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Biomedical subjects

M Martini

Publications and source records attributed to M Martini.

At least 55 records · Page 3Linked to original sources

Procedural results, in-hospital course and six-month follow-up after rescue compared to primary stenting in acute myocardial infarction.

BACKGROUND: Although many previous reports showed a worse outcome after rescue compared to primary coronary angioplasty, a direct comparison of these two strategies in the era of stenting is lacking. METHODS: Fifty patients treated with rescue stenting were retrospectively compared to 61 patients treated with primary stenting during acute myocardial infarction over a 4-year period in our Laboratory. RESULTS: Baseline demographic and angiographic parameters were not significantly different in the two groups. Despite a significantly longer time-to-reperfusion in rescue stenting (4.7 +/- 2.7 vs 2.8 +/- 2.1 hours, p < 0.0001), procedural success rate (98 vs 97%), in-hospital mortality (6 vs 11%) and target vessel revascularization at 6 months (8 vs 10%) were similar in rescue compared to primary stenting. CONCLUSIONS: These data suggest that stenting may help improve results of rescue angioplasty, and support the concept that aggressive treatment after failed thrombolysis can be pursued with satisfactory results.

Adult↗

Bax mutations are an infrequent event in indolent lymphomas and in mantle cell lymphoma.

BACKGROUND AND OBJECTIVES: The Bax gene is one of the most important genes involved in apoptosis regulation. Recently, it has been proposed that inactivating mutations of this death agonist may contribute to the pathogenesis of human tumors. This study was aimed at defining the status of the Bax gene in indolent lymphomas. DESIGN AND METHODS: Fifty paraffin-embedded biopsies from indolent lymphomas (10 small lymphocytic lymphomas, 5 immunocytomas, 20 follicular lymphomas and 15 marginal zone lymphomas) and 10 mantle cell lymphomas ( MCL ) were studied. All six exons of the Bax gene, together with their flanking sequences, underwent mutational analysis by PCR-SSCP followed by direct sequencing of positive cases. Moreover, Bax protein expression was investigated in all samples by immunohistochemical analysis. RESULTS: All analyzed cases showed wild type Bax gene alleles and variable levels of Bax protein expression. INTERPRETATION AND CONCLUSIONS: This study indicates that deregulation of apoptotic control in indolent lymphomas and MCL is not caused by Bax mutations and that other molecular mechanisms must, therefore, be involved.

Gene Frequency↗

The effects of ovine lentivirus infection on some productive aspects in a Sardinian sheep flock from Italy.

The effects of ovine lentivirus infection on the fat, protein and lactose concentrations on the somatic cell counts in ewes' milk, on milk production and on the birth weight and growth of lambs were studied in a flock of Sardinian sheep from central Italy. Data on 61 lactations of ewes positive to both the agargel immunodiffusion test and an enzyme-linked immunosorbent assay were compared with those on 46 lactations of seronegative ewes. Confounders such as parity, age, lactation length, litter size, and the sex of the lambs were considered. None of these traits seemed to be negatively influenced by the infection.

Animals↗

Subacute thrombosis after stenting in acute myocardial infarction: four-year experience in a low-volume center.

BACKGROUND: Despite substantial technical and therapeutic improvements, subacute stent thrombosis (SST) remains a feared complication of stenting, especially in acute coronary syndromes. Results of large interventional trials obtained in selected highly skilled centers may underestimate the incidence of SST in the real world of interventional cardiology. OBJECTIVE: To analyze the incidence of SST after stenting in acute myocardial infarction (AMI) and to identify clinical or procedural parameters associated with its occurrence in a center performing < 40 interventional procedures in AMI per year. MATERIALS AND METHODS: The authors examined their catheterization laboratory database and analyzed a series of 80 consecutive patients treated with stenting for AMI from 1995 to 1998. The incidence of SST among these patients (AMI group) was compared with that observed among 389 elective patients treated during the same period (non-AMI group). Then, results obtained for AMI patients treated during the first half of the study period (1995-1996) were compared with those obtained for patients treated during 1997-1998. RESULTS: The incidence of SST in AMI group was 6.3%, significantly higher (P < 0.0001) than the 0.5% which occurred in non-AMI group. However, all cases of SST were concentrated during the first half of the experience, whereas no case was reported among the 47 patients treated during 1997-1998 (P = 0.016). Although most clinical and angiographic baseline data for the two study periods were comparable, less bail-out stenting (17 versus 42%; P = 0.024) and higher maximal inflation pressure (15 +/- 4 versus 13 +/- 5; P = 0.031) were found during the latter period. CONCLUSION: The authors conclude that SST after stenting in AMI was significantly decreased. Relatively low-volume centers should not be denied the possibility of performing interventional procedures in the clinical setting of AMI, provided that results and complication rates are within pre-defined standards of adequacy.

Acute Disease↗

Long non-iatrogenic right coronary artery dissection in stable angina pectoris treated with stenting.

An extensive spontaneous right coronary artery dissection was the only abnormal angiographic finding detected in a 67-year-old man with chronic exercise-induced angina pectoris. The lesion was treated with multiple stenting with good angiographic results. The clinical implications of this finding and the details of the intervention performed are discussed in light of published data concerning this increasingly recognized angiographic entity.

Aged↗

[Prenatal care of a HIV-1-positive pregnancy and birth].

Mother-to-child (vertical) transmission of the human immunodeficiency virus type-1 (HIV-1) is now the main route of infection in HIV-positive children. Without any medical measures and avoiding breastfeeding the rate of vertical HIV-1-transmission is 15-20% in Europe. The rate of vertical HIV-transmission in the German centers is today approximately 2%. This low risk is the result of interdisciplinary prenatal care, antiretroviral therapy according to the individual risk profile as well as cesarean section before onset of labor, and antiretroviral treatment of neonates in the centers.

Anti-HIV Agents↗

Pseudotuberculosis in marmosets, tamarins, and Goeldi's monkeys (Callithrichidae/Callimiconidae) housed at a European zoo.

Yersinia pseudotuberculosis is an insidious bacterial infectious agent distributed worldwide and endemic to European countries. It has caused several animal deaths and may threaten the effectiveness of breeding projects for endangered species. In this retrospective study, we examine the prevalence of pseudotuberculosis in Jersey Zoo (Channel Islands, U.K.) over a period of 16 yr to obtain information that can be applied to prevent the infection. The efforts made to control the disease through vaccination are also explored. Our results show that pseudotuberculosis has been endemic to Jersey Zoo since 1979 and is responsible for significant animal loss in the Callithrichidae/Callimiconidae group. Mortality due to Y. pseudotuberculosis was seasonal; a high percentage of deaths occurred during wet and cold seasons. No significant difference was found in mortality rates of vaccinated versus nonvaccinated animals. Although the efficacy of vaccination has not been confirmed, we believe that an improved vaccination program could be an important tool in controlling outbreaks of infection in marmosets and tamarins.

Animals↗

A case-control study on bovine tuberculosis in the Veneto Region (Italy).

A case-control study was undertaken to provide information about the role of some husbandry practices and farm characteristics in the epidemiology of bovine tuberculosis in the Veneto Region. Twenty-seven breeding herds where a positive result to the single intradermal cervical tuberculin test was confirmed by post-mortem examination were compared with seventy-four herds which had been free of the disease for at least three years. Epidemiological information was collected on farms. The factors taken into account in the study were chosen on the basis of their epidemiological plausibility and of the local livestock characteristics. Multiple logistic regression was applied to analyse the data. Factors identified as possibly involved in increasing the risk of bovine tuberculosis in the Veneto Region were the presence of mixed (dairy and beef) enterprises (OR = 4.9, P = 0.001) and of cattle purchase (OR = 5.8; P = 0.003). Other factors (such as herd size, housing system, summer mountain pasture, possible contact with wild animals, and indirect contacts with other herds) did not appear to significantly contribute to tuberculosis presence in this area. The results of this case-control study support the hypothesis that in the Veneto Region bovine tuberculosis infection is still associated with classical risk factors both (directly or indirectly) related to cattle movements.

Animal Feed↗

Effects of ipriflavone on perialveolar bone formation.

The effect of ipriflavone (IP), a synthetic isoflavonoid derivative, on in vivo bone formation was studied in rat perialveolar bone by surgically producing a hole in the mandibular bone. The holes were filled either with powdered IP or with compounds containing no osteoinductive properties such as biostite and Htr (hard tissue replacement). In control animals, the holes were left to heal spontaneously. The animals were killed 3, 28, and 40 days after surgery and a detailed morphological and morphometric study was performed on the perialveolar bone surrounding the wounds. Three days after surgery (inflammatory phase) the bone wounds were occupied by hemorragic and inflammatory cells in both the untreated and IP-treated bone defects. Twenty-eight days after surgery, bone formation was evident with new bone spiculae particularly concentrated in the area of the bone lesion closest to the adjacent periodontal ligament. Morphometric measurements of the areas occupied by new bone showed that the synthesis of perialveolar bone was significantly stimulated by IP. The repair of the bone defects by new bone formation progressed by day 40, but only in the presence of IP were the original holes almost completely repaired. Conversely, biostite and Htr did not influence promotion of new bone formation. In conclusion, the results of the present study are consistent with a role of IP in stimulating osteogenesis and suggest that this compound could represent a potential therapeutic tool to promote repair of injured perialveolar bone.

Alveolar Process↗

The effects of perilymphatic tonicity on endolymph composition and synaptic activity at the frog semicircular canal.

The effects of changes in perilymphatic tonicity on the semicircular canal were investigated by combining the measurements of transepithelial potential and endolymphatic ionic composition in the isolated frog posterior canal with the electrophysiological assessment of synaptic activity and sensory spike firing at the posterior canal in the isolated intact labyrinth. In the isolated posterior canal, the endolymph was replaced by an endolymph-like solution of known composition, in the presence of basolateral perilymph-like solutions of normal (230 mosmol/kg), reduced (105 mosmol/kg, low NaCl) or increased osmolality (550 mosmol/kg, Na-Gluconate added). Altered perilymphatic tonicity did not produce significant changes in endolymphatic ionic concentrations during up to 5 min. In the presence of hypotonic perilymph, decreased osmolality, K and Cl concentrations were observed at 10 min. In the presence of hypertonic perilymph, the endolymphatic osmolality began to increase at 5 min and by 10 min Na concentration had also significantly increased. On decreasing the tonicity of the external solution an immediate decline was observed in transepithelial potential, whereas hypertonicity produced the opposite effect. In the intact frog labyrinth, mEPSPs and spike potentials were recorded from single fibers of the posterior nerve in normal Ringer's (240 mosmol/kg) as well as in solutions with modified tonicity. Hypotonic solutions consistently decreased and hypertonic solutions consistently increased mEPSP and spike frequencies, independent of the species whose concentration was altered. These effects ensued within 1-2 min after the start of perfusion with the test solutions. In particular, when the tonicity was changed by varying Na concentration the mean mEPSP rate was directly related to osmolality. Size histograms of synaptic potentials were well described by single log-normal distribution functions under all experimental conditions. Hypotonic solutions (105 mosmol/kg) markedly shifted the histograms to the left. Hypertonic solutions (380-550 mosmol/kg, NaCl or Na-Gluconate added) shifted the histograms to the right. Hypertonic solutions obtained by adding sucrose to normal Ringer's solution (final osmolality 550 mosmol/kg) increased mEPSP and spike rates, but did not display appreciable effects on mEPSP size. All effects on spike discharge and on mEPSP rate and size were rapidly reversible. In Ca-free, 10 mM EGTA, Ringer's solution, the sensory discharge was completely abolished and did not recover on making the solution hypertonic. These results indicate that perilymphatic solutions with altered tonicity produce small and slowly ensuing changes in the transepithelial parameters which may indirectly affect the sensory discharge rate, whereas relevant, early and reversible effects occur at the cytoneural junction. In particular, the modulation of mEPSP amplitude appears to be postsynaptic; the presynaptic effect on mEPSP rate of occurrence is presumably linked to local calcium levels, in agreement with previous results indicating that calcium inflow is required to sustain basal transmitter release in this preparation.

Action Potentials↗

Endotoxin-mediated intestinal damage: protective effect of capsaicin in the rat.

BACKGROUND: Endotoxin provokes the disruption of intestinal mucosal architecture. To investigate whether afferent fibers of the enteric nervous system are involved in this damage, we have used capsaicin to induce a selective, long-lasting degeneration of these fibers in the rat. METHODS: The rats were divided in two groups, receiving subcutaneously either capsaicin or its vehicle. After 10 days the rats from each group were injected with nonlethal doses of endotoxin or with saline. The next day all the animals were killed, and the jejunum and ascending colon were collected for light and scanning electron microscopy analysis; morphometric analysis of jejunal villus height was also performed. RESULTS: The rats receiving endotoxin but not pretreated with capsaicin had severe morphologic alterations and a significant reduction in villus height. In contrast, the rats pretreated with capsaicin and then with endotoxin showed a preserved mucosa with normal mean villus height. CONCLUSIONS: Capsaicin pretreatment is able to prevent endotoxin-induced damage of intestinal mucosa; this result seems to indicate that afferent fibers of the enteric nervous system are involved in the pathogenesis of this damage.

Animals↗

Intraoperative endoscopy during colorectal surgery.

In cases where preoperative studies may have been inadequate or could not be performed, intraoperative endoscopy (IOE) becomes an essential investigative tool for identification of synchronous lesions, of nonpalpable lesions, of sources of bleeding, and localization of lesions during laparoscopic colonic surgery. We report our experience with IOE, and describe our techniques of transabdominal colonoscopy. A review of the IOE performed in hospitals affiliated with the University of Miami was done. Fifty-eight patients received IOE from July 1994 to August 1996. There were 47 colonoscopies (38 transanal and 9 transabdominal), and 11 flexible sigmoidoscopies. Colorectal cancer, diverticulitis, inflammatory bowel disease, and lower gastrointestinal bleeding represented 83% of cases. In 10% of cases IOE changed the extent of the surgical procedure. There were no complications related to IOE. We conclude that in selected patients undergoing colorectal procedures, IOE is an essential tool. It can be performed safely, effectively, and rapidly.

Adult↗

Assessment of right ventricular function and interstitial fibrosis in idiopathic dilated cardiomyopathy: hemodynamic correlates and prognostic value.

BACKGROUND: Right ventricular (RV) function and morphometric quantitation of interstitial fibrosis in idiopathic dilated cardiomyopathy (IDC) have not been the subject of specifically designed clinical observations. In particular, their role in routine assessment and prognostic evaluation of patients (pts) with IDC remains to be settled. METHODS: Eighty-one consecutive IDC patients (63 M, 18 F; mean age 52 +/- 11 yrs) with left ventricular (LV) systolic dysfunction (angiographic ejection fraction - EF - < 55%), normal coronary arteries and no histologic evidence of myocarditis were studied. Cardiac catheterization and endomyocardial biopsy (EMB) were routinely performed in all cases. RV volumes and EF were obtained by angiography according to Ferlinz' method and interstitial fibrosis was quantitated by computer-assisted morphometric analysis. These data were analyzed in order to study correlations with hemodynamic parameters and to assess their prognostic value in a long-term follow-up. RESULTS: In the study population, right ventricular EF was significantly lower than in normal controls (35 +/- 11% vs 53 +/- 6%, p < 0.0001) and showed a significant positive correlation with LV EF (r = 0.54; p < 0.0001), and a weak but significant negative correlation with fibrosis (r = -0.29; p = 0.03). RV volumes, but not EF, were significantly related to mean pulmonary pressure. At multivariate analysis, RV end-diastolic volume (EDV) and EF were the two independent predictors of severe heart failure (NYHA class III-IV). After a mean follow-up of 64 +/- 36 months, 20 pts died and 9 had heart transplantation, for a 63% transplant-free survival rate (TFS). Multivariate analysis identified three independent predictors of TFS: LV stroke work index (p < 0.0001), RV stroke work index (p = 0.02) and RV EDV (p = 0.03). Fibrosis was predictive of survival only in the subgroup with LV EF < 20%. CONCLUSIONS: Assessment of RV function provides useful information in the evaluation of hemodynamic profile and prognosis of pts with IDC. Quantitation of interstitial fibrosis by morphometry provides little additional data.

Adult↗

Leptospira interrogans serovar icterohaemorrhagiae seropositivity and the reproductive performance of sows.

The reproductive performance of 28 sows seropositive to Leptospira interrogans serovar icterohaemorrhagiae was compared with that of 87 Leptospira sp. seronegative dams belonging to the same herd. Sows were sampled during 1988 to 1993. During this period the herd was not submitted to any kind of intervention (antibiotic therapy, immunoprophylaxis or rodent control). Relative risks (RR) of return to heat, mummified fetuses, stillbirth, and weak newborn piglets for infected sows were assessed and the differences in means of total piglets born per litter, piglets born alive, piglets effectively housed, weaned piglets, stillbirths, mummified fetuses, weak newborn piglets, weight at birth of the piglets effectively housed, weight at 21 days of life and weight at weaning were evaluated. Seropositive dams had a greater risk of having weak newborn piglets (RR = 1.67, 1.02 < or = CI 95% < or = 2.72) and also of having more weak newborn piglets per litter (P = 0.01). Other variables examined were not different (P > 0.05).

Aging↗

Peroxy radical oxidation of thymidine.

The peroxy radical (ROO) is unique among reactive oxygen species implicated in the production of DNA damage in that it possesses an extremely long half-life (order of seconds) and is predicted to have a relatively greater chemical selectivity in its reactions relative to other radical intermediates. Yet no product studies of the reactions of ROO with bases, nucleosides, or DNA have appeared, and thus no meaningful predictions can be made regarding its potential involvement in the production of DNA base damage and the mutagenic process. We report here on the reaction products formed by peroxy radical with thymidine, major target of oxidative base damage. ROO reacts with thymine to yield predominantly 5-Me oxidation products. The highly mutagenic 5-(hydroperoxymethyl)-2'-deoxyuridine, 5-formyl-2'-deoxyuridine, and 5-(hydroxymethyl)-2'-deoxyuridine are produced by peroxy radical oxidation. In contrast, 5Me oxidation products are minor products of thymidine oxidation by OH, which yields predominantly saturated derivatives via addition to the 5,6 double bound. A plausible mechanistic scheme for the formation of the base oxidation products of thymidine by peroxy radicals is presented. Attach at the deoxyribose moiety resulting in oxidative depyrimidination is also found to occur, as indicated by free base release. Phosphodiester backbone cleavage resulting in single and double strand breaks is also catalyzed by peroxy radical, as demonstrated using a plasmid nicking assay.

DNA Damage↗

[Troponin T, Troponin I and CK-MB (mass) in the detection of periprocedural myocardial damage after coronary angioplasty].

The development of methods for the detection of circulating CK-MB mass, cardiac troponin T (cTn-T) and troponin I (cTn-I) has increased the diagnostic potential in the identification of myocardial damage. Coronary angioplasty (PTCA) represents a widely accepted revascularization procedure and a clinical model of induced ischemia. Using these new biochemical markers, we evaluated the incidence and the clinico-procedural correlates of minor myocardial damage (MMD) in a series of patients treated with PTCA in our Department. In 57 consecutive patients (75% males; mean age 58 years; range 35-80) undergoing elective PTCA from March 1 to June 30, 1995, serum levels of CK-MB mass, cTn-T and cTn-I were measured at baseline and at 6, 12 and 24 hours after the procedure. Seventy-eight coronary stenoses were dilated (mean 1.4 lesion/patient), 17 of these were in infarct-related vessels; 8 were total occlusions and 2 were located in saphenous vein grafts. Twenty-two procedures were completed by coronary stenting (17 elective). cTn-T and cTn-I were considered abnormal when serum levels were > 0.2 ng/ml and > 0.6 ng/ml, respectively. CK-MB mass was also determined in all patients (abnormal > 5 ng/ml). No patients had clinical or electrocardiographic evidence of myocardial infarction after the procedure. Overall, 16 patients (28%) developed biochemical evidence of post-procedural MMD (defined as the presence of at least one abnormal sample of any among the three markers tested). Four (7%) had abnormal CK-MB mass (at least one sample), 9 (16%) abnormal cTn-T, and 15 (26%) abnormal cTn-I. When CK-MB mass was elevated, both cardiac troponins were also elevated. In patients positive for MMD and abnormal CK-MB mass, peak cTn-I was significantly higher than in patients with normal CK-MB (3.02 +/- 1.07 vs 1.02 +/- 0.11 ng/ml; p = 0.009). The difference was not evident when comparing the same groups of patients for cTn-T (0.26 +/- 0.04 vs 0.18 +/- 0.10 ng/ml; p = 0.16). Also, peak cTn-I but not peak cTn-T had a positive correlation with peak CK-MB mass (r = 0.89; p < 0.0001 and r = 0.23; p = 0.40). The elevation of either marker of MMD was not related to clinical, angiographic or procedural variables. A possible interpretation for MMD was found in 2/3 of cases: bail-out (2); late occlusion (1); minor side branch occlusion (3); distal embolization from saphenous vein grafts (2) or total occlusions (2). In our series, MMD after PTCA occurs in 28% of cases and is unrelated to clinical, angiographic and procedural variables. Both cTn-T and cTn-I increase the sensitivity of CK-MB mass in the detection of MMD after PTCA, cTn-I being the most sensitive marker. In about 1/3 of cases, the presence of MMD remains unexplained. The prognostic implications of MMD are as yet undefined.

Adult↗