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Biomedical subjects

M Marcucci

Publications and source records attributed to M Marcucci.

At least 19 recordsLinked to original sources
PubMed1999

Effect of AMPK activation on muscle glucose metabolism in conscious rats.

The effect of AMP-activated protein kinase (AMPK) activation on skeletal muscle glucose metabolism was examined in awake rats by infusing them with 5-aminoimidazole-4-carboxamide 1-beta-D-ribofuranoside (AICAR; 40 mg/kg bolus and 7.5 mg. kg-1. min-1 constant infusion) along with a variable infusion of glucose (49.1 +/- 2.4 micromol. kg-1. min-1) to maintain euglycemia. Activation of AMPK by AICAR caused 2-deoxy-D-[1,2-3H]glucose (2-DG) uptake to increase more than twofold in the soleus and the lateral and medial gastrocnemius compared with saline infusion and occurred without phosphatidylinositol 3-kinase activation. Glucose uptake was also assessed in vitro by use of the epitrochlearis muscle incubated either with AICAR (0.5 mM) or insulin (20 mU/ml) or both in the presence or absence of wortmannin (1.0 microM). AICAR and insulin increased muscle 2-DG uptake rates by approximately 2- and 2.7-fold, respectively, compared with basal rates. Combining AICAR and insulin led to a fully additive effect on muscle glucose transport activity. Wortmannin inhibited insulin-stimulated glucose uptake. However, neither wortmannin nor 8-(p-sulfophenyl)-theophylline (10 microM), an adenosine receptor antagonist, inhibited the AICAR-induced activation of glucose uptake. Electrical stimulation led to an about threefold increase in glucose uptake over basal rates, whereas no additive effect was found when AICAR and contractions were combined. In conclusion, the activation of AMPK by AICAR increases skeletal muscle glucose transport activity both in vivo and in vitro. This cellular pathway may play an important role in exercise-induced increase in glucose transport activity.

AMP-Activated Protein Kinases↗
PubMed1999

Effects of free fatty acids on glucose transport and IRS-1-associated phosphatidylinositol 3-kinase activity.

To examine the mechanism by which free fatty acids (FFA) induce insulin resistance in human skeletal muscle, glycogen, glucose-6-phosphate, and intracellular glucose concentrations were measured using carbon-13 and phosphorous-31 nuclear magnetic resonance spectroscopy in seven healthy subjects before and after a hyperinsulinemic-euglycemic clamp following a five-hour infusion of either lipid/heparin or glycerol/heparin. IRS-1-associated phosphatidylinositol 3-kinase (PI 3-kinase) activity was also measured in muscle biopsy samples obtained from seven additional subjects before and after an identical protocol. Rates of insulin stimulated whole-body glucose uptake. Glucose oxidation and muscle glycogen synthesis were 50%-60% lower following the lipid infusion compared with the glycerol infusion and were associated with a approximately 90% decrease in the increment in intramuscular glucose-6-phosphate concentration, implying diminished glucose transport or phosphorylation activity. To distinguish between these two possibilities, intracellular glucose concentration was measured and found to be significantly lower in the lipid infusion studies, implying that glucose transport is the rate-controlling step. Insulin stimulation, during the glycerol infusion, resulted in a fourfold increase in PI 3-kinase activity over basal that was abolished during the lipid infusion. Taken together, these data suggest that increased concentrations of plasma FFA induce insulin resistance in humans through inhibition of glucose transport activity; this may be a consequence of decreased IRS-1-associated PI 3-kinase activity.

Adolescent↗
PubMed1998

[Epidemiological surveillance of trachoma in a school in a city of southeast Brazil].

INTRODUCTION: Epidemiological surveillance activities undertaken after the detection of an active trachoma case in the APAE-SP are described. MATERIAL AND METHOD: A total of 1,009 pupils, employees and household contacts had an eye examination. Treatment control was carried out at the institution 4 times at 45 day-intervals. RESULTS: The overall prevalence was of 5.9%, 5.1% being of follicular trachoma (TF), 0.3% of intense trachoma (TF/TI) and 0.5% of cicatricial trachoma (TS). At the first control exercise 45.5% of the trachoma cases had no signs of the disease and 40.0% underwent treatment. At the last control exercise 20% were found to have been cured with no vestigial scars. Non-attendance was of 38.2%. The distribution of secondary cases showed great dispersion, suggesting dissemination throughout Greater S. Paulo. DISCUSSION AND CONCLUSIONS: The trachoma control activities do not show satisfactory results, perhaps due to the prolonged duration of the treatment and follow-up. The development of strategies of clinical intervention should be implemented for better control of the disease.

Adolescent↗
PubMed1998

Need and supply of liver grafts in Tuscany.

BACKGROUND: Epidemiological data are fundamental to adequately plan the activity of a liver transplantation centre. AIM: To evaluate the ratio between need and supply of liver grafts in Tuscany and to develop a regional strategy aimed at increasing donor recruitment. METHODS: The need for liver grafts was estimated on the basis of an epidemiological study: 19 Medical Units were requested to fill in a questionnaire inquiring into all Tuscan patients evaluated for liver disease during three different periods of one month each in 1996. The information collected was matched with the selection criteria currently employed at our centre and the patients were classified into the following four categories: 1. current transplantation candidates; 2. future transplantation candidates; 3. candidates not suitable on account of age; 4. candidates not suitable on account of exclusion criteria. The number of liver donors was obtained from the donor registry. RESULTS: Questionnaires were returned for a total of 452 patients: 27 (5.97%) were classified as current transplantation candidates, 62 (13.72%) as future transplantation candidates and 19 (4.20%) as candidates not suitable on account of age. The annual incidence and prevalence of transplantation candidates were 14.7 and 30.6 cases per million inhabitants, respectively. If age (> or = 61 years) was not considered in the exclusion criteria, the annual prevalence of transplantation candidates reached 52.1 cases per million inhabitants. During the same period there were 44 organ donors (12.2 donors per million inhabitants) of whom 33 were suitable for liver donation (9.3 liver donors per million inhabitants). To reduce this discrepancy a new programme for organ recruitment, based upon the Spanish model, has been recently employed. CONCLUSIONS: The annual need for liver grafts in Tuscany largely exceeds the number of donors currently available. It is hoped that the new regional programme for organ recruitment will improve these figures.

Aged↗
PubMed1995

Total hip replacement with bone grafting using the removed femoral head in severe acetabular dysplasia.

We carried out total hip replacement and femoral head bone-grafting in 21 hips with congenital dysplasia or dislocation, obtaining as much support of the cup by the host bone as was possible. A Charnley small or extra small cup was implanted in 20 cases and a miniature femoral component in 15. The results of 20 hips were reviewed prospectively at an average of 10 years. Nineteen patients had no pain. Three cups showed radiological signs of loosening, one was causing other symptoms. All the stems, except one, were radiologically stable and were symptomless. The graft had fused without resorption in 18 cases. Two grafts showed severe resorption with loosening of the cup. Satisfactory long term results of total hip replacement and femoral head bone-grafting can be achieved using special surgical techniques and the appropriate components. Medialisation of the hip and the use of small cups are important in allowing sufficient support of the prosthesis by bone so that the distribution of load on the graft is minimised. The grafted femoral head provides suitable bone stock for reconstruction of the acetabulum.

Adult↗
PubMed1994

Evacuation of traumatic intracerebral haematomas using a simplified stereotactic procedure.

The authors present a series of 37 traumatic intracerebral haematomas (ICH) evacuated by a simplified stereotactic surgical procedure. The mortality rate was 80% in patients with Glasgow coma scale (G.C.S.) scores of 3-5 and 25% in patients with scores of 6-7. There were no deaths in patients with G.C.S. of 8 or more. With the exception of the first group of patients, the results were better than those achieved by wide craniotomy. The importance of reduced operative trauma in patients with ICH, which often are associated with multifocal or diffuse brain injuries, are discussed.

Brain Injuries↗
PubMed1992

Epidemiological survey of Streptococcus mutans in a group of adult patients living in Pisa (Italy).

An epidemiological investigation was carried out to evaluate the prevalence of Streptococcus mutans in a group of 134 adult patients. Markedly higher frequency of isolation was observed in caries-active subjects than in caries-inactive or caries-free subjects, indicating a significant association between the prevalence of the microorganism and the caries status. Moreover, the presence of the microorganism appeared to have a significant association with the extent of caries experience evaluated by the DMF score. These findings are in agreement with those reported previously for school children in other areas of Italy. Isolation of S. mutans was compared among patients groups with different caries activity in relation to culture times of dental plaque samples in a transport medium (Colorimetric Broth Medium). S. mutans was most frequently isolated from caries-active subjects when the medium was incubated for 48 h after inoculation with dental plaque samples.

Adolescent↗
PubMed1991

Clinical experience in the treatment of dental pain.

Good dental analgesia requires drugs that are endowed with strong and fast activity and that are well tolerated. In addition, optimal analgesia should essentially be of the peripheral type, thereby eliminating the risk of sedation that may cause unpleasant effects on the patient's daily life. Meclofenamic acid is among those substances whose analgesic effect is more evident than that of anti-inflammatory action. The mechanism of action of meclofenamic acid makes it distinctly different from other nonsteroidal anti-inflammatory drugs (NSAIDs) in that it inhibits the metabolic pathways of arachidonic acid and, at the same time, antagonizes the effects of prostaglandins at the peripheral receptor level. A number of controlled clinical trials showed that meclofenamic acid is an excellent analgesic, offering good tolerability when used in oral surgery, dysodontiasis, avulsion of the third impacted molar, and periodontitis. The following report is a presentation of results obtained in a controlled clinical trial in which the speed of pain relief was assessed in 20 patients suffering from acute periodontitis. The patients were treated orally with a single dose of meclofenamate sodium (100 mg) or with piroxicam-beta-cyclodextrin (20 mg). The intensity of the drug's analgesic effect was measured at 0.5, 1, 2, 4, and 6 h after administration. After initial testing, meclofenamate sodium was found to be significantly more effective than piroxicam-beta-cyclodextrin. Both the physician and patient found this drug to be considerably better. Pain relief after treatment with meclofenamate sodium was clinically and statistically faster than piroxicam-beta-cyclodextrin, and both drugs were found to be well tolerated.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1991

Verified causes of failure in the treatment of femoral neck fractures with multiple Knowles pins.

The authors examine 152 cases of femoral neck fractures treated with Knowles pins in order to analyze the incidence and causes of nonunion and avascular necrosis. The displaced fractures were all treated with closed reduction, and weight-bearing was permitted after 30-45 days. Seventy fractures were followed up after an average of four years. Criteria are proposed for evaluating the quality of both the reduction and the internal fixation. Healing was achieved in all cases of Garden grade I and II fractures; the incidence of avascular necrosis was 4.1%. In the displaced fractures the incidence of nonunion was 15.2% and avascular necrosis 13%. Technical errors in either reduction or internal fixation were present in 50% of the necroses and in 100% of the nonunions. The quality of the reduction was the most important factor in fracture healing, yet an accurate reduction and a valid fixation could not completely overcome the risk of avascular necrosis in the femoral head.

Adult↗
PubMed1991

[The clinical efficacy of roxithromycin in patients with acute odontogenic infections].

The clinical efficacy of a macrolide antibiotic, roxithromycin, was evaluated in 24 patients affected by acute odontogenic infections. Patients were treated with a first dose of 300 mg p.o. which was followed by 150 mg p.o. 12-hourly for the following two days. Total responses were evaluated by an arbitrary scale. The results showed that an excellent and good response was obtained in 99.96% of treated patients. On the basis of clinically compared data and the drug safety it may be concluded that roxithromycin can be successfully used in the treatment of odontogenic infections.

Acute Disease↗
PubMed1990

Roxithromycin penetration into gingiva and alveolar bone of odontoiatric patients.

The concentrations of the new macrolide antibiotic roxithromycin in plasma, saliva, gingiva, and alveolar bone were studied in 24 odontoiatric patients treated with a first dose of 300 mg p.o. followed by three maintenance doses of 150 mg p.o., 12-hourly. Samples of blood, saliva, gingiva, and bone were collected at various time points up to 24 h after the last dosing, and the roxithromycin concentration was measured microbiologically, using Bacillus subtilis ATCC 6633 as the reference organism. Pharmacokinetic analysis was performed according to a two-compartment open model with first-order absorption. The plasma, gingiva, and alveolar bone peak concentrations were 6.12 +/- 1.94 mg/l, 6.55 +/- 2.54 mg/kg, and 5.09 +/- 1.60 mg/kg, respectively. Low levels of roxithromycin were detected in saliva (0.67 +/- 0.12 mg/l at the 3rd h). The values of the area under the concentration-time curve for plasma, gingiva, and bone were 59.47 mg/l.h, 51.88 mg/kg.h and 46.80 mg/kg.h, respectively; the half-life values were 7.52 h for plasma and 6.36 and 5.20 h for gingiva and bone, respectively. These results indicate that roxithromycin reaches high levels in periodontal tissues.

Adult↗
PubMed1989

[Aseptic loosening of the Charnley prosthesis].

Out of 100 Charnley prostheses implanted for idiopathic arthrosis and followed up a minimum of 5 years after surgery, 59 were fixed, 24 were characterised by probable radiologic loosening of the femoral component, 13 by probable loosening, and 4 by possible radiologic loosening of the acetabular component. None of the patients was submitted to further surgery. Some of the features of the patients were found to be associated with a higher incidence of femoral loosening. In most of the cases loosening was minimal, only radiologic, and not clinically apparent, and numerous technical improvements in the use of cement and in the design of the prosthesis were introduced subsequent to the period when these patients were operated on.

Adult↗
PubMed1989

[Total hip prosthesis according to Charnley. Review of our cases].

This is a follow-up study of 363 Charnley hip replacements out of 548 implanted from 1970 to June 1984. Clinical results, with a 2-year minimum follow-up (average 5 years, maximum 15 years) are excellent or good in 89.5% of the cases. In the group with minimum 5-year follow-up (average 7, maximum 15 years) the clinical results remain good to excellent in 89.2% of the cases. Radiographic results have been studied in the group with minimum 5-year follow-up. Component stability or radiographic loosening have been studied, taking into account the presence of radiolucent lines between bone and cement, between metal and cement, or based on component migration or positional shift. We have detected radiographic loosening in 11.5% of the acetabular and 13.5% of the femoral components. A correlation was sought between radiographic loosening and some clinical (diagnosis, weight, follow-up period) and radiographic (postoperative component position, polyethylene wear, cement technique, periosteal reaction, myositis ossificans) parameters. There is no strong relationship between radiographic loosening and clinical results, as 28 of 35 radiographically loose prostheses maintained excellent or good results. Finally, the results of a selected group of 29 hips, with a minimum follow-up of 10 years, is reported.

Adult↗