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Biomedical subjects

M Catalano

Publications and source records attributed to M Catalano.

At least 73 records · Page 4Linked to original sources

Platelet activation markers in patients with peripheral arterial disease--a prospective comparison of different platelet function tests.

Peripheral vascular disease (PVD) is an indicator of diffuse atherosclerosis and is associated with a greatly increased incidence of coronary heart and cerebrovascular disease. Although several studies have assessed whether in vivo platelet activation takes place in patients with PVD, no data are available comparing different platelet function tests in this patient population. We have compared prospectively four tests for the measurement of in vivo platelet activation (plasma betaTG, plasma PF4, intraplatelet betaTG and urinary excretion of 11-dehydro-TXB2) and one in vitro platelet function test (ADP-induced platelet aggregation) in 63 well-characterized patients with intermittent claudication and in 18 age- and sex-matched healthy volunteers. No statistically significant difference was found between patients and controls for plasma betaTG (20.0 +/- 11.8 vs. 18.8 +/- 9.0 ng/ml, respectively), plasma PF4 (5.2 +/- 2.9 vs. 6.3 +/- 3.5 ng/ml), betaTG/PF4 ratio (4.0 +/- 2.9 vs. 3.6 +/- 1.8), intraplatelet betaTG (4503 +/- 1482 vs. 4059 +/- 1065 ng/ml), and threshold aggregatory concentration of ADP (1.7 +/- 0.72 vs. 1.45 +/- 0.56 microM). Urinary 11-dehydro-TXB2 was instead significantly higher in the PVD group (55.4 +/- 27.5 vs. 26.7 +/- 7.0 ng/h, p <0.001). Our study shows that urinary 11-dehydro-TXB2 is a more sensitive index of in vivo platelet activation than the measurement of either platelet specific proteins or of in vitro platelet aggregation in patients with PVD.

Adenosine Diphosphate↗

Systematic screening for mutations in the coding region of the human serotonin transporter (5-HTT) gene using PCR and DGGE.

Dysfunctions in serotonergic pathways may underlie several psychiatric disorders. The reuptake of serotonin (5-HT) from synaptic terminals is mediated by a specific transporter (5-HTT). Genetic variation in the gene coding for the 5-HTT protein might be involved in the predisposition to psychiatric disorders. A systematic screening of the whole coding sequence of the 5-HTT gene in mood disorder (MD) and obsessive-compulsive disorder (OCD) patients, as well as in healthy controls, using PCR and denaturing gradient gel electrophoresis (DGGE) revealed the presence of two mutations. The first was in intron 4, and the second was a C-->A transversion leading to an amino-acid exchange (Leu-->Met) in position 255 of the deduced protein sequence. No further occurrence of this substitution was found in an extended sample of patients and controls. Therefore, structural modifications of the 5-HTT gene do not seem to play either a major or minor role in the genetic predisposition to MD or OCD.

Adult↗

Predictive value of tryptophan/large neutral amino acids ratio to antidepressant response.

The molar ratio of total plasma tryptophan to the sum of other large neutral amino acids (viz., valine, isoleucine, leucine, tyrosine, phenylalanine), thought to reflect brain serotonin formation, was estimated in 69 patients with major depression before and after 1 week of treatment with different serotonin reuptake inhibitors, fluvoxamine (n = 28), fluoxetine (n = 10), citalopram (n = 7), mixed serotonin-noradrenaline reuptake inhibitor amitriptyline (n = 11), clomipramine (n = 8) and the preferentially noradrenaline reuptake inhibitor, nortriptyline (n = 5). A significant difference among 'good', 'intermediate' and 'poor' responders for the percentual variation of tryptophan/large neutral amino acids ratio after 1 week of therapy was found, while pretreatment values of tryptophan/large neutral amino acids ratio, basal Hamilton Depression Rating Scale scores and its percentual variation after 1 week of therapy did not show any significant differences. These results suggest that the percentual variation of tryptophan/large neutral amino acids ratio could be a useful tool in predicting drug response.

Adult↗

Dose-range and dose-frequency study of recombinant human interleukin-1 receptor antagonist in patients with rheumatoid arthritis. The IL-1Ra Arthritis Study Group.

OBJECTIVE: To preliminarily evaluate the safety and efficacy of different dose levels and dosing frequencies of recombinant human interleukin-1 receptor antagonist (rHuIL-1Ra) in the treatment of patients with rheumatoid arthritis (RA). METHODS: One hundred seventy-five patients with active RA were enrolled in a randomized, double-blind trial of rHuIL-1Ra administered by subcutaneous injection. There were 9 treatment groups in the trial. During the initial 3-week treatment phase, patients were treated with 20, 70, or 200 mg rHuIL-1Ra, administered either once, 3 times, or 7 times per week, followed by a 4-week maintenance phase, during which all patients received the treatment-phase dose once per week. To maintain the blindness of the study, patients received daily injections of either rHulL-1Ra or placebo on the days rHuIL-1Ra was not administered. RESULTS: Recombinant HuIL-1Ra was well tolerated. The most frequent adverse event was injection-site reactions, which were reported in 62% of patients and caused 8 patients (5%) to withdraw prematurely from the study. Five patients (3%) developed serious adverse reactions unrelated to dose or dosing frequency. Due to the lack of a placebo arm and to the multiple small treatment groups, a definitive statement regarding efficacy could not be made. However, by the end of the 3-week treatment phase, daily dosing appeared more effective than weekly dosing when assessed by the number of swollen joints, the investigator and patient assessments of disease activity, pain score, and C-reactive protein levels. CONCLUSION: These preliminary data suggest that rHuIL-1Ra may be safely administered by subcutaneous injection to RA patients. The frequency of dosing appears to be important in determining clinical response, with daily administration providing the most benefit. A placebo-controlled trial is in progress to further assess the clinical usefulness and to better define appropriate doses of rHuIL-1Ra in patients with RA.

Antibodies↗

Comparative usefulness of ribotyping, exotoxin A genotyping, and SalI restriction fragment length polymorphism analysis for Pseudomonas aeruginosa lineage assessment.

Ribotyping, exotoxin A genotyping (EAGP), and restriction fragment length polymorphism (RFLP) analysis of total DNA with SalI (SalI RFLP) were compared for intraspecies discrimination of 93 Pseudomonas aeruginosa isolates. Type-ability of all methods was 100% and the results of typing with each method remained unchanged during laboratory manipulation. Clonal groups defined with each molecular method were largely coincident and, in those cases where inconsistencies were detected, isolates were analyzed by transverse alternating field gel electrophoresis (TAFE) and arbitrarily primed polymerase chain reaction (AP-PCR). SalI RFLP analysis was highly discriminative so as to distinguish unrelated isolates of close lineage. However, it was not a good method to identify isolates of unrelated lineage because SalI RFLP appeared to be subjected to convergent evolution. The index of discrimination suggested by Hunter and Gaston was determined to assess the discriminatory power of the molecular methods utilized either alone or in several combinations. Combined use of ribotyping and SalI RFLP analysis reached the highest index of discrimination (0.982) and proved to be a very valuable tool for epidemiological differentiation of P. aeruginosa isolates.

Bacterial Typing Techniques↗

Pseudomonas aeruginosa ribotyping: stability and interpretation of ribosomal operon restriction patterns.

Fifty-one Pseudomonas aeruginosa isolates were differentiated into 21 types by ribotyping. Several enzyme combinations, including the best ones proposed in literature, were utilized and the highest discrimination was reached by individual digestion with PvuII, HindII, and EcoRI or BamHI. Clinical isolates from outbreaks were clonally related as identified by this molecular approach. Restriction rDNA profiles were composed of strong and weak bands. Using 6 micrograms DNA we were able to demonstrate that PvuII, HindIII, and BamHI weak bands were reproducible. These weak bands should be considered not only to accomplish the highest discrimination but also to correctly assign isolate clonality. Conversely, we found that EcoRI weak bands were not reproducible and, therefore, are not recommended for ribotype analysis. Finally, profiles differing in one single band actually represented isolates of different genotype, as confirmed by further analysis using other molecular methods. In this report on P. Aeruginosa ribotyping of clinical isolates, criteria for band pattern interpretation are established.

Bacterial Typing Techniques↗

Clinical implications of endoscopic ultrasound: the American Endosonography Club Study.

BACKGROUND: Despite increased clinical use of endoscopic ultrasound (EUS), there are little data regarding complications of EUS or its impact on patient management. METHODS: A prospective multicenter study was completed to evaluate clinical outcomes of EUS. Before each EUS examination the endosonographer recorded further theoretical patient management plans as if EUS was unavailable. After the EUS, endosonographers recorded actual management plans based on EUS results. The actual management plan after EUS was compared to the theoretical management before EUS. Complications were assessed in short-term follow-up. RESULTS: Four hundred twenty-eight subjects were enrolled. Of subjects able to be evaluated, EUS changed the treatment plan in 74%. Management changes of major importance occurred in 120 patients (31% of subjects able to be evaluated) and included decisions regarding surgery (62 patients), decisions regarding nonsurgical invasive management (36 patients), and decisions regarding further follow-up (22 patients). When there was a change in management, the change was to less costly, risky, or invasive management in 55%, to more costly/risky/invasive in 37%, and to equally costly/risky/invasive in 8%. Short-term follow-up was completed in 81% of subjects, with six complications identified (1.7%). Three complications were mild, two were moderate, one severe, and none fatal. CONCLUSIONS: (1) Changes in management plan may occur in the majority of patients based on EUS results. (2) The management changes are often of major importance with regard to health care costs and safety, and are more often in the direction of less costly, risky, and invasive management. (3) EUS is safe in experienced hands.

Adolescent↗

The use of plasmid profile analysis and ribotyping for typing Acinetobacter baumannii isolates.

Plasmid profiles were used to analyse 39 Acinetobacter baumannii isolates from 36 patients at three hospitals. The isolates were prevously classified by biotyping and rDNA fingerprinting. Ribotyping was useful to establish the lineage of isolates and to confirm genospecies identification. Thirty-seven isolates (94.9%) contained plasmids. The variable number of plasmids with different molecular weights in each isolate enabled the identification of 13 profiles without the need for endonuclease digestion. Fifteen A. baumannii biotype 2 isolates of similar ribotype and antibiotype contained identical plasmids over a two-month outbreak at one hospital. Plasmid typing discriminated these isolates from sporadic A. baumannii isolates of close ribotype obtained from different hospitals. A few isolates of different lineage, however, showed similar plasmid profile. Our results suggest that plasmid typing is a practical method to assist infection control of nosocomial A baumannii. A combination of plasmid typing and ribotyping is suggested to confirm genospecies classification and to identify strains against reference band profiles.

Acinetobacter↗

Association study of a null mutation in the dopamine D4 receptor gene in Italian patients with obsessive-compulsive disorder, bipolar mood disorder and schizophrenia.

Although serotonergic dysregulation is a leading pathogenetic hypothesis for obsessive-compulsive disorder (OCD), some evidence also suggests a possible dysregulation of the dopaminergic system in this disorder. Therefore, individual differences in deoxyribonucleic acid (DNA) coding for dopamine receptor proteins might contribute to the genetic background of this disorder. Previously we reported a null mutation in exon 1 of the dopamine D4 receptor gene. The variant type is characterized by a 13 bp deletion and is predicted to code for a truncated, non-functional receptor. We assessed the frequency of this polymorphism in 157 OCD patients, 196 schizophrenics, 111 bipolars and 162 healthy controls of Italian descent. Our findings do not implicate a role for this mutation in conferring a susceptibility to OCD and confirm previous negative results regarding its involvement in schizophrenia and bipolar disorder.

Bipolar Disorder↗

Increased superoxide anion production in humans: a possible mechanism for the pathogenesis of hypertension.

Although endothelium-dependent vasodilation is impaired in human hypertension, the mechanism underlying this abnormality is not yet completely elucidated. It has been suggested that accelerated inactivation of nitric oxide (NO) due to superoxide anion, which is rapidly removed by superoxide dismutase (SOD) in physiological condition, may be related to hypertension. Therefore, SOD deficiency following an increase in superoxide anion production contributes to a rise in arterial blood pressure (BP). We hypothesized that there is defective endogenous SOD in patients with essential hypertension. To examine this assumption we measured the SOD activities of the erythrocytes in 335 healthy Chinese volunteers (age 2-76 years) and 30 hypertensive patients (age 60-75 years). The SOD activities of the healthy volunteers exhibited decreased trend with advancing aging. There was no significant difference in the SOD activities between men and women in each group. There is significant difference in the SOD activities (1814.35 +/- 250.00 vs 1584.06 +/- 126.19 u/Hb.g; P < 0.001) between the two groups (age 20-59 years; mean age 34 years vs age 60-76 years; mean age 67 years). The SOD activities in patients with essential hypertension were 1322.4 +/- 139.5 u/Hb.g and significantly lower than the corresponding healthy controls (P < 0.05). In the hypertensives, the SOD activities against systolic and diastolic arterial pressure seem to be shown the trend of negative correlation but did not reach the statistical significance. We conclude that the SOD activities in the erythrocytes are reduced in subjects with essential hypertension and increasing aging. The present findings, in a limited data, could suggest that the fall in SOD activities following an increased superoxide anion production with subsequently augmented NO inactivation is, at least in part, involved in the pathogenesis of human hypertension, although the evidence is indirect. The decrease in erythrocyte SOD activities may serve as a function of human aging.

Adolescent↗

A novel functional polymorphism within the promoter of the serotonin transporter gene: possible role in susceptibility to affective disorders.

The serotonin transporter (5-HTT) is a candidate locus for aetiological involvement in affective disorders. Biochemical studies in suicides and depressed patients suggest that 5-HT uptake function is frequently reduced in affective illness. Furthermore, 5-HTT is targeted by widely used antidepressant drugs such as fluoxetine. We have performed an association study of a short variant of the 5-HTT-linked polymorphic region (5-HTTLPR), which restricts transcriptional activity of the 5-HTT promoter leading to low functional expression of the 5-HTT, in 454 patients with bipolar or unipolar affective disorder and 570 controls, derived from three European Centres (London, Milan and Würzburg). In all three centres, the frequency of the low activity allele was higher in patients than in controls (50% vs 45% in London, 45% vs 43% in Milan, 47% vs 40% in Würzburg). Although these differences were not individually significant, a stratified analysis of all three samples gave a significant overall odds ratio of 1.23 (95% confidence interval 1.02-1.49, P = 0.03). The excess of the homozygous low-activity genotype among the patients was even greater (odds ratio 1.53, 95% confidence interval 1.04-2.23, P = 0.02), suggesting partial recessively of the low-activity allele. Given the functional role of 5-HTT, our findings suggest that 5-HTTLPR-dependent variation in functional 5-HTT expression is a potential genetic susceptibility factor for affective disorders. If this finding is replicated, further work on genetic variants with low 5-HTT activity may facilitate the differential diagnosis of affective disorders, the assessment of suicidal behaviour, and the prediction of good clinical response to antidepressants.

Alleles↗

Influence of IL-1 receptor blockade on the human response to endotoxemia.

Although the experimental administration of IL-1 induces several aspects of the inflammatory response, such as fever, tachycardia, and acute phase proteinemia, the contribution of IL-1 to the human responses to injury or infection remains unclear. A specific IL-1R antagonist (IL-1ra), which effectively blocks the actions of IL-1, was utilized to evaluate the influence of endogenous IL-1 during experimental human endotoxemia. Eighteen healthy volunteers each underwent one control study day, followed 3 days later by one of three randomly chosen treatments: a 6-h infusion of IL-1ra alone (133 mg/h), 20 U/kg national reference endotoxin alone, or both endotoxin and IL-1ra infusion. IL-1ra administration alone was not associated with any observable response. Despite achieving high circulating levels of IL-1ra (34 +/- 3 micrograms/ml), there were no significant differences in hemodynamic parameters, core temperature, or resting energy expenditure in those endotoxemic volunteers receiving IL-1ra when compared with those who did not. Furthermore, leukocyte kinetic and circulating cytokine, acute phase protein, and endocrine responses were similar in both endotoxemic groups. However, IL-1 blockade did significantly reduce the subjective severity of symptoms experienced by the endotoxemic volunteers (p < 0.05). This study demonstrates that an endogenous IL-1 response does not play a significant role in the hemodynamic, immunologic, and metabolic responses to mild endotoxemia in humans.

Adrenocorticotropic Hormone↗

Neutral amino acid availability in two major psychiatric disorders.

1. Evidence suggests catecholamines and indoleamines may play a role in the pathogenesis of several psychiatric disorders. These neurotransmitters (i.e. dopamine, norepinephrine and serotonin) are synthesized within the human brain from their precursors, the aromatic large neutral amino acids tyrosine and tryptophan. Other large neutral amino acids, namely valine, isoleucine, leucine and phenylalanine affect precursor availability by competing with tryptophan and tyrosine for the transport system across the blood brain barrier. 2. The authors evaluated the brain availability of L-tryptophan and tyrosine in a sample of psychiatric patients with a diagnosis of major depression and schizophrenia. 3. The present results suggest a possible usefulness of Tryptophan/Large Neutral Amino Acids ratio in distinguishing major depression from schizophrenia, while Tyrosine/Large Neutral Amino Acids ratio shows a very limited usefulness. The absolute need of powerful and accurate statistical analysis to evaluate the power of a biological test clearly stands out from the present study.

Adolescent↗

Molecular typing of Acinetobacter baumannii-Acinetobacter calcoaceticus complex isolates from endemic and epidemic nosocomial infections.

Ribotype, biotype and resistance phenotype were used to characterize 37 Acinetobacter baumannii-A. calcoaceticus complex isolates responsible for nosocomial infections in Buenos Aires. Nineteen isolates were recovered from endemic infections at 2 hospitals and 18 represent an intensive care unit outbreak that occurred in a third hospital. By ribotyping isolates were classified into five different clones of A. baumannii biotype 2, 3 of A. baumannii biotype 9, and 3 of Acinetobacter genospecies 13. Combination of the three epidemiological markers permitted categorization of 18 outbreak isolates into four probable strains: 2 A. baumannii biotype 2, named type I, and II, and 2 A. baumannii biotype 9. Type I (15 isolates) was the most prevalent strain at one hospital and was responsible for the outbreak. In conclusion, combined analysis of biotypes, resistance phenotypes, and ribotypes was an accurate approach for epidemiologic investigation of A. baumannii. Furthermore, ribotyping discriminated Acinetobacter genospecies 13 isolates which were phenotypically difficult to type.

Acinetobacter↗

Identification of two novel polymorphisms and a rare deletion variant in the human dopamine D4 receptor gene.

We report two novel polymorphisms and a rare deletion variant in the human dopaine D4 receptor gene. The two polymorphisms are characterized by single base pair substitutions, namely a G-->C transversion changing codon 11 from GGG (encoding Gly) to CGG (encoding Arg) and a C-->T transition in position -11 upstream from the start codon. The Arg11 variant occurs at a frequency of about 1% and the C-->T transition at a frequency of about 7% in German control subjects (n = 148). Allele frequencies observed in patients suffering from schizophrenia (n = 256) and bipolar affective disorder (n = 99) were similar. The deletion variant is characterized by a 21 bp deletion affecting codons 36 to 42 coding for amino acids Ala-Ala-Leu-Val-Gly-Gly-Val located in the first transmembrane domain of the dopamine D4 receptor. The mutation was identified in a single individual suffering from obsessive-compulsive disorder and panic disorder. We were unable to detect the deletion in patients with schizophrenia and bipolar affective disorder, nor in healthy controls.

Adult↗

Scintigraphic recording of blood volume shifts.

UNLABELLED: A scintigraphic device consisting of small scintillation probes tightly fixed to the skin was developed to record intravascular blood volume shifts continuously and simultaneously at several sites. The aim of the present study was to ascertain the reliability of the measurements obtained, show the blood shifts induced by common daily activities in healthy subjects and clarify the mechanisms responsible for hemodynamic changes. METHODS: Measurements were made in three fields of the right lung, the liver, thighs and calves of 16 men during Valsalva maneuver, hyperventilation, various posture changes and treadmill walking. Some tests were repeated. RESULTS: The measured blood volume shifts were always in the expected direction and in accordance with those reported in the literature; they also were reproducible. Therefore, the measurements were reliable. A pattern of blood volume changes peculiar to some common daily activities was recorded in subjects moving freely. Insights were obtained on the mechanisms responsible for the blood volume shifts. CONCLUSION: Our noninvasive technique provides reliable continuous measurements of blood volume changes at several sites during common daily activities and could be applied not only in healthy subjects but also in patients.

Activities of Daily Living↗

Triflusal in the treatment of patients with chronic peripheral arteriopathy: multicentre double-blind clinical study vs placebo.

Many clinical trials have shown the effectiveness of platelet-antiaggregant drugs in the treatment of obliterative peripheral arteriopathy, both locally and in the system, by improving the claudication symptoms and by preventing major cardiovascular events. In this study we evaluated the effectiveness of a 24-week treatment with triflusal, a comparatively new inhibitor of platelet aggregation, in patients affected by chronic peripheral arteriopathy, comparing twice-daily oral doses of 300 mg triflusal with twice-daily placebo doses. The percentages of successes (defined as a 40% increase of total walking distance over the basal control) were 63.6% in the triflusal group (35/55 patients) and 22.5% in the placebo group (14/62 patients). Patients treated with triflusal showed a more important increase in total walking distance and in pain-free walking distance over the basal values than those treated with placebo, together with an improvement of the symptomatology correlated with claudication. Moreover, in the triflusal group there was an increase in the peak-flow recorded through strain-gauge plethysmography. In conclusion, triflusal significantly increased both the distance which could be walked and the clinical symptoms, presumably by improving microperfusion.

Adult↗