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Biomedical subjects

M Testa

Publications and source records attributed to M Testa.

At least 55 records · Page 3Linked to original sources
PubMed1996

Circulating levels of cytokines and their endogenous modulators in patients with mild to severe congestive heart failure due to coronary artery disease or hypertension.

OBJECTIVES: This study sought to determine the circulating levels of cytokines and their respective endogenous modulators in patients with congestive heart failure of variable severity. BACKGROUND: Activation of immune elements localized in the heart or periphery, or both, may promote release of cytokines in patients with congestive heart failure. Although an increased circulating level of tumor necrosis factor-alpha (TNF-alpha) and its soluble receptor type II (sTNF-RII) is well documented, less is known about other cytokines (i.e., interleukin-1-beta [IL-1-beta], interleukin-6 [IL-6] and interleukin-2 [IL-2] and their soluble receptor/receptor antagonists). METHODS: Circulating levels of TNF-alpha and sTNF-RII, IL-1-beta, IL-1 receptor antagonist (IL-1-Ra), IL-6, IL-6 soluble receptor (IL-6-sR), IL-2 and IL-2 soluble receptor-alpha were measured using enzyme-linked immunosorbent assay kits (Quantikine, R&D Systems) in 80 patients with congestive heart failure due to coronary artery disease or hypertension. The severity of their symptoms, which ranged from New York Heart Association functional class I to IV, was confirmed by measurement of peak oxygen consumption. RESULTS: The percentage of patients with elevated levels of cytokines and their corresponding soluble receptor/receptor antagonists significantly increased with functional class. For TNF-alpha and IL-1-beta, the percentage of patients with elevated levels of soluble receptor/receptor antagonists was higher than that of patients with elevated levels of the cytokine itself. For IL-6, the percentage of patients with elevated levels of IL-6-sR tended to be lower than that of patients with elevated levels of IL-6. All but two patients had undetectable levels of IL-2, and all but seven had levels of IL-2-sR within a normal range. CONCLUSIONS: In patients with congestive heart failure, circulating levels of cytokines increased with the severity of symptoms. In these patients, circulating levels of sTNF-RII and IL-1-Ra are more sensitive markers of immune activation than are circulating levels of TNF-alpha and IL-1-beta, respectively. Levels of IL-2 and IL-2-sR are not elevated when congestive heart failure is due to coronary artery disease or hypertension.

Aged↗
PubMed1996

The lingual distalizer system.

Class II molar relationships can be corrected by several methods. In previous systems, orthodontic forces have been applied to crowns and distal movement of the first molar has mainly been by tipping and a rotation of the crowns. A new Lingual Distalizer (LD) has recently been developed to distalize the maxillary molars without the drawbacks of previous appliances. The lingual distalizer is relatively easy to insert, is well-tolerated, does not require patient co-operation and is aesthetic. It distalizes molars without loss of anchorage and moves them with bodily translation.

Adolescent↗
PubMed1996

Individual differences in perceived riskiness of drinking in pregnancy: antecedents and consequences.

OBJECTIVE: This study examined whether differences in perceived riskiness of alcohol consumption during pregnancy were related to self-reported alcohol consumption among a community sample of pregnant women. Further, this study examined the impact of prior experiences on risk perceptions, focusing on previous pregnancy experiences and on previous alcohol-related problems. METHOD: The hypothesized relationships among variables were tested simultaneously in a structural equation model. Subjects included 159 pregnant women, all of whom drank regularly before pregnancy recognition, who were recruited from prenatal clinics and through newspaper advertisements. RESULTS: Perceived riskiness of drinking during pregnancy was lower among women who had previously given birth to a healthy child and among women with greater numbers of previous alcohol problems. Prior adverse pregnancy experience did not predict perceived risk. Perceived risk negatively predicted actual alcohol consumption during pregnancy, suggesting that previous healthy pregnancy experiences and alcohol problems increase drinking in pregnancy indirectly, through perceived risk. A direct positive effect from previous alcohol problems to drinking in pregnancy also was observed. CONCLUSIONS: Findings suggest that risk perceptions play a role in drinking behavior among pregnant women and help to illuminate the relationship between parity and alcohol consumption. Interventions designed to reduce drinking among pregnant women, which have generally relied on providing information, may be improved by considering the impact of previous experiences and addressing erroneous beliefs.

Adolescent↗
PubMed1995

Allogeneic bone marrow transplantation from HBsAg+ donors: a multicenter study from the Gruppo Italiano Trapianto di Midollo Osseo (GITMO).

Hepatitis B virus (HBV)-infected individuals are occasionally used as donors for bone marrow transplantation (BMT). We studied the rate of HBV infection and the clinical expression of the associated liver disease in patients receiving marrow from HBsAg+ donors. We performed a retrospective survey in 14 BMT units in Italy in which all BMTs performed between 1984 and 1994 were reviewed and those involving HBsAg+ donors were identified. Donors and recipients were analyzed for HBV markers and liver disease. A total of 24 of 2,586 patients (0.9%) had received an HBsAg+ marrow. HBsAg became detectable in 22% of pre-BMT HBsAg- patients, but only 5.5% became chronic HBsAg carriers. Antigenemia developed more frequently in anti-HBs- compared with anti-HBs+ patients independently of passive prophylaxis with hyperimmune anti-HBs Ig, although the difference was not significant. Severe liver failure with death occurred in 21% of patients, which was a value greater than that generally observed after BMT in our units (3.7%). Patients with an anti-HBe+ donor had higher frequency of liver failure (28% v 0%) and alanine aminotransferase peaks as compared with those of patients with an HBeAg+ donor. Liver failure was not observed in anti-HBs+ recipients. The use of HBsAg+ donors, particularly if anti-HBe+, increases the risk of severe liver disease in BMT recipients. Anti-HBs positivity may prevent severe liver damage.

Adolescent↗
PubMed1995

Practical issues for the use of ACE inhibitors in acute myocardial infarction.

Numerous large, double-blind, randomized trials have demonstrated that, overall, angiotensin converting enzyme (ACE) inhibition improves survival of patients after acute myocardial infarction (AMI). However, several practical issues concerning ACE inhibition in the presence of AMI have not yet been answered. These include whether ACE inhibition should be initiated in all patients with AMI, how soon ACE inhibition should be attempted in relation to onset of pain and possibly thrombolysis, and, lastly, how long ACE inhibition should be maintained after the acute event. Each of these issues is addressed, and recommendations are made on the basis of the results from recent randomized trials in AMI and congestive heart failure.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1995

Hepatitis C virus infection and liver failure in patients undergoing allogeneic bone marrow transplantation.

The role of hepatitis C virus (HCV) infection in severe liver failure (LF) following bone marrow transplantation is still uncertain. We therefore decided to determine the presence of HCV-RNA in 31 patients who died of severe LF after BMT and in 26 matched BMT controls who did not develop LF. HCV-RNA was identified by polymerase chain reaction and anti-HCV by second generation enzyme-linked immunoassay and by 4-band recombinant immunoblotting assay in serum samples obtained before and after BMT. Biochemical and clinical parameters of liver disease were obtained by reviewing clinical records. LF developed at a median interval of 80 days (20-570) from transplantation and was clinically assessed as VOD (n = 7), liver GVHD (n = 5) or hepatitis (n = 19). HCV-RNA was detected, respectively, in 15/31 (48%) and in 12/26 (46%) of LF patients and controls (P = 0.9). Conversely, the risk of dying of LF was 62% and 53% (P = 0.5) respectively, for HCV-RNA positive and negative patients. Anti-HCV profile did not correlate with viremia, nor with type of liver disease. These findings indicate that, despite a 47% prevalence of HCV infection in our series, HCV-RNA positivity was neither a predictor of VOD nor a marker for life-threatening liver disease.

Adolescent↗
PubMed1994

Color Doppler study of mitral regurgitation during percutaneous transluminal coronary angioplasty.

Mitral regurgitation (MR) was evaluated by color Doppler echocardiography during percutaneous transluminal coronary angioplasty (PTCA) in 28 patients with one-vessel artery disease (left anterior descending artery in 11, right coronary artery in 8, and circumflex artery in 9) and normal left ventricular function. In all three groups, left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) decreased significantly during artery occlusion in comparison with baseline values (no differences among various groups). Anterior and inferior akinesia/dyskinesia was observed in all patients during left anterior descending and right coronary artery occlusion, respectively. Lateral akinesia/dyskinesia was induced by occlusion of the circumflex artery in six patients (all with proximal lesions [p < 0.05 vs the other two groups]) and the right coronary artery in one. Only the six patients with circumflex artery occlusion showed PTCA-related MR (> 2+ in two). LVEF and WMSI were similar during artery occlusion in patients with and without MR. Neither mitral leaflet prolapse nor anulus dilation occurred during PTCA in any of the patients. Our data show that during brief occlusion of the proximal circumflex artery, functional MR (usually mild) frequently occurs in relation to specific lateral akinesia/dyskinesia.

Acute Disease↗
PubMed1994

Psychopharmacology and abuse potential of transnasal butorphanol.

The effects of butorphanol administered by a nasal spray (transnasal, TN) and by intramuscular (IM) injection were compared to determine the onset of action, relative potency, profile of effects, and relative abuse liability of TN butorphanol. TN/IM placebo and TN and IM butorphanol (1, 2, and 4 mg) were tested in seven male opioid abusers not currently physically dependent on opioids using a double-blind, double-dummy, Latin square design. Measures of subjective, behavioral and physiological response were assessed. The onset and duration of action of butorphanol administered by the IM and TN routes were similar at low doses, but onset of TN butorphanol 4 mg was slower than that of 4 mg IM. IM butorphanol produced miosis, some opiate-like behavioral and subjective effects, and increasing dysphoric sedation and perceptual effects with increasing dose. TN and IM butorphanol 1 and 2 mg produced effects that were qualitatively and quantitatively similar; however, TN butorphanol 4 mg was less potent than 4 mg IM. Pharmacodynamic evidence suggests that the abuse potential of TN butorphanol is not different from that of IM butorphanol.

Administration, Intranasal↗
PubMed1993

Left atrial thrombus and spontaneous echo-contrast in nonanticoagulated mitral stenosis. A transesophageal echocardiographic study.

OBJECTIVE: The aim of the study was to investigate if evidence at transthoracic echocardiography (TTE) of left atrial (LA) thrombus and LA spontaneous echo-contrast (LA SEC), which are potential precursors of embolization, can be predicted by clinical and TTE variables in nonanticoagulated mitral valve stenosis (MS). DESIGN: Clinical (age, NYHA class, rhythm, previous embolization) and TTE variables were related to transesophageal echocardiography (TEE) evidence of LA thrombus and/or LA SEC. SETTING: Nonanticoagulated MS was the setting. PATIENTS: Fifty-nine patients had MS, and they were not receiving anticoagulant or antiplatelet therapy (24 in sinus rhythm and 35 in atrial fibrillation). Previous arterial embolization had occurred in 12 patients (20.3 percent). MEASUREMENTS: The following TTE variables were analyzed: mitral orifice area (pressure half-time method), mitral gradient (Bernouilli's equation), LA end-systolic area, and mitral regurgitation (color Doppler grading). LA thrombus and LA SEC were analyzed by monoplane TEE. RESULTS: LA thrombus was found by TEE in 12 patients (20.3 percent). Of these 12, 11 (91.6 percent) were in atrial fibrillation. LA SEC was found by TTE in 2 patients (3.5 percent) and by TEE in 40 (67.8 percent) (p < 0.001). Previous embolization had occurred only in patients with LA SEC, of whom 5 had and 7 did not have LA thrombus. Patients with LA SEC, compared with those without LA SEC, were characterized by more frequent advanced NYHA class, atrial fibrillation, smaller mitral valve area, and larger LA size. By multivariate regression analysis, atrial fibrillation and LA end-systolic area were factors related to both LA thrombus and LA SEC, whereas mitral area was related only to LA SEC. However, whereas LA SEC was accurately predicted by the presence of atrial fibrillation (sensitivity: 87.5 percent; specificity: 100 percent) and a LA area > or = 30 cm2 (sensitivity: 72.5 percent; specificity: 89.5 percent), among patients with LA SEC no clinical or TTE variable accurately identified those with actual LA thrombus. CONCLUSIONS: TEE is not necessary in many patients with MS in order to recognize LA SEC. However, when actual LA thrombus detection is necessary for clinical decision making, TEE should be performed.

Adult↗
PubMed1993

Interrelationships between victimization experiences and women's alcohol use.

The interrelationships between experiences of childhood victimization and the development of women's alcohol-related problems are explored. Two different forms of childhood victimization are examined: (1) parent-to-child violence and (2) childhood sexual abuse (familial and nonfamilial). Data were collected from 472 women between the ages of 18 and 45 during in-depth interviews. Women were grouped to allow for the following two sets of comparisons: comparison 1: alcoholics in alcoholism treatment (n = 98), drinking drivers (n = 100) and a household sample (without alcohol problems) (n = 82); comparison 2: women with alcohol problems in treatment (n = 178), women without alcohol problems in treatment (n = 92) and a household sample (n = 82). High rates of childhood victimization for women with alcohol problems suggest that there is a link between victimization and the development, specifically, of women's alcohol problems. The strength of the interrelationships between childhood victimization and the development of women's alcohol problems when holding the treatment condition constant is of particular interest in this study. The rates of childhood victimization were significantly greater for women with alcohol problems in treatment as compared to women without alcohol problems in treatment. Thus, even when holding the treatment condition and family background variables constant, childhood victimization has a specific connection to the development of women's alcohol problems. These findings remained significant even when controlling for demographic and family background differences, including parental alcohol problems.

Adolescent↗
PubMed1993

Doppler analysis of portal vein flow in tricuspid regurgitation.

Portal and hepatic vein flow-velocity profiles were examined by pulsed Doppler in 66 patients with tricuspid regurgitation (color Doppler grading: severe: 37, moderate: 18; mild: 11) and 20 normal subjects to determine if portal vein flow analysis is useful in the evaluation of tricuspid regurgitation. Portal vein flow was defined as one of the following categories: subcontinuous (dependent on respiration), pulsatile systolic (not inverted), inverted after systole, and continuous (not dependent on respiration). An index of portal vein flow pulsatility was also calculated. Standard classification of hepatic vein flow pattern was performed. Portal vein flow was pulsatile in 20% of normals subjects, and in 27.3% 44.5% and 51.3% of patients with respectively mild, moderate and severe tricuspid regurgitation; portal vein flow was inverted after systole in further 32.4% of patients with severe tricuspid regurgitation. Portal vein pulsatility index correlated with color Doppler grading of tricuspid regurgitation (r:0.63; p < 0.001) and right ventricle-atrium pressure gradient (r:0.39; p < 0.01). However, when compared with hepatic vein flow, both sensitivity and specificity of quantitative portal vein flow analysis was less reliable in diagnosing and grading tricuspid regurgitation. In particular, in patients with severe tricuspid regurgitation, the portal vein flow pattern was quite variable (pulsatile in 19 patients, inverted after systole in 12, and continuous in six). Liver biopsy was performed in nine patients, four of them with severe tricuspid regurgitation and continuous portal vein flow. Histology showed severe liver fibrosis in all four.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Choledocholithotomy and papillosphincterotomy in surgery of the bile ducts].

The Authors argue about the different surgical choices feasible in case of CBD stones. They consider a case-record of 74 patients that underwent, from January 1988 to June 1990, choledocholithotomy or transduodenal sphincterotomy for non-neoplastic pathology of the CBD in the I Divisione di Chirurgia Generale OO.RR. Bergamo. Analysis of the data shows a significant pre-operative alteration of the gamma-GT plasmatic levels. That represent a risk-index useful to suspect a silent CBD lithiasis. The good results attained with the choledocholithotomy and with the transduodenal sphincterotomy show the efficacy of both methods, that keep up different indications. The Authors point out the efficacy of the antibiotic prophylaxis in the prevention of the operative infections.

Common Bile Duct↗
PubMed1992

The moderating impact of social support following childhood sexual abuse.

The role of social support in moderating the impact of childhood sexual abuse on adult psychological adjustment was examined. Subjects included 475 women, age 18-45, some of whom were currently receiving treatment, others who were not. Women in the treatment group were receiving therapy for either alcoholism, for being battered, or for mental health problems. The comparison group was drawn from two sources: a random household sample and a sample of women attending drinking driver classes. Among both groups, women who had been sexually abused exhibited more psychological symptoms and lower self-esteem compared to those who were not abused. Latency of disclosure of childhood sexual abuse had no impact on long-term consequences of the abuse for either the treatment or the comparison group. However, among women in the comparison group, those who experienced supportive reactions following disclosure of sexual abuse had fewer psychological symptoms and somewhat higher self-esteem relative to those who did not receive support. Social support had no apparent effect on the long-term adjustment of women in the treatment group. Possible explanations for this pattern and directions for future research are discussed.

Adaptation, Psychological↗
PubMed1992

[Transcutaneous oximetry in symptomatic diabetics].

In a group of 33 patients affected by diabetes mellitus transcutaneous oxygen tension (PtcO2) was measured by means of a Clark polarographic electrode. Patients were divided into 3 groups according to the symptoms and/or to the clinical findings: group A: paresthesia (22 limbs); group B: claudication (6 limbs); group C: rest pain and/or necrosis (13 limbs). Moreover, group C was divided into: C1 trophic neuropathy lesion (7 limbs) and C2 trophic ischemic lesion (6 limbs). Our data point out that there is a statistically significant difference between mean PtcO2 values in limbs with trophic ischemic lesions versus the other 3 groups. Therefore, PtcO2 is particularly indicated and useful in the study of diabetic patients with peripheral vascular disease where integrates the other instrumental noninvasive techniques.

Arterial Occlusive Diseases↗