Biomedical subjects

Silvia Romano

Publications and source records attributed to Silvia Romano.

6 recordsLinked to original sources

PubMed2005

Autonomic modulation and clinical outcome in patients with chronic heart failure.

OBJECTIVE: Several studies documented the relevance of autonomic activity in the pathophysiology of heart failure. In our study we evaluated the adjustment of this activity under different stimuli, by means of heart rate variability (HRV), and correlated these findings with long-term mortality and sustained VT occurrence. PATIENTS AND METHOD: Fifty-three patients (mean age 54+/-9 years) with heart failure were submitted to time and frequency domain HRV analysis. This latter analysis was performed at rest, during paced breathing and during passive tilt. RESULTS: Lower standard deviation of RR intervals (76.76+/-24 versus 107.70+/-43, p=0.02), mean of the 5-min standard deviations of RR intervals (35.14+/-15 versus 62.39, p<0.01), standard deviation of the 5-min average RR intervals (69.42+/-19 versus 91.79+/-30, p=0.02), and baseline Low-Frequency (LF) power (15.15+/-12 versus 40.39+/-24 nu, p=0.001) characterized patients who died. Paced breathing induced a significant reduction of LF (40.39+/-24 to 20.12+/-18 nu, p<0.0001) and increase of High Frequency power (HF) (47.31+/-23 to 70.63+/-16 nu, p<0.0001) in survivors, while tilting induced a reduction of HF (47.31+/-23 to 29.80+/-16 nu, p<0.0001). Patients who died did not show significant variation of HRV neither during paced breathing nor during tilt. Reduced time domain indexes were significantly correlated to sustained VT occurrence. CONCLUSIONS: Patients with heart failure with a better prognosis are characterized by a responsiveness of autonomic modulation. Simple maneuvers, such as tilting and paced breathing, seem to provide more useful information, than the baseline evaluation of autonomic status, in identifying patients with a higher mortality. Time domain analysis was more helpful to estimate arrhythmic risk.

Adult↗

PubMed2004

Cerebrospinal fluid isoprostanes are not related to inflammatory activity in relapsing-remitting multiple sclerosis.

Oxidative stress leads to lipid peroxidation and may contribute to the pathogenesis of lesions in multiple sclerosis (MS), an autoimmune disease characterised by inflammatory as well as degenerative phenomena. We previously found that cerebrospinal fluid (CSF) levels of isoprostane 8-epi-PGF2alpha, a marker of free radical damage and lipid peroxidation in vivo, were elevated in MS patients. Such levels were correlated with the degree of disability and reduced in subjects under steroid therapy. Here we investigated weather the CSF isoprostane levels correlated with disease inflammatory activity. To this aim, we enrolled 41 relapsing-remitting (RR) MS patients who underwent at the same time full neurological examination, NMR-imaging brain scan and diagnostic CSF test. No evidence of correlation was found between 8-epi-PGF2alpha levels and the presence of gadolinium (Gd)-enhancing NMR lesions or the time elapsed since the last relapse. We suggest that isoprostanes are not useful as surrogate inflammatory markers in MS. However, they may represent a sensitive index of degenerative phenomena, which can persist also in the absence of inflammatory activity.

Adolescent↗

PubMed2004

Corticosteroids treatment.

Corticosteroids (Cs) are widely used for treatment of multiple sclerosis (MS) acute relapses because of the potent immunosuppressive and anti-inflammatory properties. As for patients with relapsing-remitting (RR) MS, short-term administrations of Cs markedly less severity of symptoms and promote faster recovery of clinical attacks. Chronic administrations of Cs significantly diminish the formation of T1 hypointense lesions and the progression of brain atrophy. As for patients with secondary progressive MS treatment with Cs delays the time to onset of sustained disability. Finally the association between methylprednisolone and interferon beta (IFNbeta) leads the recovery of active lesions at greater extent and reduces the formation of neutralizing antibodies (NABs) against IFNbeta in patients with RRMS.

Adrenal Cortex Hormones↗

PubMed2002

Effect of renal artery stenting on the progression of renovascular renal failure: a case of intravascular ultrasound-confirmed renovascular disease.

We report the case of a 71-year-old male, submitted to percutaneous transluminal renal angioplasty (PTA) plus stent implantation following the confirmation, at intravascular ultrasound, of severe unilateral renal artery stenosis in the setting of a single functional kidney and of evidence of renal insufficiency (serum creatinine value 300 mumol/l). At 6 months of follow-up the serum creatinine levels had returned to normal (98 mumol/l). This case shows the role of direct PTA on the overall renal function in a case of global renal ischemia.

Aged↗

PubMedDate not supplied

Noninvasive evaluation of a fistula between a giant coronary aneurysm and coronary sinus performed via multidetector row computed tomography.

Coronary artery fistula (CAF) is an uncommon anomaly of congenital and rarely iatrogenic etiology. Most of the patients are asymptomatic, and the anomaly is incidentally recognized during a coronary angiography performed for other reasons. Also, coronary artery aneurysms are rare. We report a case of CAF associated with a giant aneurysm evaluated using multidetector row computed tomography.

Aged↗

PubMedDate not supplied

Epidemiology and current treatment of multiple sclerosis in Europe today.

Multiple sclerosis (MS) is a chronic disease affecting the central nervous system, usually leading to early disablement in young adults. At least 350,000 persons in Europe have the disease. Wide variations exist both between and within European countries in the incidence and prevalence of the disease as well as in the general standard of care for MS patients. The needs, well-being, and social participation of people with MS are systematically influenced by their physical and cultural environment and the nature of the community services. Moreover, the rate of introduction of the new disease-modifying therapy also widely differs from country to country. This article helps clinical researchers to understand better the differences in epidemiology and in the current treatment of MS in Europe.

Combined Modality Therapy↗