring in these patients. METHODS: We performed a cross-sectional study in CD subjects attempting to (1) document the pattern of serum IGF-I and IGF binding protein (IGFBP) 1 and 3 at diagnosis and (2) assess the response of circulating IGF system to dietary treatments, in comparison with the response of clinical and laboratory findings utilized for the diagnosis of CD. Thirty-two prepubertal CD children were divided into three groups based on the dietetic treatment: at diagnosis (D, n=18); on gluten-free diet for at least 6 months (GFD, n=7); and on gluten challenge for at least 3 months (CH, n=7). Six postpubertal CD patients were also studied at diagnosis. RESULTS: In prepubertal children IGF-I levels were significantly reduced (by 29%) in D vs sex- and age-matched normal control (NC) subjects, with reductions being more pronounced before 3 years of age. Likewise, serum IGFBP-3 concentrations were decreased by 22%, whereas circulating IGFBP-1 levels were increased by 60%, compared with NC, with more marked IGFBP changes in older children. Similar alterations were observed in postpubertal patients. Changes in the circulating IGF system disappeared in GFD subjects and reappeared in CH children, as positivity of disease-specific antibodies. Body mass index (BMI) also improved in GFD subjects, but did not decrease in CH children. Changes in IGF-I and IGFBPs did not correlate with each other. Levels of IGF-I, but not of IGFBPs, maintained the relation with age and correlated significantly with BMI and positivity of antibodies. CONCLUSIONS: These results demonstrate that CD patients show significant changes in serum IGF-I, in younger children, and IGFBPs (particularly IGFBP-1), in older children and adolescents, correlating with clinical course and response to dietary treatments. The alteration in the circulating IGF system could be implicated in the pathogenesis of growth retardation occurring in CD and may provide an additional tool in monitoring of the disease.

Autoantibodies↗

Increased retinal endothelial cell monolayer permeability induced by the diabetic milieu: role of advanced non-enzymatic glycation and polyol pathway activation.

BACKGROUND: Increased vascular permeability could be involved in the pathogenesis of diabetic retinopathy. The present study was aimed at assessing whether high glucose concentrations can impair retinal endothelial cell barrier function directly, irrespective of changes in other determinants of permeability, and the role of non-enzymatic glycation and polyol pathway activation in these alterations. METHODS: Bovine retinal endothelial cells (BREC) were exposed for various periods to high glucose vs iso-osmolar mannitol and normal glucose containing media+/-agents mimicking or inhibiting advanced glycation end product (AGE) formation and polyol pathway activation. Monolayer permeability was assessed by measuring the transendothelial passage of (125)I-labeled proteins. RESULTS: Permeability increased significantly (up to +70%) in BREC exposed to high glucose, but not to mannitol, for 1-30 days, vs normal glucose control cells. Exposure to AGE-modified bovine serum albumin (BSA) (> or = 90%) and, to a lesser extent, sorbitol (+28%) mimicked the high glucose effect. The AGE formation and nitric oxide synthase (NOS) inhibitor aminoguanidine significantly reduced (by 60%) changes induced by 30-day exposure to high glucose, whereas methylguanidine, which inhibits only NOS activity, did not affect permeability. Aldose reductase or sorbitol dehydrogenase inhibitors decreased (by approximately 40%) the enhanced leakage produced by 1-day, but not 30-day, incubation in high glucose. CONCLUSIONS: The present results indicate that high glucose is capable of impairing retinal endothelial cell barrier function directly and that non-enzymatic glycation and polyol pathway activation may mediate these changes, with AGEs participating in the long-term alterations and increased flux through the sorbitol pathway in the short-term effect.

Animals↗

Effects of nephrectomy and high-protein diets on glomerular hemodynamics and urinary protein excretion in diabetic rats.

Renal blood flow, GFR, albumin clearance, and urinary excretion of proteins were assessed in intact control and streptozotocin-diabetic rats (group 1), unilaterally nephrectomized control and diabetic rats (group 2), and nephrectomized control and diabetic rats (divided into high (a) and low (b) glycemia subgroups) fed a 50% protein diet (group 3). After 8 months of diabetes, blood flow did not differ from control rats within each experimental group, although it was increased significantly in both controls and diabetics of groups 2 and 3 versus group 1. GFR in control rats was increased approximately 2x by nephrectomy and approximately 3x by nephrectomy plus the high protein diet. Diabetes increased GFR approximately 50% above control values in group 1; GFR values in diabetic rats of groups 2 and 3a were virtually identical and similar to those of group 2 controls; GFR in group 3b diabetics was increased approximately 1.4x versus group 2 diabetics. 125I-BSA clearance was increased 3.4x in groups 2 and 3 control rats versus group 1 controls. Both nephrectomy and consumption of the high protein diet caused marked increases in 125I-BSA clearance and urinary excretion of albumin in diabetic rats. Urinary excretion of IgG was increased by diabetes in group 1 and remained essentially at this level in groups 2 and 3 diabetic rats.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Discordant effects of the aldose reductase inhibitor, sorbinil, on vascular structure and function in chronically diabetic and galactosemic rats.

Effects of sorbinil, an aldose reductase inhibitor, were examined on renal glomerular structure, urinary albumin and IgG excretion, and vascular albumin permeation in eyes and aorta of 8-month diabetic, galactose-fed, and age-matched control rats. Sorbinil was added to the diet of one-half of the rats in each group at the time of induction of diabetes and galactosemia. Weight gain was impaired in diabetic and galactose-fed rats versus controls and was improved slightly in corresponding sorbinil-treated groups. Plasma glucose and glycosylated hemoglobin levels, food consumption, and 24-hr urine volume were increased in diabetic rats and were unaffected by sorbinil treatment. Food consumption and glycosylated hemoglobin levels were increased in galactose-fed rats, although the increases were smaller than in diabetic rats; glycosylated hemoglobin levels were decreased by sorbinil. Diabetes- and galactosemia-induced increases in albumin permeation in eyes and aorta were prevented by sorbinil. Urinary excretion of albumin and IgG was increased by diabetes and decreased by sorbinil, although differences between the two diabetic groups were not statistically significant for albumin. Galactosemia was associated with an increase in urinary albumin and IgG excretion that did not reach statistical significance. Glomerular capillary basement membrane width (GBMW) was increased in diabetic versus age-matched control rats but was unaffected by galactose feeding. GBMW was increased in controls fed sorbinil and glomerular capillary basement membrane thickening in diabetic rats was not prevented by sorbinil. The fractional volume of the glomerulus occupied by mesangium (Vvmes) was increased in diabetic and galactose fed rats versus age-matched controls, and was unaffected by sorbinil.(ABSTRACT TRUNCATED AT 250 WORDS)

Albuminuria↗

Interactions between hypertension and diabetes on vascular function and structure in rats.

Regional 125I-albumin permeation and glomerular structural changes were assessed in male Sprague-Dawley rats with diabetes and/or hypertension. All rats underwent unilateral nephrectomy 2 weeks after induction of diabetes with streptozotocin. At the same time, one-half of the nondiabetic and diabetic animals were placed on 1% saline drinking water and given weekly intramuscular injections of deoxycorticosterone acetate to induce hypertension (systolic blood pressure greater than 150 mm Hg). Vascular permeability studies were performed after 1 and 3 months of hypertension. Hypertension, alone or in combination with diabetes, had no effect on weight gain, plasma glucose, or food consumption, but did increase 24-h urine volume in nondiabetics. In normotensive diabetics and in nondiabetic hypertensive rats, vascular 125I-albumin permeation was increased in eyes, aorta, and new granulation tissue (formed in a subcutaneous fabric implant), and glomerular basement membranes were thickened without any change in the fractional volume of the glomerulus occupied by mesangium. Urinary albumin and IgG excretion in nondiabetic hypertensive rats was increased much more than in normotensive diabetics. Hypertension and diabetes were additive in their effects on 125I-albumin permeation in eyes, aorta, and granulation tissue, and on glomerular basement membrane thickening, but were synergistic in their effects on urinary albumin excretion and mesangial fractional volume. The magnitude of the increase in vascular albumin permeation and urinary albumin and IgG excretion between and 1 and 3 months was much larger in diabetic hypertensive rats than in rats with hypertension or diabetes alone. Neither diabetes nor hypertension, alone or in combination, had any effect on albumin permeation in skeletal muscle, skin, heart, or brain. These findings demonstrate that hypertension and diabetes increase vascular albumin permeation in rats preferentially in tissues that correspond to sites of clinically significant vascular disease in human diabetics. They also attest to an important interaction between blood pressure-induced and diabetes-induced increases in vascular permeability in these tissues and in structural changes in the glomerular vasculature.

Albuminuria↗

[A rare case of giant leiomyosarcoma of the small intestine].

The authors report a case of leiomyosarcoma of the small bowel, pointing out its remarkable size and stressing the symptoms that are always unclear and late. Moreover, they outline the anatomo-pathological and clinical features of this rare neoplasm with relevant problems in terms of early and timely diagnosis.

Cecal Neoplasms↗

Reducing risks of infection during vascular access.

The insertion of an intravascular (i.v.) access device is a complicated, multistep procedure, posing risks of infection to both the patient and the healthcare worker. Patients are at risk for local or systemic bloodstream infections, and healthcare workers are at risk for occupationally acquired bloodborne pathogen infections from accidental needlestick injuries. This article summarizes the risks of i.v. device-related infectious complications in patients and highlights recommendations from the Centers for Disease Control and Prevention to reduce these risks. In addition, recent research data are presented on the risks of occupationally acquired bloodborne pathogen infections from accidental needlestick injuries from vascular access, the specific devices causing these injuries, strategies to reduce these risks, medical follow-up when injury does occur, and methods for conducting product evaluations.

Catheterization, Peripheral↗