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Biomedical subjects

M Altieri

Publications and source records attributed to M Altieri.

At least 37 records · Page 2Linked to original sources
PubMed1998

RA/DA cumulative curve analysis of local and diffuse neuroretinal rim area damage in glaucoma patients.

AIM: To evaluate the validity of cumulative rim/disc area (RA/DA) curve analysis as a clinical tool for the identification of glaucoma induced optic disc pathology. METHODS: 71 normal and 83 glaucomatous eyes were evaluated from a series of 154 subjects recruited for this study. For each eye, the cumulative distribution of RA/DA was calculated from 36 equally spaced rim sectors of each optic disc obtained by the automatic evaluation of simultaneous videographics (Image-net X Rev.3/51b). To increase the sensitivity of this analysis in early glaucoma and in normal eyes, these cumulative curves were subsequently divided into two equal segments and the slopes of their respective regression lines compared. RESULTS: The median RA/DA value obtained from the 36 sectors was significantly different in glaucomatous eyes compared with normals (p < 0.001). Nevertheless, the curves (5th-95th percentile of the cumulative curves distribution) of early glaucomatous eyes fell within the normal range. When the cumulative curve of these marginal cases was then divided into two equal segments, the comparison of the slopes of the regression lines showed a significant difference (p < 0.05) in 100% of early glaucomatous eyes. Furthermore, normal eyes were shown to be true negatives in 93% of the cases in which no significant difference between the two slopes was observed. CONCLUSION: Analysis of the RA/DA cumulative curve from 36 sectors of the optic disc was a valid method for the identification of glaucomatous disc pathology; however, a further calculation of the slopes of the two RA/DA regression lines was needed to identify early glaucomatous damage.

Female↗
PubMed1997

[Brain dysfunction in climacteric and prevention].

The risk of cardiovascular disease in women is relatively small before menopause but increases considerably afterwards. Postmenopausal women have on average a total cholesterol, LDL and VLDL cholesterol levels higher than premenopausal women; at the same time, HDL cholesterol serum level is lower. Postmenopausal estrogen replacement therapy (ERT) has been repeatedly proven to reduce the incidence of coronary heart disease as well as the mortality from cardiovascular disease. Furthermore, little is known about the potential risk of developing a stroke associated to hormonal changes involved in the menopause. Likewise the benefit of the ERT on reduction in stroke-legated mortality and morbidity is still debated. On the other hand, preliminary trials suggest a beneficial role of ERT in women with Alzheimer's disease (AD), probably due to the estrogen's cholinergic neurotrophic and neuroprotective effects. Moreover, recent reports suggest a possible additive beneficial effect of ERT to cholinergic treatments for AD In normal postmenopausal women the ERT not only improve cognitive and emotional functions but also increase verbal memory.

Aged↗
PubMed1997

Anticipation of onset age in hereditary essential tremor.

The genetic anticipation phenomenon has been described in several neurological disorders, often associated with unstable trinucleotide repeats in the affected genes. The occurrence of this phenomenon in hereditary essential tremor is still debated. We describe a family in which three male members with essential tremor showed a progressive anticipation in onset age and an increased severity of clinical symptomatology.

Adult↗
PubMed1997

Inhibition of diabetes by an insulin-reactive CD4 T-cell clone in the nonobese diabetic mouse.

A cloned Th1 cell line was isolated from pancreatic lymph nodes of NOD mice that carries a T-cell receptor encoding Vbeta14 and proliferates in response to NOD islets, islet supernatant, and crystalline bovine and rat insulin, specifically to a B-chain peptide bound to IA(g7). The response to islet supernatant was reduced by 75% by anti-insulin antibody treatment. The insulin-reactive clone reduced insulitis and totally blocked the development of spontaneous diabetes in NOD mice (n = 8) as well as the adoptive transfer of diabetes into irradiated NOD mice following the injection of splenocytes from diabetic mice (n = 13). Trafficking of the adoptively transferred cells was assessed by labeling the clone or diabetic splenocytes with a fluorescent marker (DiI). The labeled clone was detected in the islet periphery, whereas labeled splenocytes alone invaded the islets by 3 days. In contrast, the protective clone dramatically delayed and reduced the number of labeled diabetic splenocytes infiltrating the islet, although their appearance in the spleen was unaffected. In vitro, the clone as well as supernatant derived from the clone blocked the proliferation of diabetic NOD splenocytes to islets. This inhibitory effect was diminished by anti-transforming growth factor-beta. In conclusion, an insulin-specific Th1 cell was isolated from NOD mice that traffics to the islet and prevents the spontaneous development and the adoptive transfer of diabetes. It appears to act locally by releasing transforming growth factor-beta and/or other factors that inhibit homing to and/or proliferation of diabetic splenocytes within the islet. These findings may provide insights into and suggest mechanisms for the protective effects of insulin therapy against diabetes.

Adoptive Transfer↗
PubMed1997

[An original case of simultaneous cardiac, pancreatic and renal transplantation. Results over 6 years].

Combined transplantation is actually performed on specific and rare indications. We are presenting here the results of a combined heart-kidney and pancreatic graft. It was performed in a patient presenting an idiopathic cardiomyopathy in end-stage failure and a post-diabetic nephropathy on dialysis. Today, organs function is quite satisfactory with a 6 year follow-up. Only one isolated heart rejection episode was observed at the 15th post-operative day. The patient has recovered a full-time professional activity at one year. This successful graft was obtained by an "homogeneous multiorgan approach" during all the pre-peri and postoperative time.

Adult↗
PubMed1996

Longitudinal study of human herpesvirus 6 infection in organ transplant recipients.

Human herpesvirus 6 (HHV-6) has been frequently isolated from immunocompromised patients. To determine if a routine survey of HHV-6 infection is needed after organ transplantation, as is the case for human cytomegalovirus infection, we observed patients who had received kidney, liver, and kidney-liver transplants; these patients were followed up for the first 3 months after transplantation. HHV-6 infection was diagnosed by isolation of the virus and by the results of serological tests. Antibodies to HHV-6 were detected in 28 (87.5%) of the 32 recipients, before the transplant, whereas only 4 (12.5%) of the 32 recipients were seronegative for HHV-6. After engraftment, HHV-6 infection occurred in 10 (31%) of the 32 recipients; infection was diagnosed by isolation of the virus (6 of 32 recipients) or by the results of serological tests (4 of 32 recipients). Regardless of whether they had HHV-6 primary infection or reactivation, severe clinical manifestations were observed only in patients who had concomitant cytomegalovirus infection, and no correlation could be found between graft rejection and HHV-6 infection. These results suggest that HHV-6 infection occurs frequently in organ transplant recipients and that it is usually not associated with severe clinical manifestations unless accompanied by a concomitant CMV infection.

Adult↗
PubMed1992

Rat alpha 1-microglobulin: co-expression in liver with the light chain of inter-alpha-trypsin inhibitor.

A 1162 bp rat liver cDNA clone encoding the immunoregulatory plasma protein alpha 1-microglobulin was isolated and sequenced. The open reading frame encoded a 349 amino acid polyprotein, including alpha 1-microglobulin, 182 amino acids, and bikunin, the light chain of the plasma protein inter-alpha-trypsin inhibitor, 145 amino acids. The alpha 1-microglobulin/bikunin mRNA was found only in the liver when different tissues were examined. Free alpha 1-microglobulin and a polyprotein, containing both alpha 1-microglobulin and inter-alpha-trypsin inhibitor epitopes, were found in the microsomal fraction from rat liver homogenates.

Alpha-Globulins↗
PubMed1991

Patient flow in the emergency department: the chest pain patient.

Prompt treatment of the chest pain patient in the emergency department (ED) is crucial. To ensure prompt treatment, identification of factors that delay flow of these patients through the department is essential. To identify factors that delay patient flow through the ED, the authors conducted a prospective study of all chest pain patients, using a time-flow analysis. Eighty-eight (36%) of 245 patients required critical unit admissions and had an average department stay of 3 1/2 hours. Flow differences were seen between critical and noncritical care patients. Three primary sources of delay were identified: critical unit bed availability, the registration process, and the role of the unit admitting resident. Additional findings confirmed the efficacy and role of the triage nurse in patient flow. Nursing and medical education and staffing needs were addressed. The use of the community's emergency medical services was examined by analyzing the disposition of patients arriving at the ED by ambulance.

Bed Occupancy↗
PubMed1990

TAC topical anesthesia produces positive urine tests for cocaine.

The combination of tetracaine, adrenalin, and cocaine (TAC) has become increasingly popular as a topical anesthetic for the suturing of simple skin lacerations. The purpose of this study was to determine the effects of TAC on a urine drug test for cocaine. On the morning after the use of TAC, 14 of 18 patients (78%) studied had positive screening tests for benzoylecgonine (cocaine metabolite) by the enzyme multiplied immunoassay test (EMIT) method. All specimens also were analyzed by gas chromatography and mass spectrometry, the reference standard for analysis of drugs of abuse in urine, and 15 of the specimens (83%) were positive. Four of 18 positive specimens (22%) still had positive EMIT drug screens on the morning of the next day, an average of 36 hours after use of TAC. We recommend that physicians who use TAC solution as a local anesthetic caution their patients that they may fail a urine drug screen for cocaine if they are tested within 36 to 48 hours of the administration of the use of TAC.

Administration, Topical↗
PubMed1990

Preparedness for pediatric emergencies encountered in the practitioner's office.

Pediatricians in the Washington, DC, metropolitan area were surveyed to assess their readiness to deal with life-threatening emergencies in their offices. Information about emergency equipment, prearranged emergency plans, advanced life support training, and emergency medical services assistance was elicited. Recommendations are made to attain appropriate levels of preparedness in all of these areas.

Child↗
PubMed1989

Vibrio fluvialis, an unusual pediatric enteric pathogen.

An infant with diarrhea was discovered to have Vibrio fluvialis, an enteric pathogen not previously reported in children in the United States. This patient had an uncharacteristically mild clinical course and did not require hospitalization or antibiotics. Clinicians treating patients with diarrhea should include this organism in the differential diagnosis if their patients or patients' contacts have eaten seafood or been near bodies of seawater.

Bacteriological Techniques↗
PubMed1989

Serious respiratory consequences of detergent ingestions in children.

After ingesting or inhaling laundry detergent powder, eight children required hospital admission. The predominant symptoms were stridor, drooling, and respiratory distress. All but one patient underwent endoscopy of the airways and the esophagus, five children were admitted to the intensive care unit, and four children required endotracheal intubation. Laundry detergent ingestions are generally considered to have minor consequences, and there exists a paucity of literature on the subject. Evidence of significant morbidity incurred because of ingestion or inhalation of sodium carbonate-containing laundry detergent powder is presented, together with a review of the existing literature.

Burns, Chemical↗