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Biomedical subjects

M Giordano

Publications and source records attributed to M Giordano.

At least 91 records · Page 5Linked to original sources
PubMed1999

Pruritus ani.

The possible dermatological and proctologic causes, of Pruritus Ani that often, due to its persistence and for its consequent lesions of scratching, becomes a real disease, are analysed. Particular attention is given to therapeutical treatment, describing which hygienic-dietetic rules must be followed and which treatments can be utilised, if the cause of the symptom is known and if it is possible to remove it or not. Moreover, personal experience on 312 patients examined in twelve years is reported.

Adult↗
PubMed1999

Restoration of immunity with interleukin-2 therapy.

HIV replication can now be effectively suppressed using antiretroviral combination regimens. The search continues, however, for ways to restore the immune response and eliminate reservoirs of latent infection. Interleukin-2 (IL-2) may augment the immune response in HIV-infected persons. This article discusses the rationale for using IL-2 in those with HIV disease and reviews key trials of IL-2 treatment regimens.

Antiretroviral Therapy, Highly Active↗
PubMed1998

Modulation of human neutrophil apoptosis by immune complexes.

In the present study we examined whether immune complexes (IC) are able to modulate human neutrophil apoptosis. We observed different effects depending on the type of IC employed. Precipitating IC (pIC) and Ab-coated erythrocytes (E-IgG) triggered a marked stimulation of apoptosis, while heat-aggregated IgG and soluble IC, significantly delayed spontaneous apoptosis. Blocking Abs directed to Fcgamma receptor type II (FcgammaRII), but not to FcgammaRIII, markedly diminished the acceleration of apoptosis triggered by either pIC or E-IgG, supporting a critical role for FcgammaRII in apoptosis stimulation. This phenomenon, on the other hand, does not appear to involve IC phagocytosis or the participation of CR3. Acceleration of neutrophil apoptosis triggered by either pIC or E-IgG seems to require the activation of the respiratory burst, as suggested by 1) the ability of catalase to prevent apoptosis stimulation; 2) the effect of azide, an heme enzyme inhibitor, which dramatically enhanced apoptosis induced by pIC or E-IgG; and 3) the inability of pIC or E-IgG to accelerate apoptosis of neutrophils isolated from CGD patients. It is well established that IC affect the course of inflammation by inducing the release of inflammatory cytokines, proteolytic enzymes, oxidative agents, and other toxic molecules. Our results suggest that IC may also affect the course of inflammation by virtue of their ability to modulate neutrophil apoptosis.

Antigen-Antibody Complex↗
PubMed1998

Striatal transplants prevent AF64A-induced retention deficits.

The relevance of the cholinergic system in mnemonic processes has been repeatedly demonstrated. In addition to the cholinergic systems that project to the telencephalon, there are subcortical nuclei with intrinsic cholinergic cells which appear to be involved in memory consolidation; among these is the striatum. Intrastriatal administration of anticholinergic drugs, as well as excitotoxic and electrolytic lesions have been shown to disrupt the acquisition and retention of instrumentally conditioned behaviors. In the present study male Wistar rats were used to confirm the reported detrimental effects of striatal lesions produced by the cholinotoxin AF64A on long-term retention (LTR) of inhibitory avoidance and spontaneous locomotor activity, to determine its effects on short-term retention (STR) and to investigate whether intrastriatal homotopic transplants can reverse the AF64A-induced behavioral deficits. AF64A-striatal lesions did not interfere with STR but disrupted LTR of the inhibitory avoidance task, and striatal transplants prevented this deficit. Spontaneous locomotor activity increased after the lesion but promptly returned to baseline levels. These results support previous findings showing striatal involvement in long-term but not short-term retention and indicate that homotopic transplants induce behavioral recovery of a learning task in striatal lesioned rats.

Acetylcholinesterase↗
PubMed1998

Socio-sexual behavior in male rats after lesions of the dorsolateral tegmentum.

The medial preoptic area of the anterior hypothalamus (MPOA/AH) and the dorsolateral tegmentum (DLT) play an important role in the control of sexual behavior. Unilateral lesions of the MPOA/AH (medial preoptic area of the anterior hypothalamus) combined with unilateral lesions of the contralateral DLT result in deficits in male sexual behavior, while bilateral electrolytic lesions of the DLT have similar effects. In the present study, coital and socio-sexual interactions were recorded before and after bilateral electrolytic DLT lesions. Coital behavior was monitored for 15 weeks after surgery and socio-sexual interactions one 1 and 3 weeks after lesion. DLT-lesioned animals showed reduced copulatory behavior throughout the 15 weeks postlesion. This inhibition was associated with changes in exploratory (sniffing), precopulatory (pursuit and genital exploration), and postcopulatory behaviors (self-grooming). No differences were found in the weights of the testicles, prostate and seminal vesicles. These results indicate that lesions of the DLT produced permanent deficits in sexual behavior associated with a generalized modification of sociosexual behavior. These deficits indicate reduced sexual motivation possibly due to the disruption of the output pathway from the MPOA/AH (medial preoptic area of the anterior hypothalamus) to the DLT.

Animals↗
PubMed1998

Relevance of age on survival of 341 patients with multiple myeloma treated with conventional chemotherapy: updated results of the MM87 prospective randomized protocol. Cooperative Group of Study and Treatment of Multiple Myeloma.

Age could influence the prognosis of multiple myeloma patients treated with conventional chemotherapy. Between January 1987 and March 1990, 341 consecutive previously untreated patients with multiple myeloma received chemotherapy within the prospective, multicentre, randomized Protocol MM87. Survival was evaluated in patients aged > or < or = 66 years (the median age for the whole series) and in a subgroup of patients aged < 55 years. These groups were similar for main clinical characteristics, including results of cytostatic treatment. As of May 1996, 271 (79%) of the 341 patients had died, and median follow-up of the 70 (21%) living patients was 82 months. Overall, younger patients survived longer than older ones. In fact, in patients > and < or = 66 years, median survival was 31 and 44 months (P < 0.00095) and the percentage of patients surviving over 72 months was 17% and 32% (P = 0.0018) respectively; in patients < 55 years, these figures were 57 months and 35% respectively (P = 0.02 and 0.01, with respect to patients aged > 55 years). In all groups, about 50% of the patients surviving over 72 months had stage I disease. For multiple myeloma patients treated with chemotherapy, survival is favourably affected by relatively young age and early stage of disease.

Adult↗
PubMed1998

Derangements in protein metabolism induced by type I diabetes mellitus.

In poorly controlled diabetics, the whole-body protein flux is increased by 20-30% in comparison to well-controlled type I diabetes (IDDM) and normal subjects. Intensive insulin administration completely reverses these abnormalities. In poorly controlled IDDM, the primary effect of insulin administration is to reduce the increased protein catabolic rate by suppressing the accelerated rate of protein breakdown. Studies in humans have demonstrated that the increased rate of protein synthesis observed in these patients is the consequence of elevated plasma amino acid levels. When IDDM subjects develop renal complications, a protein-restricted diet may be recommended to preserve the remnant kidney function. However, it has been demonstrated that in IDDM patients, metabolic adaptation to protein restriction is incomplete because suppression of endogenous proteolysis is impaired. Since this component of protein metabolism is very sensitive to insulin action, maintaining strict metabolic control during the protein restriction regimen has been suggested. The major studies on the effects of amino acid and insulin on protein metabolism in patients with diabetes mellitus are reviewed.

Amino Acids↗
PubMed1998

The (dP/dt)max derived from arterial pulse waveforms during 24 h blood pressure oscillometric recording.

BACKGROUND: The modern developments in engineering allow one to record the speed at which the blood pressure rises on the advancing pulse wave front. It was possible to obtain this through the conversion of a conventional pulse from a single suprasystolic oscillation to the oscillometric envelope into its first derivative with respect to time. OBJECTIVE: The aim of this study was to report a preliminary comparison between healthy subjects and patients with heart failure as a first step towards the clinical ujse of this first derivative of a time-dependent function (dP/dt).METHODS: For 10 normal healthy subjects (aged 37 +/- 5 yhears) and five subjects with ischaemic cardiomyopathy (aged 41 +/- 7 years), whose ejection fractions (invasively assessed) wee < 40%, we evaluated six sequential oscillometric measurements of blood pressure obtain by using a Dynapulse Ps5000 (Pulse Metric, San Diego, California, USA) device, which simultaneously records blood pressure and analyses every arterial waveform. The mean and SD of (dP/dt)max for each subject were calculated, together with the relative mean distribution and the significance of the differences. RESULTS: The data show that (dP/dt)max of subjects with an impairment of cardiac function is less than normal. The mean (dP/dt)max of normalk subjects was significantly different (P < 0.05) from that of patients with ischaemic cardiomyopathy and lower than normalk ejection fractions. CONCLUSION: These preliminary results allowed us to raise the hypothesis that this parameter, being representative of the cardiac function, because many data are obtained, is extremely useful for monitoring changes during daily activities or to outline the nycthoemeral rhythm. We have to test the hypotheses that the analyses of the correlations between (dP/dt)max and other haemodynamic parameters may be used in the pathphysiological study of cardiomyopathies and that the comparison of differences in (dP/dt)max can be used in the evaluation of the effects of the treatment.

Journal Article↗
PubMed1998

[Suprasystolic dP/dt max an additional parameter of contractile cardiac function obtained by cuff oscillometric tracings].

Technological evolution allowed to record high fidelity traces that--when analysed by complex mathematical systems--may provide extremely detailed and new information about all the factors involved in the determinism of pulse wave. Suprasystolic waves, i.e. those recorded immediately before systolic pressure, may be regarded as similar to aortic pressure waves evaluated during cardiac catheterization. Suprasystolic dP/dt max was calculated from the profile of pulse wave recorded by the DynaPulse, an automatic portable non-invasive oscillometric method to simultaneously measure BP and analyse arterial waveforms, in 10 normal healthy subjects (age 37 +/- 5) and 5 subjects with ischaemic dilatative cardiomyopathy (age 41 +/- 7) whose ejection fraction--invasively assessed--was < 40%. The 24 h dP/dt max curves were analysed by parametric and non parametric tests. We found a significant difference (p < 0.001) in the average 24-h dP/dt max between healthy subjects (471 +/- 36.7 mmHg/sec) and patients with impaired cardiac function (271 +/- 54.2 mmHg/sec). The average daytime and nighttime dP/dt max values showed significantly higher values in normal subject in comparison to patients with heart failure (daytime 7.23 h: 529 +/- 74 mmHg/s versus 227 +/- 64 mmHg/s, p < 0.001; nighttime: 572 +/- 82 mmHg/s versus 202 +/- 67 mmHg/s, p < 0.001). We also found a difference in the occurrence of acrophases, at similar blood pressure value, i.e. the highest dP/dt values occurred during the night in normal subject, the opposite in ischaemic patients. Furthermore, the dP/dt max correlates only with systolic blood pressure.

Adult↗
PubMed1997

Inhibition of human neutrophil apoptosis by platelets.

In the absence of appropriate stimuli, polymorphonuclear neutrophils rapidly undergo characteristic changes indicative of programmed cell death or apoptosis. We report here that neutrophils cultured in the presence of platelets (neutrophil:platelet ratios of 1:50, 1:25, and 1:10) show a dramatic inhibition of apoptosis compared with neutrophils cultured alone. Similar degrees of apoptosis delay were induced by viable unstimulated platelets, fixed unstimulated platelets, or fixed activated (1 U/ml thrombin) platelets. Inhibition of apoptosis was associated with prolongation of the functional lifespan of the neutrophil, as indicated by the higher capacity of platelet-treated neutrophils to display chemiluminescence responses triggered by FMLP, immune complexes, and zymosan. The mechanism responsible for the inhibition of neutrophil apoptosis by platelets has not yet been defined. However, it seems that classical recognition systems such as those mediated by the interaction between platelet P-selectin (CD62) or glycoprotein IIb/IIIa complex and their counter-receptors expressed by neutrophils are not involved.

Apoptosis↗
PubMed1997

Evidence for gene conversion in the generation of extensive polymorphism in the promoter of the growth hormone gene.

The human growth hormone gene (GH-N) is located in a cluster of five highly homologous genes that are coordinately expressed in pituitary (GH-N) and in placental tissues (the chorionic-somatomammotropin-like gene, the GH-variant gene and the two chorionic somatomammotropin genes). Sequence analysis from position -162 to position +100 of the GH-N gene has revealed eight nucleotide polymorphisms with no significant difference in frequency between patients affected by isolated growth hormone deficiency and controls. Remarkably, all these variations are located at positions where the GH-N differs from at least one of the other four homologous genes. The analysis of the twelve GH-N haplotypes originating from the combinations of the eight polymorphisms has revealed that not only single variations, but also nucleotide combinations are identical to those of the other placental genes. These findings suggest that whole stretches of the GH-N gene promoter have been replaced by homologous DNA stretches copied from one of the other four loci by repeated gene-conversion-like events, where the GH-N gene has acted as the recipient and the placental genes as donors of the converted sequences. The presence of a Chi-like element also indicates that the GH-N promoter represents a hot spot of gene conversion. Three of these variations cause, in addition, an amino-acid substitution in the GH-gene-derived transcriptional activator gene whose coding sequence overlaps the GH-N promoter. Thus, a DNA region that serves two distintic functions representing the proximal promoter of a gene and the 5' coding region of another gene displays an unusually high degree of polymorphism that has probably arisen because of gene conversion.

Base Sequence↗
PubMed1997

Na+/Li+ and Na+/H+ countertransport activity in hypertensive non-insulin-dependent diabetic patients: role of insulin resistance and antihypertensive treatment.

We measured erythrocyte Na+/Li+ and Na+/H+ countertransport (CT) activity (millimoles per liter per cell per hour) in 10 healthy control subjects (age, 38 +/- 4 years; body mass index, 25 +/- 1 kg/m2) and in 25 hypertensive patients with non-insulin-dependent diabetes mellitus ([NIDDM] age, 49 +/- 3 years; body mass index, 29 +/- 1 kg/m2; fasting plasma glucose, 157 +/- 12 mg/dL) 4 weeks after discontinuation of previous antihypertensive treatment. Na+/Li+ CT was significantly increased in hypertensive NIDDM patients compared with controls (0.56 +/- 0.04 v 0.30 +/- 0.03, P < .01), whereas Na+/H+ CT was similar to control levels (21 +/- 1 v 20 +/- 2). A positive correlation was found between Na+/Li+ CT and the severity of insulin resistance (r = .69, P < .01), mean arterial pressure ([MAP] r = .64, P < .01), plasma triglyceride concentration (r = .46, P < .05), and plasma total cholesterol (r = .41, P < .05). An inverse correlation was found between Na+/Li+ CT activity and plasma insulin concentration (r = -.47, P < .05). No relationship was observed between Na+/Li+ CT activity and either creatinine clearance or proteinuria. Stepwise multiple regression analysis for all metabolic variables and blood pressure showed that only the severity of insulin resistance was positively correlated with increased Na+/Li+ CT activity. Na+/H+ and Na+/Li+ CT activity were not altered by 3 hours of euglycemic physiologic hyperinsulinemia (84 +/- 3 microU/mL). Hypertensive NIDDM subjects were treated for 3 months with captopril, nifedipine, or doxazosin. After captopril, a reduction of Na+/H+ CT was observed (22 +/- 4 v 13 +/- 2, P < .05); Na+/Li+ CT decreased after doxazosin (0.56 +/- 0.06 v 0.45 +/- 0.05, P < .05) and nifedipine (0.52 +/- 0.06 v 0.42 +/- 0.05, P < .05). In conclusion, in hypertensive NIDDM subjects, (1) Na+/Li+ CT is increased and is correlated with the level of insulin resistance and the MAP; (2) acute physiologic hyperinsulinemia does not affect Na+/Li+ or Na+/H+ CT activity; and (3) Na+/H+ CT activity is reduced by captopril, and Na+/Li+ CT is decreased by doxazosin and nifedipine.

Adult↗
PubMed1997

Correlation between amino acid induced changes in energy expenditure and protein metabolism in humans.

The relationship between energy expenditure and protein metabolism during amino acid (AA) administration was evaluated in normal humans. A balanced AA solution was infused for 180 min at five different rates: 20 (study I), 40 (study II), 80 (study III), 160 (study IV), and 240 mg.m2(-1).min-1 (study V), on separate days, in seven normal, overnight-fasted subjects (age 25 +/- 2 y; height 172 +/- 5 cm; weight 68 +/- 4 kg). Indirect calorimetry and [1-14C] leucine infusion techniques were employed. Basal total plasma AA concentration averaged 1827 +/- 121 mumol/L and increased to 2192 +/- 142, 2576 +/- 158, 3677 +/- 195, 5638 +/- 237, and 7185 +/- 261 mumol/L in studies I-V, respectively. Basal energy expenditure averaged 0.60 +/- 0.02 kcal.m2(-1).min-1 and increased slightly in studies I and II (to 0.62 +/- 0.03, 0.63 +/- 0.02, respectively), and significantly in studies III-V (to 0.65 +/- 0.03, 0.70 +/- 0.04, and 0.77 +/- 0.05 kcal.m2(-1).min-1, respectively, all P < 0.01 versus basal; P < 0.05-0.01 for each study versus preceding study). Basal nonoxidative leucine disposal (NOLD), an index of protein synthesis, averaged 73 +/- 3 mumol.m2(-1).min-1 and increased, albeit not significantly, in studies I and II (to 75 +/- 5, 76 +/- 4, respectively). In contrast, a significant increase in NOLD was observed in studies III-V (to 87 +/- 7, 103 +/- 7, and 127 +/- 9 mumol.m2(-1).min-1, respectively; all P < 0.01 versus basal; P < 0.05-0.01 for each study versus preceding study). Basal respiratory quotient averaged 0.81 +/- 0.02 and did not change significantly in studies I-V (0.80 +/- 0.02, 0.79 +/- 0.02, 0.80 +/- 0.03, 0.82 +/- 0.02 and 0.82 +/- 0.03, respectively). The thermic effect of AA administration, calculated as percent of the AA energy infused, was constant and averaged 24 +/- 4, 19 +/- 3, 17 +/- 4, 17 +/- 3, and 18 +/- 3% in studies I-V, respectively. When AA-induced increase in protein synthesis was plotted with the increment in energy expenditure, a positive correlation was obtained (r = 0.792, P < 0.001). In summary, during AA administration (1) the absolute rise in energy expenditure is dose-dependent and does not show evidence of achieving a plateau; (2) it is positively correlated with AA-induced protein synthesis; and (3) the thermic effect is not dependent upon the AA dose administered. The data provide a quantitative assessment of AA-induced thermogenesis in normal humans and the energy needs associated with an acute stimulation of protein synthesis.

Adult↗
PubMed1997

Immunoglobulin M antibody response to measles virus following natural virus infection, primary vaccination, and reexposure to the virus.

Evaluation of the measles virus ELISA kit (Merck) to detect specific IgM as an indicator of primary measles antibody response was carried out. A modification of the manufacturer's cutoff value interpretation was introduced to allow for equivocal results in addition to positive and negative ones. With this modification, the test assayed gave an overall reproducibility of 96.16%. The IgM seropositivity rate for seroneutralization-confirmed measles cases was 100% for naturally infected measles subjects and 90% for primary measles vaccinated subjects. Individuals with positive neutralizing antimeasles antibodies in close contact with a confirmed measles case gave the following measles IgM ELISA results: 54.54% negative, 9.09% positive, and 36.36% equivocal, showing a booster with IgM antibody response on reexposure to the virus. Positive subjects with neutralizing antimeasles antibodies without recent contact with a measles case gave negative IgM results. IgM seropositivity was strongly associated with IgG seroconversion and clinical measles (p < 0.0001). The technique assayed performed adequately for the confirmation of both measles natural infection and primary vaccination and for the differentiation of primary and secondary antibody response, taking into account the modification in the cutoff value interpretation introduced and providing that the serum samples are obtained between days 5 and 30 after onset of rash.

Adolescent↗
PubMed1997

Chlorine dioxide: a new agent for dialysis monitor disinfection in a pediatric center.

In order to evaluate the bacterial and endotoxin contamination in the dialysis fluids of our pediatric center and the effectiveness of chlorine dioxide (CD) compared with a conventional method, (1) deionized water, (2) dialysate fluid, (3) basic concentrate, and (4) acid concentrate were tested in 4 dialysis machines. Monitor sterilization was made using CD in protocol A and sodium hypochlorite/acetic acid in protocol B. Once every 2 weeks the deionized water set of distribution was routinely disinfected with peracetic acid. Each protocol lasted 1 months and the samples were taken, under aseptic conditions, on the 15th, 22nd and 27th day. All samples, at all stages of the study, showed an endotoxin concentration below the limits recommended by the Canadian Standard Association. Fifty-nine out of 72 samples in A and 62 out of 72 samples in B showed a bacterial count within the range recommended by the Association for the Advancement of Medical Instrumentation. The data show that both protocols produced the same results. However, protocol A is to be preferred for its simultaneous disinfecting-cleaning and descaling activity which proves time-saving.

Bacteria↗
PubMed1997

[Prevalence of Helicobacter pylori antibodies in patients with kidney transplantation].

INTRODUCTION: Our target was to verify if belonging to a selected group of patients, who have undergone a kidney transplantation and before that suffered from high level of uremia sometimes with border line levels , could be a risk factor for acquiring HP antibodies. MATERIALS AND METHODS: We evaluated in 23 patients, with an average age of 16.3, attending our Day-Hospital Unit to be followed up after a kidney transplant, the prevalence of anti-HP antibodies, measured in serum by the ELISA method. The prevalence in this group has been compared with that observed in a healthy cohort of 36 people. RESULTS: Antibodies were present in 31.8% of our patients without any correlation with age, age of transplant, serum urea level, cyclosporinemia, total lgG and IgA antibodies. DISCUSSION: In the end, kidney transplantation doesn't seem to be a risk factor for acquiring HP infection. Detecting HP antibodies can be a method to select patients that must undergo other strumental examinations.

English Abstract↗