Biomedical subjects
L Esposito
Publications and source records attributed to L Esposito.
Making peace with uncertainty.
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Martyr is not a career choice.
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Failure to detect Glut4-Ile383 and IR-Gln1152 variants in NIDDM (non-insulin dependent diabetes mellitus) and control subjects in an Italian population.
Insulin receptor (IR) and insulin-responsive glucose transporter (Glut4) represent two candidate genes involved in the development of non-insulin dependent diabetes mellitus (NIDDM); detection of molecular alterations in these genes might explain their possible contribution to NIDDM. Recently, mutations within the coding region of IR and Glut4 have identified: they include the Glut4Ile383 and IRGln1152 variants which were found at low frequencies in diabetic Caucasian populations. In this study Italian NIDDM patients and control subjects were analysed and mutated alleles were not found. Therefore in our population these variants appear to have little relevance to the genetic susceptibility to NIDDM.
HLA DQA1-DQB1-TAP2 haplotypes in IDDM families: no evidence for an additional contribution to disease risk by the TAP2 locus.
The TAP2 gene, located in the HLA class II region, encodes a subunit of a transporter involved in the endogenous antigen-processing pathway, and has been suggested to contribute to the genetic risk for insulin-dependent diabetes (IDDM). In order to determine whether the TAP2 locus modulates the risk conferred by HLA DQ loci, HLA DQA1-DQB1-TAP2 haplotypes were analysed in 48 IDDM probands, their first degree relatives, and in 62 normal control subjects. A decreased frequency of the TAP2B allele was confirmed in this IDDM cohort (12 vs 28% in control subjects, pc < 0.05). Analysis of 73 informative meiotic events in IDDM and control families demonstrated a recombination fraction between HLA DQB1 and TAP2 loci of 0.041 (Log of the odds score = 16.5; p < 10(-8)) indicating strong linkage between these loci. Family haplotype analysis demonstrated linkage disequilibrium between TAP2 and HLA DQA1-DQB1, and showed that the reduced frequency of TAP2B was associated with its absence on the IDDM susceptible DQA1*0301-DQB1*0302 haplotype, its low frequency on DQA1*0501-DQB1*0201, and the association of TAP2B with DQA1*0101-DQB1*0501 haplotypes which were less frequent in IDDM patients. Comparison of transmitted with non-transmitted haplotypes in IDDM families showed a slight but not significant decrease in TAP2B allele frequency on transmitted (3 of 37) vs non-transmitted (2 of 9) HLA DQA1*0501-DQB1*0201 haplotypes. No other differences were observed. Twenty-four unrelated DQA1*0501-DQB1*0201 haplotypes from non-diabetic families had a TAP2B allele frequency (4%) similar to that in IDDM haplotypes.(ABSTRACT TRUNCATED AT 250 WORDS)
The effects of medication education on adherence to medication regimens in an elderly population.
The purpose of this intervention study was to evaluate educational protocols to see which would be more effective in increasing medication compliance rates within an elderly population. Forty-two patients were randomized into four groups. Group 1 received a standard education protocol; group 2 received the standard education and 30 minutes of verbal instruction; group 3 received the standard education and a medication schedule; and group 4 received the standard education, a medication schedule, and 30 minutes of verbal instruction. The intervention was given on the day of hospital discharge. Home visits were made 2 weeks, 1 and 2 months post-hospital discharge. Results of the visits revealed that groups 1 and 2 had higher rates of errors with medications than groups 3 and 4. In conclusion, the groups with a medication schedule had higher compliance rates. Considering the sample size of 42, this study can act as a pilot study to justify further research in the effects of a medication schedule on compliance.
The home care nurse as case manager.
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Vitiligo in two water buffaloes: histological, histochemical, and ultrastructural investigations.
Vitiligo, a skin disease, characterized by the spontaneous loss of melanin, has been described in several animals as well as in humans. Most of the reports of large domestic animals have dealt with clinical investigations without morphological data. In this report, the histological and ultrastructural characteristics of two cases of vitiligo in water buffaloes (Bubalus bubalis) are presented. Interestingly, many of the ultrastructural observations for vitiliginous buffaloes resemble those previously described for other species, e.g., humans, mouse, and chicken. These data suggest that one or more forms of human vitiligo may have a similar etiopathogenesis to that of the buffalo. Therefore, it is proposed that vitiliginous buffalo may prove to be a useful animal model for the human disease.
Medication knowledge and compliance. Home care vs. senior housing clients.
Are home care patients as knowledgeable about their medications and do they take them with as much adherence to prescription as their counterparts in senior citizen housing do? A study concentrates on knowledge and compliance in two geriatric populations.
Growth in homozygous beta-thalassemia after bone marrow transplantation.
In 8 homozygous beta-thalassemic patients, aged between 1.9 and 18 years, that received bone marrow transplantation (BMT), a longtidinal study of growth before and after BMT and relative Height Standard Deviation Score (SDS), has been performed. In all patients, also after BMT, a progressive growth retardation has been observed except in a case who presented serum ferritin levels in a normal range for age. The study shows that iron depletion must be continued, even after BMT, in those subjects that have after bone marrow transplantation high serum ferritin levels and short stature.
Do nonesterified fatty acids displace thyroxin from its plasma binding sites in severe nonthyroidal illnesses?
Severe nonthyroidal illnesses have been associated with increases in nonesterified fatty acids (NEFA) and the dialyzable fraction of thyroxin (T4) in plasma. We have further investigated their possible relationship in severe nonthyroidal illnesses as well as in induced in vivo and in vitro situations involving increased NEFA. We demonstrate that there is no relationship between NEFA and the dialyzable fraction of T4, either in severe nonthyroidal illnesses or in the other situations, unless plasma NEFA concentrations exceed 5 mmol/L in normal persons or 1.7 mmol/L in nonthyroidal illnesses, and that this concentration was not reached in the patients we studied, with one exception. We conclude that NEFA are unlikely to contribute to an inhibition of the binding of T4 to the binding proteins that might be present in plasma of patients with severe nonthyroidal illnesses unless their NEFA concentrations are very high.
Mortality from cancer of the stomach, colon and rectum in the city of Naples and the provinces of Campania.
Utilizing data on deaths from 1951 to 1981, this study attempts to verify a time trend for stomach, colon and rectum cancer in the city of Naples. Time trend analysis and cohort analysis have shown an increase of colon rectum cancer mortality affecting cohorts born after 1871 and a decrease of stomach cancer mortality for those born after 1886. A comparison of mortality rates in three geographical areas shows that, while there is not any difference for stomach cancer, the mortality curves relating to cancer of the colon and rectum are higher in the city of Naples than in the province of Naples and the other provinces of Campania.