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Biomedical subjects

A Bellini

Publications and source records attributed to A Bellini.

At least 37 records · Page 2Linked to original sources
PubMed1996

Bone density in young patients with congenital adrenal hyperplasia.

One of the major complications of glucocorticoid treatment is bone loss. 21-Hydroxylase deficiency is the most frequent inborn error of steroidogenesis, leading to congenital adrenal hyperplasia (CAH): synthesis of cortisol is impaired and replacement therapy is therefore mandatory. We studied the bone mineral density in a group of patients with congenital adrenal hyperplasia (CAH) on long-term glucocorticoid replacement therapy. We selected 30 Caucasian patients with CAH due to 21-hydroxylase deficiency (mean +/- SD age = 17.45 +/- 2.49 years). 22 patients had the classical CAH form and the remaining 8 had the nonclassical (late-onset) form. The mean duration of therapy was 15.20 +/- 4.04 years. Bone mineral density (BMD) was evaluated with a dual-energy X-ray absorptiometer. BMD was also measured in 73 healthy white volunteers of comparable age (17.35 +/- 2.99 years). BMD values of the spine (sBMD), total body (TBBMD), legs, and arms of CAH patients, adjusted for confounding variables (age, gender, body mass index), did not differ from those of control subjects (p = 0.86; p = 0.17; p = 0.06 and p = 0.26, respectively). sBMD and TBBMD values did not show relationships with the duration of treatment and the dose of corticosteroids. Patients with the classical form of CAH had bone density values comparable with those of patients with the nonclassical form (sBMD: p = 0.33; TBBMD: p = 0.97). Our data show that, despite long-term treatment with glucocorticoids, CAH patients have bone density values comparable with controls.

Absorptiometry, Photon↗
PubMed1996

High-dose versus low-dose cisplatin in combination with cyclophosphamide and epidoxorubicin in suboptimal ovarian cancer: a randomized study of the Gruppo Oncologico Nord-Ovest.

PURPOSE: The aim of the study was to compare high-versus low-dose cisplatin in combination with cyclophosphamide and epidoxorubicin as primary chemotherapy for suboptimal stage III and IV ovarian cancer. PATIENTS AND METHODS: One hundred forty-five patients were randomized to receive six courses of cisplatin 50 or 100 mg/m2 plus epidoxorubicin 60 mg/m2 and cyclophosphamide 600 mg/m2. The two treatment arms were well balanced; all patients had greater than 2 cm and 37.2% had greater than 5 cm of residual disease; 29.6% had stage IV disease. RESULTS: Patients in the high-dose arm received a double dose-intensity and double total dose of cisplatin. The high-dose regimen induced significantly more episodes of leukopenia (47.8% v 32.8%, P = .05), thrombocytopenia (21.7% v 3.2%, P = .003), anemia (37.6% v 12.5%, P = .002), nephrotoxicity (six v one patient), and neurotoxicity (30.4% v 6.3%, P = .002). There were no significant differences in efficacy in terms of clinical response rate (high-dose 57.5% v low-dose 61.1%), pathologic complete response (CR) (9.6% v 18.1%), median survival times (29 v 24 months), and median progression-free survival (18 v 13 months). CONCLUSION: This study shows that doubling the dose-intensity and total dose of cisplatin in combination with epidoxorubicin and cyclophosphamide has significant toxic effects and does not improve clinical outcome in patients with suboptimal ovarian cancer.

Adult↗
PubMed1995

Bronchial epithelial cells of atopic patients with asthma lack the ability to inactivate allergens.

The cause of asthma is still unknown. Though most asthmatic patients are atopic, only certain atopic subjects develop this disease, and atopic asthmatics recover from asthma after transplantation of lungs from nonasthmatic donors. Thus, there might be a primary local defect in the bronchial wall which affects the expression of asthma in atopic individuals. We show here that the bronchial epithelial cells from atopic patients with asthma are aberrantly permeable to the airborne allergen most often implicated in the pathogenesis of this disease, indicating how it can have access to the antigen-presenting cells (dendritic cells) below the apical surface of the epithelium in vivo. In addition, allergen exposure induces asthmatic epithelial cells to express granulocyte/macrophage colony-stimulating factor, a cytokine involved in the proliferation and function of dendritic cells.

Allergens↗
PubMed1995

Bone mineral metabolism and thyroid replacement therapy in congenital hypothyroid infants and young children.

Impairment of calcium metabolism and low bone density have been found in hypothyroid adults. We investigated the effect of thyroid replacement therapy on calcium metabolism and bone mineralization in congenital hypothyroid (CH) infants and children. One hundred and 16 Caucasian CH consecutive patients were studied and were grouped according to their age: 23 patients at diagnosis, 20 at 3 mo, 24 at 6 mo, 25 at 12 mo and 24 at 36 mo. Thyroid replacement therapy was started at an initial dose of 6-8 micrograms/kg/day of L-thyroxine, and then decreased progressively. Calcium, phosphorus, magnesium, alkaline phosphatase (AP), parathyroid hormone (PTH) and osteocalcin (BGP) were measured as calcium metabolism indices. Bone mineral content (BMC) was measured at the mid-portion of the right radius AP, PTH and BGP concentrations were significantly higher in subjects at 3 mo of age (p < 0.05). This rise coincided with the end of the period of maximum dosage of L-thyroxine. Mild asymptomatic hypercalcemia was observed in 20 patients. All the other indices did not differ between age groups. BMC values and BMC annual increment were not different from those calculated for age-matched controls. We found that L-thyroxine replacement therapy does not alter bone mineralization of CH infants and children. Only a transitory increase of osteoblastic function was observed after the first few months of therapy.

Bone Density↗
PubMed1995

Constitutive expression of endothelin in bronchial epithelial cells of patients with symptomatic and asymptomatic asthma and modulation by histamine and interleukin-1.

BACKGROUND: An upregulation of endothelin-1 expression occurs in bronchial epithelial cells of asthmatic patients. This peptide may mediate bronchoconstriction in asthma, but the mechanisms that modulate endothelin-I synthesis and release are unknown. OBJECTIVE: This study was done to compare the pattern of endothelin-1 expression in patients with symptomatic and asymptomatic asthma and evaluate the ability of inflammatory factors to upregulate endothelin-1 synthesis and release in the epithelial cells of subjects who are free of symptoms. METHODS: Two groups of 10 asthmatic patients were selected. One group had symptomatic asthma with airflow obstruction and moderately to severely increased airway responsiveness. The second group was free of symptoms: they did not show airflow obstruction, and airway responsiveness was borderline or slightly increased. Bronchial biopsy specimens were obtained by means of bronchoscopy and used for immunohistochemical evaluation, epithelial cell isolation, and stimulation experiments with interleukin-1 and histamine. RESULTS: Endothelin-1 immunoreactivity was detected in vivo in the bronchial epithelial cells of all the patients with symptoms and in only two subjects without current symptoms. Incubation of bronchial epithelial cells from patients with asymptomatic asthma with interleukin-1 or histamine, for 8 to 24 hours, resulted in increased expression of endothelin-1 messenger RNA and release of appreciable amounts of the peptide to the culture medium. Those effects were dose- and time-dependent. Histamine and interleukin-1 were effective at concentrations similar to those detected in the bronchoalveolar lavage of patients with symptomatic asthma. CONCLUSION: Endothelin-expression is upregulated in bronchial epithelial cells of asthmatic patients with symptoms and evidence of functional derangement as compared with patients without symptoms and airflow obstruction. Exposure of cells from patients with asymptomatic asthma to factors that are released during acute exacerbation of the disease induces endothelin synthesis and release.

Adolescent↗
PubMed1995

Stroke and alcohol intake in a hospital population. A case-control study.

BACKGROUND AND PURPOSE: The aim of the study was to assess whether excessive alcohol intake is an independent risk factor for stroke. METHODS: A case-control study was undertaken in 200 consecutive ischemic and hemorrhagic stroke patients and 372 age- and sex-matched control subjects (170 hospital-based and 202 community-based individuals). Data were collected through direct interview regarding demographics, risk factors for stroke, current daily alcohol consumption, and diagnosis of alcoholism. Blood was also taken to test the common biological markers of alcohol intake (erythrocyte mean cell volume, uric acid, aspartate aminotransferase, and gamma-glutamyl transferase). RESULTS: After controlling for the most significant risk factors (antecedent strokes, hypertension, diabetes, smoking) and using hospital control subjects for reference, we determined the risk of stroke to be 2.2 (95% confidence interval [CI], 1.2 to 4.0) in moderate drinkers (men, < or = 60 g/d; women, < or = 40 g/d) and 2.9 (95% CI, 1.4 to 6.1) in heavy drinkers (men, > 60 g/d; women, > 40 g/d). The corresponding risk values obtained when we compared case subjects and external control subjects were 1.4 (95% CI, 0.8 to 2.7) and 3.0 (95% CI, 1.3 to 7.0). Even with some fluctuations across groups, the risk did not change significantly after subgroup analysis in men, patients with first-ever stroke, patients with ischemic stroke, and after exclusion of subjects with risk factors for stroke. Compared with hospital and external control subjects, stroke patients included a higher proportion of heavy drinkers (26.6% versus 20.6% versus 10.8%), alcoholics (14.6% versus 7.7% versus 2.5%), and cases with abnormal erythrocyte mean cell volume (63.0% versus 47.6% versus 34.2%) or gamma-glutamyl transferase (35.5% versus 32.4% versus 12.9%). Mean alcohol consumption was 42.2 g/d in the case subjects, 30.8 g/d in the hospital control subjects, and 23.2 g/d in the external control subjects. CONCLUSIONS: The study indicates that alcohol can be considered an independent risk factor for stroke in Italy.

Adult↗
PubMed1995

Impact of a programme of autologous blood donation on the incidence of infection in patients with colorectal cancer.

OBJECTIVE: To assess the effects of both autologous and homologous blood transfusion on the incidence of infective complications after elective operations for colorectal cancer. DESIGN: Prospective open study. SETTING: University hospital, Italy. INTERVENTIONS: Recording of variables known to influence the development of infection. MAIN OUTCOME MEASURES: Infective morbidity and mortality. RESULTS: Fifty-three patients (33%) deposited their own blood. Eighty-six of the 161 (53%) patients were transfused, 36 were given autologous blood, 48 homologous blood and 2 both autologous and homologous blood. These two were excluded from the analysis. Infective complications developed in 28 patients (17%), of which 7/75 (9%) were in patients who had not been transfused, 5/56 (14%) in patients given autologous transfusion, and 16/48 (33%) in patients given homologous transfusions (p < 0.001). Multivariate analysis identified homologous blood transfusion as the only variable significantly associated with the development of postoperative infective complications. No patient died. CONCLUSION: Transfusion of autologous blood was associated with significantly fewer postoperative infective complications than transfusion of homologous blood or no blood transfusion.

Adult↗
PubMed1994

Detection of cytokines and their cell sources in bronchial biopsy specimens from asthmatic patients. Relationship to atopic status, symptoms, and level of airway hyperresponsiveness.

This study evaluated immunoreactivity for several cytokines in bronchial tissue of asthmatic patients and related this to the clinical and functional characteristics. Patients were allocated into two different groups on the basis of their atopic status (atopic and nonatopic), with two subgroups of symptomatic and asymptomatic subjects in each. Five healthy volunteers were tested as control subjects. After clinical and functional assessment, all of the subjects underwent bronchoscopy. Several biopsy specimens were obtained for immunohistochemical and immunoelectron microscopic evaluation. Symptomatic asthmatic subjects had increased expression of immunoreactive interleukin (IL) 1 beta, IL-2, IL-3, IL-5, granulocyte-macrophage colony-stimulating factor (GM-CSF), and tumor necrosis factor alpha (TNF alpha) when compared to the asymptomatic patients or normal control subjects. The cell sources of IL-1 beta were monocytes and dendritic cells in atopic patients and monocytes alone in nonatopic asthmatic subjects. The CD4+ T lymphocytes from atopic asthmatic subjects predominantly expressed IL-3, IL-4, IL-5, and GM-CSF immunoreactivity, whereas CD4+ T cells from nonatopic patients predominantly expressed IL-2, IL-3, and IL-5, and GM-CSF immunoreactivity. Mast cells showed immunoreactivity for TNF alpha, IL-3, IL-5, and GM-CSF. Immunostaining for TNF alpha and GM-CSF was also detected in bronchial epithelial cells and monocytes. Tissue eosinophilia and the level of airway hyperresponsiveness more closely correlated with IL-5 immunoreactivity in atopic asthmatic subjects and with IL-2 and GM-CSF immunoreactivity in nonatopic patients.

Adult↗
PubMed1993

Bronchial epithelial cells of patients with asthma release chemoattractant factors for T lymphocytes.

BACKGROUND: T lymphocytes may orchestrate the inflammatory response in atopic asthma, but the mechanisms that promote T-cell accumulation in asthmatic airways are still unclear. In this study, we tested the hypothesis that bronchial epithelial cells of patients with atopic asthma release chemoattractant factors for T lymphocytes. METHODS: Sixteen patients with atopic asthma and eight healthy control subjects were selected for this study. Bronchial epithelial cells were isolated from biopsy specimens obtained by means of bronchoscopy and cultured for 48 hours in serum- and hormone-free medium, with or without 10(-6) mol/L histamine. RESULTS: Only the supernatants of cells from donors with asthma showed chemotactic activity for T lymphocytes, and this was significantly increased (p < 0.025) by exposure to histamine. Chemotactic activity was in part mediated by interleukin-8 (IL-8), because an antibody against human IL-8 significantly reduced it (p < 0.05) and the cell supernatants contained appreciable amounts of immunoreactive IL-8 (0.89 +/- 0.39 ng/ml). Both the residual chemotactic activity of unstimulated epithelial cells and the increased activity caused by histamine were mediated by a single protease-sensitive substance with an apparent molecular weight of 56,000 d and an estimated isoelectric point of 8.8 to 9.1. The partially purified chemoattractant specifically enhanced the migration of CD4+ T lymphocytes, and its activity was inhibited by the univalent Fab fragment of a monoclonal antibody against CD4. CONCLUSION: These results extend our previous observations, indicating an important effector role of bronchial epithelium in asthma.

Adult↗
PubMed1993

Effect of gluten-free diet on bone mineral content in growing patients with celiac disease.

Osteoporosis is a complication of celiac disease in adulthood, but little is known about the influence of the disease on bone mineralization in children. In the present study we evaluated radial bone mineral content (BMC) in celiac children and adolescents at diagnosis and after they consumed a gluten-free diet (GFD). The BMC values of 33 celiac patients at diagnosis were significantly lower than those of 255 control subjects (P < 0.001). There was no difference between diabetic and non-diabetic celiac patients. In 14 patients the BMC increased significantly (P < 0.05, ANCOVA) after 1.28 y of GFD. In these patients the mean annual BMC increment was 0.07 g/cm, significantly greater (P < 0.05) than the increment of normal growing children (0.05 g.cm-1.y-1). Our data indicate that although osteoporosis complicates celiac disease during childhood and adolescence, GFD alone is able to remarkably improve bone mineralization.

Bone Density↗
PubMed1993

Intraepithelial dendritic cells and selective activation of Th2-like lymphocytes in patients with atopic asthma.

This study examines the distribution of intraepithelial dendritic cells in eight atopic patients with symptomatic asthma and their ability to induce activation of autologous T lymphocytes in vitro. All subjects were sensitized to Dermatophagoides pteronyssinus. The incubation of asthmatic epithelial cells and dendritic cells with autologous resting CD4-positive T cells and purified extracts of D pteronyssinus induced T cell activation and release of high levels of interleukin-4 (IL-4) and interleukin-5 (IL-5). The antigen-presenting activity of dendritic cells was potentiated by epithelial cell-derived granulocyte-macrophage colony-stimulating factor (GM-CSF), since an antibody against GM-CSF reduced it. Circulating monocytes of the two groups of donors were equally effective in promoting selective activation of IL-4- and IL-5-producing T cells. Thus, an interaction between dendritic cells and allergens may favor local activation of CD4-positive T cells with Th2-like function in atopic asthmatic subjects, thereby promoting the expression of the disease.

Adolescent↗
PubMed1990

[Several risk indicators in industrial accidents].

Since the 1986, the National Institute for Occupational Accident Insurance (INAIL) provides each single Region with the occupational accident data on magnetic support. This strengthens the need to critically evaluate the most commonly used risk indicators. In this paper we discuss advantages and limits of the usual frequency and severity measures; the formulae for the standard errors are also given. A method proposed by I. Bross (1958), the RIDIT Analysis, is considered and exemplified. The appealing properties of this method ask for a more extensive application in this field.

Accidents, Occupational↗
PubMed1988

Recombinant alpha-interferon and vinblastine in metastatic renal cell carcinoma: efficacy of low doses.

Twenty-six patients with metastatic renal cell carcinoma (RCC) were treated in a phase I-II trial with recombinant interferon alpha-2b (alpha-IFN) and vinblastine (VBL) in combination. Patients received IFN at a starting dose of 3 x 10(6) IU/m2 subcutaneously three times a week and VBL 0.1 mg/kg intravenously every 3 weeks, with dose modification for toxicity. All patients were evaluable for toxicity; 18 patients were evaluable for efficacy. An objective response rate of 44% was observed (eight of 18 patients, with one complete response and seven partial responses). The median duration of response was 5 months. The actuarial survival of responding patients was significantly longer than that of nonresponding patients. In general, the toxicity was tolerable; the subjective toxicity and fever were similar to that reported for the same doses of IFN alone. Only a mild neurotoxicity, usually mixed polyneuropathy, occurred with increased frequency. Alpha-IFN and VBL administered at low doses in combination demonstrated the highest response rate so far reported in RCC without significant toxicity.

Adult↗
PubMed1982

Pharmacological data and technical feasibility of intraperitoneal 5-fluorouracil administration.

Via a surgically implanted Tenckhoff catheter, 5-fluorouracil was intraperitoneally administered to patients with malignant disease confined to abdominal space. Treatment was well tolerated without local complications. Peritoneal and plasmatic drug levels were measured, showing that: 1) peritoneal drug levels declined as a first order function; 2) plasmatic levels were very close to those reported for continuous i.v. administration, but peritoneal concentrations were much higher (log 1 to 3); 3) concentration x time product had a peritoneum: plasma ratio ranging from 120 to 1350. The hypothesized role of intraperitoneal 5-fluorouracil administration and the questions still to be answered are summarized.

Aged↗