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Biomedical subjects

R Marino

Publications and source records attributed to R Marino.

At least 19 recordsLinked to original sources
PubMed2006

Posttraumatic cerebral infarction in patients with moderate or severe head trauma.

OBJECTIVE: To evaluate the frequency, types, and location of posttraumatic cerebral infarction, to assess if secondary cerebral insults were associated with cerebral infarction, and to determine if cerebral infarction affected patients' outcome. METHODS: We based diagnosis of cerebral infarction on review of brain CT scans. We assessed frequency of secondary cerebral insults, including intracranial hypertension, cerebral hypoperfusion, systolic hypo- and hypertension, arterial blood oxygen desaturation, hypocapnia, and hyperthermia, using clinical charts. We used the Glasgow Outcome Scale to evaluate outcome at 6 months after trauma. RESULTS: Of the 89 patients included, a total of 28 cerebral infarctions were found in 17 cases (19.1%). Infarctions were territorial in 23 (82.1%) and watershed in 5 (17.9%) cases. Territorial infarctions were localized to the middle cerebral artery (n = 9, 32.1%), lenticulostriate arteries (n = 6, 21.4%), posterior cerebral artery (n = 3, 10.7%), anterior cerebral artery (n = 3, 10.7%), thalamoperforating arteries (n = 1, 3.6%), and basilar artery (n = 1, 3.6%) territories. Watershed infarctions were in the boundary (n = 4, 14.3%) and terminal (n = 1, 3.6%) zones. Intracranial hypertension was the only independent variable predicting cerebral infarction (odds ratio [OR] 13.3; 95% CI 2.8 to 62.6). At 6 months after trauma, there was a lower proportion of patients with good outcome among patients with cerebral infarction vs patients without (23.5 and 61.1%; p = 0.005). Cerebral infarction was the only independent predictor of 6-month outcome (OR of good outcome 0.19, 95% CI 0.06 to 0.66). CONCLUSIONS: The risk of developing posttraumatic cerebral infarction may be higher in patients with intracranial hypertension than in those without. Patients with posttraumatic cerebral infarction may be at increased risk of residual disability.

Adult↗
PubMed2006

Unexpected peripheral markers of thyroid function in a patient with a novel mutation of the MCT8 thyroid hormone transporter gene.

The specific thyroid hormone transporter, MCT8, located on the X chromosome, has led to the identification a novel syndrome. The objective is to relate phenotype with several tissue-specific thyroid functions. A 1-year-old boy, who had severe psychological damage and low serum T4, had received l-T4 for 3 months. At admission, body length was normal but weight was low. Off therapy, serum TSH was mildly elevated, serum T4 and free T4 were low, and serum T3 and free T3 were high. Direct sequencing of the MCT8 gene revealed a single nucleotide change that resulted in a novel nonsense mutation at codon 261 (Q261X) in exon 3. Since serum T3 was high, peripheral markers of hyperthyroidism were looked for. Bone age was advanced, despite the presence of malnutrition and low T4. Serum SHBG, a marker of thyroid hormone action in liver, was markedly elevated. Markers of skeletal muscle catabolism, ammonemia and lactic acid, were found to be elevated. The phenotype of MCT 8 mutation might be explained by differences in the entry of thyroid hormones into different cells. In the presence of an inactive MCT8 transporter, the high blood T3 levels might not be enough to prevent brain damage early in life, while they seem to be able to induce a postnatal state of peripheral hyperthyroidism in other tissues, such as liver, bone and skeletal muscle.

Age Determination by Skeleton↗
PubMed2006

Dose dependency of the serum bio/immuno GH ratio in children during pharmacological secretion tests.

Dissociation between GH bioactivity (bio-GH) and GH immunoactivity (immuno-GH) is due to the heterogeneity of the molecule: the measurements do not always provide reliable information on the bio-GH. We studied the ratio of bio-GH and immuno-GH during pharmacological secretion tests in 211 sera to study the concentration-response curve of the assay (C1), 16 samples of normally growing subjects with idiopathic short stature (C2), 13 samples from patients with GH deficiency (GHD1) and 6 samples of 3 patients with GHD and normal provocative tests (GHD2). GH bioactivity was determined by the Nb2 cell proliferation assay (bio-GH) and immuno-GH by a time-resolved immunofluorometric assay (IFMA) (immuno-GH). A non-linear negative relationship between the serum bio-GH/immuno-GH ratio and serum immuno-GH was observed in C1. In log-log plotting representation, two cut-off lines were drawn: a vertical cut-off line separating above-below cut-off serum peak immuno-GH values in provocative tests, and a diagonal cut-off line separating normal-abnormal serum bio-GH/immunoGH ratio; four areas were defined. GHD1 had normal ratios, but below cut-off peak immuno-GH responses. P2 and P3 of Group GHD2 had abnormal ratios in samples with low serum immuno-GH but only P2 had autosomal dominant mutation. P1 had the same autosomal dominant isolated GHD as P2 but a low normal ratio. Our data underline the importance of relatively low serum GH concentrations in mediating GH biological actions. An abnormal serum bio-GH/immuno-GH ratio might explain certain cases of GHD and might be useful in detecting abnormal circulating isoforms of GH in patients with growth failure.

Adolescent↗
PubMed2006

Patient's quality of life and hearing outcomes after stapes surgery.

OBJECTIVES: To determine the quality of life (QOL) after stapes surgery and whether audiological parameters for hearing correlate with specific QOL factors. DESIGN: A retrospective cross-sectional study. SETTING: A tertiary referral centre. PARTICIPANTS: A series of 35 patients who underwent stapes surgery of which three were excluded because they were <18 years of age, chronically or mentally ill, or in a dependant relationship. Response rate was 93% (30/32). Nine were further excluded because they had revision or bilateral surgery, or missing data. Twenty-one patients were included in this study. MAIN OUTCOME MEASURES: The Glasgow Benefit Inventory (GBI) was used to evaluate general QOL and the Hearing Disability and Handicap Scale (HDHS) was used as a disease-specific measure. The Belfast Rule of Thumb and Glasgow Benefit Plot assessed hearing outcomes. RESULTS: Operative success was 86% using the Belfast Rule of Thumb and 95% had closure of the air-bone gap to within 20 dB. 81.8% of patients reported a better overall QOL as surgery. Glasgow Benefit Inventory Social and GBI Physical scores correlated positively with the HDHS speech component (P < 0.05). The duration of hearing loss correlated inversely with the average HDHS score (P < 0.05). CONCLUSION: The majority of patients report a better QOL as undergoing stapes surgery. Speech impacts on people's physical and social QOL of patients. Quality of life tools, in addition to objective audiologic measurements can provide clinicians with patients' subjective perspective that helps guide clinical decision-making and counselling.

Activities of Daily Living↗
PubMed2005

Clinical outcome and olanzapine plasma levels in acute schizophrenia.

PURPOSE: This open label study was performed to evaluate the relationship between the plasma concentration of olanzapine and the response in acute schizophrenic inpatients. MATERIAL AND METHODS: A total of 54 inpatients, 38 males and 16 females, age ranging from 18 to 75 years, affected by Schizophrenia (DSM IV criteria) during an exacerbation phase were included in the study. Olanzapine (OLZ) was started at a dose of 5-20 mg/day and was increased to a mean dose of 15.27 mg +/-5.53 S.D. Patients were evaluated at baseline, and after 2 weeks, by using BPRS, PANNS, HRS-D, EPSE, and ACS. RESULTS: BPRS and total PANSS showed a statistically significant improvement at the end of the study. Olanzapine plasma levels (PL) ranged from 5 to 120 ng/ml (mean 33.15 ng/ml +/- 28.28 S.D.) and showed a positive correlation with OLZ dosage. A significant curvilinear correlation between OLZ PL and clinical improvement (BPRS, PANSS and HRS-D percent of amelioration) was observed. CONCLUSION: Olanzapine plasma level determination seems to be a useful tool in optimizing acute treatment particularly for more problematic cases.

Acute Disease↗
PubMed2004

Effects of somatic cell count and stage of lactation on the plasmin activity and cheese-making properties of ewe milk.

The experiment was conducted from March to July 2002 using 5 intensively managed flocks of Southern Italy. In each flock, 2 groups of 50 ewes were created. The groups were designated LSCC (low somatic cell count [SCC]) when their milk SCC was lower than 500,000/mL and HSCC (high SCC) when their milk SCC was higher than 1,000,000/mL. Bulk milk and whey samples were analyzed for fat, total protein, lactose, casein, and whey protein contents. Renneting properties of milk were also determined. Moisture, NaCl, and nitrogen fractions were determined in fresh cheese curds. In addition, plasmin (PL) and plasminogen (PG) activities in milk and cheese were monitored. The proteolytic activity of plasmin by urea-polyacrylamide gel electrophoresis and the white blood cell (WBC) differentials were determined. The HSCC resulted in higher pH values in milk and in higher moisture and lower fat contents in fresh cheese curds. Moreover, a lower recovery of fat and whey proteins was obtained from the HSCC than from the LSCC raw milk. The crude protein and casein contents were higher in the HSCC than in the LSCC curds during early and midlactation; an opposite trend was observed in late lactation. Plasmin and PG activities underwent more marked fluctuations in the LSCC than in the HSCC curds through lactation. The results of this experiment demonstrate that the PL activity in ewe milk is markedly influenced by the SCC, although SCC is not the only parameter for predicting PL and PG evolution in ewe milk. The LSCC milk resulted in a higher proteolytic potential of Canestrato pugliese cheese curds.

Animals↗
PubMed2003

Ventilation effects on air quality and on the yield and quality of ewe milk in winter.

The effects of ventilation on air quality, and on the welfare and production performance of dairy ewes were assessed in a 6-wk trial conducted during the winter of 2002. Thirty-six midlactation Comisana ewes were divided into three groups of 12, which were randomly balanced for parity, time of lambing, and number of lambs suckled. Treatments were low (LOV), moderate (MOV), and programmed ventilation regimen (PROV). In LOV and MOV rooms, fans provided 10 ventilation cycles of 40 min each at a fan speed of 1 and 2 m/s, respectively. In the PROV room, the fan was programmed to maintain a 70% relative humidity. Mean ventilation rates were 23, 47, and 73 m3/h per ewe in LOV, MOV, and PROV rooms, respectively. Air concentrations of microorganisms and dust, and of gaseous pollutants were measured twice weekly. Cell-mediated immune response to phytohemagglutinin at d 1, 21 and 42, and humoral response to chicken egg albumin at d 11, 21, 30, and 40 were determined. At d 39, ewes were injected with 2 IU of porcine adreno-corticotropic-hormone/kg body weight(0.75), and subjected to blood sampling for evaluation of cortisol concentrations immediately before and 1, 2, and 4 h after adreno-corticotrophic-hormone injection. Milk yield was recorded daily. Individual milk samples were analyzed weekly for composition, renneting parameters, and somatic cell count. The LOV treatment resulted in higher air concentrations of NH3 and CO2 than the MOV and PROV treatments. Greater amounts of total and respirable dust were found in the PROV room than in the LOV and the MOV rooms. The LOV ewes had lower milk yield than the PROV ewes, lower milk casein content, and higher rate of clot formation than the MOV and PROV ewes. The ventilation regimen did not affect the immune and endocrine responses of the ewes. Results suggest that an intermittent ventilation regimen, providing a mean ventilation rate of 47 m3/h per ewe at a fan speed of 2 m/s, is required to sustain the yield and cheese-making ability of ewe milk during the winter season.

Air Microbiology↗
PubMed2003

Bedside burr hole for intracranial pressure monitoring performed by anaesthetist-intensive care physicians. Extending the practice to the entire ICU team.

BACKGROUND: To evaluate the effects of extending the practice of bedside burr hole for intracranial pressure (ICP) monitoring to the entire ICU team. METHODS DESIGN: a 10-year observational cohort study. SETTING: A general-neurologic 12-bed ICU of a University Hospital with 10 full-time specialists in anaesthesia-intensive care. PATIENTS: patients admitted for acute neurologic lesions requiring ICP monitoring. MEASUREMENTS: ICP monitoring was performed by means of intraparenchymal fiberoptic cathe-ters. Rates of successfully performed procedures and complications were compared between 2 study periods: January 1990 - August 1997, in which the procedure was performed by 2 experienced physicians (group 1), and September 1997-July 2000 in which the procedure was extended to the entire team (group 2). RESULTS: Two hundred and seventy patients had 293 catheters positioned (group 1=180; 2=113). The procedure was successfully performed in all cases. Occurrence of complications was similar in the 2 groups: minor surgical wound infections (3.3%; 2.6%); meningitis (0.5%; 0); scalp (3.9%; 2.6%) and dural (5.0%; 6.2%) bleeding; intracranial haematoma (1.1%; 1.8%). Two of these latter (1 for each group) required surgical evacuation. Twelve anaesthetist-intensive care physicians were trained, and they were able to perform burr hole for ICP monitoring without help after 2-3 assisted procedures. CONCLUSIONS: Extending the practice of ICP monitoring to the entire ICU team is safe and feasible. To decide whether or not to implement this technique, one should consider the high costs on one side and prompt availability of ICP monitoring on the other. Haemorrhagic and infectious complications are comparable to those of neurosurgical series.

Catheterization↗
PubMed2002

Sustained release of low-dose ganciclovir from a silicone formulation prolonged the survival of rats with gliosarcomas under herpes simplex virus thymidine kinase suicide gene therapy.

A silicone formulation of ganciclovir (GCV-pellet) was developed to enhance the cytotoxic effects of herpes simplex virus thymidine kinase suicide gene therapy. The effectiveness of this drug delivery system was assessed in a rat 9L gliosarcoma model. The GCV-pellets (1 mm in length and in diameter) used in this experiment contained a total amount of 0.15 mg of GCV. In vitro experiments demonstrated that GCV was gradually released over a period of 7 days. Five days after stereotactic tumor inoculation into the right caudate nucleus, a herpes simplex virus type 1 (HSV-1) vector expressing herpes simplex virus thymidine kinase (HSV-tk) (T1, 2x10(6) pfu) was administered at the same location. The survival rate of the group treated with the GCV-pellet was compared with that of the T1 group injected intraperitoneally (IP) with GCV (30 mg/kg/day for 7 days). The GCV-pellet-treated group had a significantly prolonged survival (a median of more than 80 days) compared with the GCV IP group (a median of 65 days) and with control groups (P<0.05). The control groups (untreated or receiving only the virus vector) had a survival of 35-38 days. The survival rate of the GCV-pellet group over 80 days was 75%, and all the rats that survived more than 80 days and did not show tumors upon histological examination of the brain were deemed cured. No toxic effects or immunological reactions were observed histologically around the pellet in brain sections from the rats treated with the GCV-pellet. After GCV-pellet inoculation into the tumor, drug concentrations were kept at 1-10 microg/g tissue for 3-4 days. When the same dose of GCV (0.15 mg) in aqueous solution was injected into the tumor, GCV concentrations reached a peak of 0.5 mg/g tissue after 30 min and decreased below measurable level within 12 h. After IP injections of 3 mg GCV, GCV concentrations in the tumor reached a peak of 5.7 microg/g tissue after 30 min and also decreased below measurable level within 12 h. This sustained release of a low and effective GCV dose with the silicone formulation significantly prolonged survival in combinations with HSV-tk expression if compared to IP administration of GCV. Histological examination suggests that the treatment appears to be safe.

Animals↗
PubMed2002

Serotonin transporter gene promoter variants do not explain the hyperserotoninemia in autistic children.

Autism is a biologically-heterogeneous disease. Distinct subgroups of autistic patients may be marked by intermediate phenotypes, such as elevated serotonin (5-HT) blood levels, potentially associated with different underlying disease mechanisms. This could lead to inconsistent genetic association results, such as those of prior studies on serotonin transporter (5-HTT) gene promoter variants and autistic disorder. Contributions of 5-HTT gene promoter alleles to 5-HT blood levels were thus investigated in 134 autistic patients and 291 first-degree relatives. Mean 5-HT blood levels are 11% higher in autistic patients carrying the L/L genotype, compared to patients with the S/S or S/L genotype; this trend is not observed in first-degree relatives. The probability of inheriting L or S alleles is significantly enhanced in patients with 5-HT blood levels above or below the mean, respectively (P < 0.05), but quantitative TDT analyses yield a non-significant trend (P = 0.10), as this polymorphism explains only 2.5% of the variance in 5-HT blood levels of autistic patients. In conclusion, 5-HTT gene promoter variants seemingly exert a small effect on 5-HT blood levels in autistic children, which largely does not account for hyperserotoninemia. Nonetheless, the inconsistent outcome of prior association studies could partly stem from a selection bias of hyper- or hypo-serotoninemic probands.

Autistic Disorder↗
PubMed2002

Activity profile in multiple sclerosis: an integrative approach. A preliminary report.

In order to define an activity profile in patients with multiple sclerosis (MS), T-cell subpopulations and proliferative responses to myelin basic protein (MBP) associated with anti-MBP antibodies, nitrotyrosine levels in serum and cerebrospinal fluid (CSF), and serum CD40L (sCD154) were simultaneously assessed in 29 consecutive and untreated MS patients. When compared to controls, patients in secondary progressive stable (SP/I), or in full remission (RR/I) stages, individuals with secondary progressive active disease (SPIA) or in acute relapse (RR/A) showed a significant decrease of CD4/CD45RA+ T cells associated with an increase of absolute numbers of CD4/45R0+ T cells (p < 0.001). In addition, in vitro-specific T-cell proliferative responses against MBP (SP/A, RR/A, SP/I: p < 0.001 versus controls) in association with augmented sCD154 serum levels (SP/A, RR/A, versus controls p < 0.001) and a significant increase of both CSF and serum levels of anti-MBP antibodies and nitrotyrosine levels (p < 0.001) were also found. Thus, the simultaneous evaluation of antibody and cell-mediated immunopathological parameters, along with the effector mediators of inflammation such as the nitric oxide products, offers a new integrative approach to characterize markers of clinical activity in MS patients, which may be used at the moment of the initial diagnosis and during an apparent recurrences of the disease to monitor therapeutic protocols and to determine whether immune-based nerve destruction mechanisms are still operating in patients with few clinical findings.

Adolescent↗
PubMed2002

Effects of ventilation regimen on the welfare and performance of lactating ewes in summer.

A 6-wk trial was performed with thirty-six lactating Comisana ewes during the summer of 2001. The animals were divided into three groups of 12, which were designated low (LVR), moderate (MVR), and programmed (PROGR) ventilation regimens. In LVR and MVR rooms, fans provided 10 ventilation cycles of 12.5 and 25 min/h, respectively, whereas in the PROGR room, the fan was programmed to operate at 30 degrees C air temperature and 70% relative humidity. Mean ventilation rates were 33, 66, and 173 m3/h per ewe in LVR, MVR, and PROGR rooms. Air concentrations of microorganisms and dust and of gaseous pollutants were measured twice weekly. Respiration rate and rectal temperature were monitored throughout the trial at 1430. Behavioral traits of ewes were recorded once per week from 0930 to 1230. Cell-mediated immune response to phytohemagglutinin at d 3, 20, and 40 and humoral response to chicken egg albumin at d 11, 21, 30, and 40 were determined. At d 37, ewes were injected with 2 IU porcine ACTH/kg body weight(0.75) and subjected to blood sampling for evaluation of cortisol concentrations immediately before and 1, 2, and 4 h after ACTH injection. Milk yield was recorded daily. Individual milk samples were analyzed weekly for composition and renneting parameters and fortnightly for bacteriological characteristics. Averages of temperature-humidity index values were 78.9, 76.8, and 74.5 in LVR, MVR, and PROGR rooms, respectively. The LVR and MVR treatments resulted in higher NH3 and CO2 air concentrations than PROGR treatment (P < 0.05). The LVR and MVR ewes had higher rectal temperatures than PROGR ewes (P = 0.001). LVR animals also exhibited higher idling compared to PROGR (P < 0.01) and lower feeding times than MVR (P < 0.05) and PROGR animals (P < 0.01). Ewes under the LVR treatment displayed significant lower averages of antibody titers and higher plasma cortisol levels than PROGR (P < 0.01) and MVR ewes (P < 0.05) 60 min after ACTH injection. The LVR treatment resulted in lower yields of milk (P < 0.01) and reduced feed efficiency (P < 0.01) than PROGR treatment. Results suggest that a fan-ventilated system, providing ventilation cycles during the warmest hours of the day and the night at a mean ventilation rate of 66 m3/ewe per hour, may sustain the performance and welfare in lactating ewes raised in warm climates during summer. A ventilation regimen, programmed to operate over upper critical air temperature and relative humidity, may be economically unattractive under these conditions.

Air Microbiology↗
PubMed2001

Barrel pattern formation requires serotonin uptake by thalamocortical afferents, and not vesicular monoamine release.

Thalamocortical neurons innervating the barrel cortex in neonatal rodents transiently store serotonin (5-HT) in synaptic vesicles by expressing the plasma membrane serotonin transporter (5-HTT) and the vesicular monoamine transporter (VMAT2). 5-HTT knock-out (ko) mice reveal a nearly complete absence of 5-HT in the cerebral cortex by immunohistochemistry, and of barrels, both at P7 and adulthood. Quantitative electron microscopy reveals that 5-HTT ko affects neither the density of synapses nor the length of synaptic contacts in layer IV. VMAT2 ko mice, completely lacking activity-dependent vesicular release of monoamines including 5-HT, also show a complete lack of 5-HT in the cortex but display largely normal barrel fields, despite sometimes markedly reduced postnatal growth. Transient 5-HTT expression is thus required for barrel pattern formation, whereas activity-dependent vesicular 5-HT release is not.

Aging↗
PubMed2001

Guidelines for neurosurgical trauma in Brazil.

This chapter emphasizes some aspects of the Brazilian Guidelines for the Assessment of Head Injury Patients, written based on the experience of the Emergency Service, Neurosurgical Division of the University of São Paulo Medical School Hospital, and sponsored by the Brazilian Society of Neurosurgery. These guidelines approach the management of head-injury patients from their initial assessment in the Emergency Room until the final suggested clinical or surgical management. The Brazilian Guidelines represents our efforts to provide the basis for a common unified data collection system, which may allow cooperative studies in the future.

Brain Injuries↗
PubMed2001

Reelin gene alleles and haplotypes as a factor predisposing to autistic disorder.

Autistic disorder (MIM 209850) is currently viewed as a neurodevelopmental disease. Reelin plays a pivotal role in the development of laminar structures including the cerebral cortex, hippocampus, cerebellum and of several brainstem nuclei. Neuroanatomical evidence is consistent with Reelin involvement in autistic disorder. In this study, we describe several polymorphisms identified using RNA-SSCP and DNA sequencing. Association and linkage were assessed comparing 95 Italian patients to 186 ethnically-matched controls, and using the transmission/disequilibrium test and haplotype-based haplotype relative risk in 172 complete trios from 165 families collected in Italy and in the USA. Both case-control and family-based analyses yield a significant association between autistic disorder and a polymorphic GGC repeat located immediately 5' of the reelin gene (RELN) ATG initiator codon, as well as with specific haplotypes formed by this polymorphism with two single-base substitutions located in a splice junction in exon 6 and within exon 50. Triplet repeats located in 5' untranslated regions (5'UTRs) are indicative of strong transcriptional regulation. Our findings suggest that longer triplet repeats in the 5'UTR of the RELN gene confer vulnerability to autistic disorder.

Adult↗
PubMed2001

Social work intervention and failure to thrive in infants and children.

Failure to thrive (FTT) is a diagnostic term used to describe infants and children who fail to grow and develop at a normal rate. There has been limited literature focused on the role social workers play in working with children who fail to thrive. Because the focus of the current health care system is on using an interdisciplinary team approach, it is crucial that social workers make a place for themselves on treatment teams and continue to use their skills to provide comprehensive treatment. This article educates social workers about FTT and addresses the roles social workers have in the treatment of children who fail to thrive and how their services provide a therapeutic and team-oriented approach.

Adult↗