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Biomedical subjects

Massimo Franchini

Publications and source records attributed to Massimo Franchini.

At least 73 records · Page 4Linked to original sources
PubMed2005

Efficacy of Haemate-P as prophylaxis of recurrent bleeding in a patient with type 2B von Willebrand's disease.

We report the case of a 58-year-old woman with type 2B von Willebrand's disease who received regular infusions of the factor VIII/von Willebrand factor concentrate Haemate-P (2000 IU every other day) for 4 months to prevent recurrent bleeding from a malignant esophageal ulcer. Prophylaxis with Haemate-P was shown to be safe and effective in this patient, thus enabling completion of radiochemotherapy.

Esophageal Neoplasms↗
PubMed2005

Recombinant factor VIIa. An update on its clinical use.

Recombinant activated factor VII (rFVIIa, NovoSeven) has been successfully used to treat bleeding episodes in patients with antibodies against coagulation factors VIII and IX. In recent years, rFVIIa has also been employed for the management of uncontrolled bleeding in a number of congenital and acquired haemostatic abnormalities. Based on a literature search, this review examines the current knowledge on therapy with rFVIIa, from the now well-standardized uses to the newer and less well-characterised clinical applications.

Blood Coagulation Disorders↗
PubMed2005

Efficacy of platelet gel in reconstructive bone surgery.

Autologous platelet concentrate and cryoprecipitate, mixed to obtain a gel, have been successful in various operations, primarily oral and maxillofacial surgery. This study assessed the use of platelet gel in 19 patients undergoing 22 reconstructive bone surgical procedures. After a median follow-up of 12.9 months, improved osteoblastic reaction and reconstruction of physiologic bone structure was observed in all patients with no adverse reactions. These findings confirm the osteoinductive property of platelet gel in reconstructive bone surgery.

Adolescent↗
PubMed2005

Clinical heterogeneity of acquired hemophilia A: a description of 4 cases.

Acquired hemophilia A is a rare but severe auto-immune bleeding disorder characterized by the presence of autoantibodies directed against clotting factor VIII. Acquired hemophilia A may be idiopathic or associated with several conditions, such as postpartum, autoimmune diseases, malignancies or drugs. The treatment modalities of bleeding episodes and eradication of the factor VIII auto-antibody depend on the titer of anti-factor VIII:C and may include desmopressin (DDAVP), prednisolone, prednisolone-cyclophosphamide, high dose intravenous gammaglobulin, FVIII-VWF concentrate and/or recombinant FVIIa (rFVIIa). In this study we report four cases of autoimmune factor VIII inhibitors (2 associated with autoimmune disorders, 2 idiopathic) demonstrating the heterogeneity of this disease from pathogenic, clinical, therapeutic and prognostic points of view.

Autoantibodies↗
PubMed2005

Thrombosis and bleeding: when opposites are not so far apart.

Thrombotic events in patients with inherited bleeding disorders occur only rarely. However, in some cases, the co-existence of acquired or inherited prothrombotic risk factors may overcome the hypocoagulative state, modulating the clinical phenotype to a decrease in bleeding symptoms or even to an increase in the likelihood of developing thrombotic complications. This review summarizes the cases of thrombosis reported in the literature and analyzes the most important risk factors for thrombosis in patients with a congenital bleeding tendency. Data were identified by searches of the published literature, including PubMed, references from reviews and abstracts from the most important meetings on this topic. There is increasing evidence that thrombotic complications in patients with hereditary bleeding disorders have a multifactorial pathogenesis, depending on acquired (coagulation factor replacement therapy, central venous catheters, surgery, viral infections) and/or inherited (thrombophilic gene mutations) prothrombotic risk factors.

Blood Coagulation Disorders, Inherited↗
PubMed2005

[Inherited thrombophilia].

Inherited thrombophilia can be defined as a genetically determined predisposition to develop thromboembolic complications. Inherited prothrombotic risk factors include antithrombin deficiency, protein C and protein S deficiencies, activated protein C resistance due to Leiden factor V mutation, inherited hyperhomocysteinemia, prothrombin G20210A variant, dysfibrinogenemia and elevated factor VIII levels. In this review we briefly analyze, from an epidemiologic, clinic and diagnostic point of view, the main inherited prothrombotic risk factors. Finally, we discuss the synergism between genetic and acquired prothrombotic risk factors in some conditions such as pregnancy and cardiovascular diseases.

Humans↗
PubMed2005

[Helicobacter pylori infection and idiopathic thrombocytopenic purpura].

There are increasing data on the association between Helicobacter pylori infection and idiopathic thrombocytopenic purpura and the significant increase in platelet count after bacterial eradication. The aim of this review was to consider the studies so far published on Helicobacter pylori infection and idiopathic thrombocytopenic purpura in order to evaluate a possible correlation between these two conditions. A review of the literature showed that 306 out of the 524 patients investigated (54.8%) were positive for Helicobacter pylori infection and that the bacterium was eradicated in 83% of cases. Eradication therapy was accompanied by a complete or partial platelet response in approximately half the cases. Overall, these data show that Helicobacter pylori eradication in patients with idiopathic thrombocytopenic purpura is effective in increasing platelet count. However, since the studies so far published are few, sometimes controversial and involve small series of patients, further studies on larger numbers of patients with longer followup are needed to confirm these preliminary findings.

Helicobacter Infections↗
PubMed2005

[Autoimmune thrombocytopenia: diagnosis and treatment].

Idiopathic thrombocytopenic purpura (ITP) is an autoimmune disease characterized by an isolated, persistent thrombocytopenia in absence of known causes. In this review, we briefly analyze the most important diagnostic criteria of this autoimmune disorder, with particular consideration to differential diagnosis (false thrombocytopenia, congenital thrombocytopenia, acquired thrombocytopenia, pregnancy-associated thrombocytopenia) and to therapeutic options.

Autoimmune Diseases↗
PubMed2005

Inherited thrombophilia: an update.

Inherited thrombophilia can be defined as a genetically determined predisposition to develop thromboembolic complications. Inherited prothrombotic risk factors include antithrombin deficiency, protein C and protein S deficiencies, activated protein C resistance due to factor V Leiden mutation, inherited hyperhomocysteinemia, prothrombin G20210A variant, dys- and hyperfibrinogenemia and elevated factor VIII levels. In this review we briefly analyze, from an epidemiologic, laboratory and clinical point of view, the main inherited prothrombotic risk factors. Finally, we discuss the synergism between genetic and acquired prothrombotic risk factors in some conditions such as pregnancy and cardiovascular diseases.

Blood Coagulation Disorders, Inherited↗
PubMed2005

The platelet function analyzer (PFA-100): an update on its clinical use.

The platelet function analyzer, PFA-100, is a relatively new method which has been developed as a quantitative, simple and rapid in vitro tool of assessing primary hemostasis. The aim of this review is to summarize the published studies reporting on the utility of the PFA-100 device as a screening tool for primary hemostasis. Data were identified by searches of the published literature, including PubMed, references from reviews and abstracts from the most important meetings on this topic. The literature data document that the PFA-100 is a useful screening tool for the investigation of von Willebrand's disease and various acquired and congenital intrinsic platelet function disorders. It is also useful for evaluating primary hemostasis before surgical procedures and for monitoring desmopressin therapy in patients with type 1 von Willebrand's disease. Moreover, recent studies have shown its potential for therapeutic monitoring of the effectiveness of anti-platelet medications in cardiovascular disease management. Given its high sensitivity, speed and simplicity of use, we conclude that the PFA-100 could replace the in vivo bleeding time as a screening test for primary hemostasis in routine clinical practice.

Blood Platelet Disorders↗
PubMed2005

[Heparin-induced thrombocytopenia].

Heparin-induced thrombocytopenia is a serious and underestimated adverse drug effect. We briefly discuss the main features of heparin-induced thrombocytopenia, particularly analyzing the most recent advances in the pathophysiology, diagnosis and treatment of this syndrome.

Anticoagulants↗
PubMed2005

Remission of severe antiphospholipid syndrome associated with non-Hodgkin's B-cell lymphoma after combined treatment with rituximab and chemotherapy.

The association of lymphoid neoplasms and antiphospolipid antibodies (APA), with or without thromboembolic complications, has been reported in several cases. We describe one case of B-cell non-Hodgkinís lymphoma (NHL) in which the combination of rituximab with standard chemotherapy led to the complete remission of a severe hypercoagulable state associated with APA.

Antibodies, Monoclonal↗
PubMed2005

Pathophysiology, diagnosis and treatment of disseminated intravascular coagulation: an update.

Disseminated intravascular coagulation (DIC) is a disorder characterized by an acute generalized, widespread activation of coagulation, which results in thrombotic complications, due to the intravascular formation of fibrin, as well as diffuse hemorrhages, due to the consumption of platelets and coagulation factors. In this review, we briefly report the present knowledge about the pathophysiology and diagnosis of DIC. We also focus on the current standard treatment of overt DIC in clinical practice. Particular attention is given to novel therapeutic strategies, which reflect the important progresses made in the understanding of the pathogenesis of this disorder in the last few years.

Anticoagulants↗