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Biomedical subjects

A Cavallini

Publications and source records attributed to A Cavallini.

At least 19 recordsLinked to original sources
PubMed2006

Lombardia Stroke Unit Network Project.

Stroke unit care represents the major advancement in stroke management and it is applicable to all stroke patients. The Lombardia Health-Care Program for the period 2000-2004 planned to implement new semi-intensive stroke units in order to guarantee access to such units to all stroke patients. As has happened in other countries, there is a need to coordinate and streamline the process of care in order to optimise resources and outcome. The aim of the Stroke Unit Network (SUN) project is the improvement of the quality of stroke care in the acute and post-acute phase, developing an efficient network between hospitals involved in stroke care in order to quickly identify patients' needs and to improve cultural exchange on clinical and therapeutic information between people involved in the process of care. A web-based network has been created connecting the Lombardia Stroke Units and the departments in which stroke units will be implemented; a website to facilitate the exchange of scientific data, the discussion of clinical problems, the sharing of research projects and results, and a web-based quality register in order to verify quality, efficacy and efficiency of stroke units participating in the project providing important, consistently available data to monitor progress in reducing the incidence of stroke and associated disability and mortality. The Lombardia Stroke Unit Network Project, promoting and facilitating the exchange of know-how and collecting data on the quality of the processes of care provided, can significantly improve stroke care in Lombardia.

Computer Communication Networks↗
PubMed2006

Stroke Active Guideline Evaluation (STAGE) project.

In 2005 the American Stroke Association's task force on the development of stroke systems established that providers and policymakers at the local, state and national levels can make significant contributions to reducing the devastating effects of stroke by working to promote coordinated systems that improve patient care. In the last few years in North America and Canada several quality stroke registers have been implemented with the aim of improving the processes of care by the diffusion and implementation of national guidelines and by the identification and correction of critical points of stroke care provided in the hospitals participating in the register. The Italian guidelines for stroke, SPREAD, have been developed with the aim of generating a tool applicable to the Italian clinical setting, able to promote the planning and linking of the assistant interventions between the different phases of the stroke care process, from the hyper-acute to the rehabilitation phase, and from primary to secondary prevention in order to harmonise and streamline the actions of the various health-care providers involved in the different phases of the diagnostic and therapeutic path of patients with stroke. The primary end-point of the Stroke Active Guideline Evaluation (STAGE) project, founded by the Italian Ministry of Health in 2003, is the diffusion, implementation and validation of the Italian Guideline for Stroke, SPREAD, in 15 acute care and 3 rehabilitative institutions across Italy. Secondary end-points are the evaluation of impact of the implementation of a workflow management in the processes of care and the identification of a national, streamlined diagnostic and therapeutic path for ischaemic stroke patients. An existing electronic patient record (EPR) has been shared with the referents of the Centres participating in the study and adapted to SPREAD's indicators. This EPR has been augmented with the decision support system. The STAGE project represents the first Italian effort in this direction. A lot of work has to be done before this goal will be achieved, but as Albert Einstein said "Imagination is more important than intelligence".

Database Management Systems↗
PubMed2006

[Treatment of celiac trunk aneurysms: personal experience and review of the literature].

INTRODUCTION: Celiac trunk aneurysms represent 4% of all splanchnic artery aneurysms. These lesions are thus extremely rare but yet have a significant clinical importance. Mortality, mainly related to site characteristics, is a significant risk (14%) in the event of rupture. PATIENTS AND METHODS: We put forward our experience in both diagnosis and treatment in three patients, two women and one man (average age 55.3 years, range 35-74), presenting aneurysms involving the celiac trunk. The preoperative diagnosis was established successively with ultrasonography, CT scan and angiography. Two patients were treated via an open surgical approach while endovascular percutaneous treatment was performed for the third patient. RESULTS: Mortality was null at 13 days on average from admission for the surgical patients and 4 days for the patient treated endovascularly. Postoperative complications were modest: pulmonary thickening with pleural effusion for the two surgical patients (spontaneous resolution), while for the third patient treated with an endovascular method, the stent migrated to a splanchnic arterial branch, with no consequence for the spleen. The average follow-up was 19 months (range 14-24). Full exclusion of the aneurysm was maintained at four months for the aneurysm treated percutaneously. A patent celiac was also maintained for the patients treated surgically. CONCLUSIONS: Considering the largely unforeseeable outcome and the high risk of rupture, we suggest that all the patients presenting this type of aneurysmal lesion should be treated. This attitude is widely advocated in the literature. Moreover, we noted null mortality in our small series, with only one percutaneous "re-do" case; resolutive at last control. With the present improvement in stent technology, endovascular treatment should be preferred. Patients should be treated surgically only if a percutaneous procedure would be risky or technically unfeasible due to the size of the aneurysm or its anatomic features.

Adult↗
PubMed2006

Distribution of Ty3-gypsy- and Ty1-copia-like DNA sequences in the genus Helianthus and other Asteraceae.

Two repeated DNA sequences, pHaS13 and pHaS211, which revealed similarity to the int gene of Ty3-gypsy retrotransposons and the RNAse-H gene of Ty1-copia retroelements, respectively, were surveyed in Asteraceae species and within the genus Helianthus. Southern analysis of the genome of selected Asteraceae that belong to different tribes showed that pHaS13- and pHaS211-related subfamilies of gypsy- and copia-like retroelements are highly redundant only in Helianthus and, to a lesser extent, in Tithonia, a Helianthus strict relative. However, under low stringency posthybridization washes, bands were observed in almost all the other Asteraceae tested when pHaS13 was used as a probe, and in several species when pHaS211 was hybridized. FISH analysis of pHaS13 or pHaS211 probes was performed in species in which labelling was observed in Southern hybridizations carried out under high stringency conditions (Helianthus annuus, Tithonia rotundifolia, Ageratum spp., Leontopodium spp., Senecio vulgaris for pHaS13, and H. annuus, Tithonia rotundifolia, and S. vulgaris for pHaS211). Scattered labelling was observed over all metaphase chromosomes, indicating a large dispersal of both Ty3-gypsy- and Ty1-copia-like retroelements. However, preferential localization of Ty3-gypsy-like sequences at centromeric chromosome regions was observed in all of the species studies but one, even in species in which pHaS13-related elements are poorly represented. Ty1-copia-like sequences showed preferential localization at the chromosome ends only in H. annuus. To study the evolution of gypsy- and copia-like retrotransposons in Helianthus, cladograms were built based on the Southern blot hybridization patterns of pHaS13 or pHaS211 sequences to DNA digests of several species of this genus. Both cladograms agree in splitting the genomes studied into annuals and perennials. Differences that occurred within the clades of perennial and annual species between gypsy- and copia-like retroelements indicated that these retrotransposons were differentially active during Helianthus speciation, suggesting that the evolution of the 2 retroelement families was, within limits, independent.

Amino Acid Sequence↗
PubMed2005

Experimental evidence of dislocation related shallow states in p-type Si.

Theory, models, and experimental phenomena provide evidence of the existence of shallow bands in silicon induced by the dislocation strain field. Nevertheless, only deep bands, likely associated with contamination at dislocations, have been detected up to now by junction spectroscopy. Here we present the first experimental result by junction spectroscopy that assesses the existence of the dislocation related shallow states. These are found to be located at 70 and 60 meV from the valence and conduction band edge, respectively.

Journal Article↗
PubMed2005

Early haemostatic therapy for spontaneous intracranial haemorrhage.

Intracranial haemorrhage (ICH) accounts for approximately 10%-15% of all strokes and is associated with the highest mortality rate and with the highest degree of disability among the survivors compared to all other strokes. The role of surgical and medical treatment is controversial. Recently, a parallel-group trial design between early surgery versus initial conservative treatment in patients with ICH showed no overall benefit from surgery. Several agents could theoretically be used. Activated recombinant factor VII administered within 4 hours after the onset of ICH seems to be the best candidate: in a recent study, it limited the growth of the haematoma, reduced mortality and improved functional outcome at 90 days. Further studies are necessary to define optimal dose of this drug, verify its efficacy and identify patients at high risk for thromboembolic complications.

Fibrinolytic Agents↗
PubMed2004

A novel mutation in KCNQ2 associated with BFNC, drug resistant epilepsy, and mental retardation.

BACKGROUND: Benign familial neonatal convulsion (BFNC) is a rare autosomal dominant disorder caused by mutations in two genes, KCNQ2 and KCNQ3, encoding for potassium channel subunits underlying the M-current. This current limits neuronal hyperexcitability by causing spike-frequency adaptation. METHODS: The authors describe a BFNC family with four affected members: two of them exhibit BFNC only while the other two, in addition to BFNC, present either with a severe epileptic encephalopathy or with focal seizures and mental retardation. RESULTS: All affected members of this family carry a novel missense mutation in the KCNQ2 gene (K526N), disrupting the tri-dimensional conformation of a C-terminal region of the channel subunit involved in accessory protein binding. When heterologously expressed in CHO cells, potassium channels containing mutant subunits in homomeric or heteromeric configuration with wild-type KCNQ2 and KCNQ3 subunits exhibit an altered voltage-dependence of activation, without changes in intracellular trafficking and plasma membrane expression. CONCLUSION: The KCNQ2 K526N mutation may affect M-channel function by disrupting the complex biochemical signaling involving KCNQ2 C-terminus. Genetic rather than acquired factors may be involved in the pathophysiology of the phenotypic variability of the neurologic symptoms associated with BFNC in the described family.

Adult↗
PubMed2004

Lateral costal artery: accessory thoracic vessel of clinical interest.

The lateral costal artery (LCA), a supernumerary branch of the internal thoracic artery (ITA), occurs in several ethnic groups on one side of the thorax or on both, in 15-30% of cases. It has been considered responsible for the "steal-syndrome" of the coronary blood after coronary artery bypass grafting and it used occasionally for myocardial revascularization. To clarify its functional significance, an interpretation based on our findings and human and comparative anatomy and embryology has been attempted. We report on a case where a right LCA of about 2 mm in caliber, rising from the ITA 2.5 cm below the subclavian, coursed as far as the 4th intercostal space for a distance of 13 cm after the anterior axillary line. Anastomosing with the intercostal arteries, it can act as a blood derivative circuit of the thoracic wall. Embryologically, this artery, like the normal parietal arteries of the trunk, might form a longitudinal channel connecting the intersegmental arteries. In mammals having a thoracic cage transversely restricted (quadrupeds), the ITA is more lateral than in primates having a circular thorax, and gives off a ventral branch toward the sternum. It might be hypothesized that the sternal branch occurring in quadrupeds, undergoing adaptation to the thoracic shape of primates, may become the main trunk of the ITA, whereas the LCA may be the remnant of the ITA of quadrupeds. Because the LCA ran partly along the "milk line" of humans, it might be regarded as a supernumerary mammary artery.

Cadaver↗
PubMed2004

New therapeutic strategies with antiplatelet agents.

Atherothrombotic pathology represents a major health problem and its prevention may be considered a primary, relevant objective in the conditions considered at risk for cerebrovascular, cardiac, and systemic ischemic diseases. Patients with previous manifestations of this disease are in fact considered at high risk of recurrence as events concerning other vascular territories are involved. Long-term antiplatelet therapy with noncompetitive inhibitors of ADP-induced platelet aggregation such as clopidogrel demonstrates the efficacy of this therapeutic approach in different strategies of secondary prevention in patients at high risk of atherothrombotic manifestations. The opportunity to combine the efficacy and safety of drugs with different mechanisms of action on platelet aggregation such as aspirin and clopidogrel is under investigation and preliminary results are very promising.

Clinical Trials as Topic↗
PubMed2003

Analysis of a dehydrin encoding gene and its phylogenetic utility in Helianthus.

Dehydrins are ubiquitous plant proteins, synthesized in late stages of plant embryo development and following any environmental stress involving dehydration. With the aim to study the evolution of such a stress-responsive gene within Helianthus and to test the possibility of using this gene for phylogenetic studies, fragments of the same dehydrin gene were isolated by PCR and sequenced in 16 wild Helianthus species or subspecies. All isolated sequences included the typical dehydrin domains (Y, S and K), a portion of 3'-UTR and an intron, inserted in the same position within the S domain-encoding region. The number of nucleotide substitutions (both synonymous and nonsynonymous) was calculated keeping separate the different gene regions, and differences occur even among coding domains, indicating that evolutionary constraints act differently on each region. The occurrence of indels and/or insertions was also observed. At the deduced protein level, the calculation of isoelectric point, molecular weight and the percentage of alpha-helix showed a diversification of biochemical properties of this protein between annual and perennial Helianthus species. Phylogenetic trees were built by the maximum-likelihood, maximum-parsimony, and neighbor-joining methods. In all cases the same topology was observed; perennial and annual species form a supported clade, and H. annuus was separated from the other annuals and from perennials. These data support the use of this stress-responsive gene to study the phylogeny of Helianthus.

Amino Acid Sequence↗
PubMed2003

A possible case of unruptured middle cerebral artery aneurysm presenting as epileptic seizures.

We report the case of a 73-year-old man with an unruptured aneurysm of the left middle cerebral artery. The initial sign was complex partial seizures. A standard scalp electroencephalogram was normal while neuropsychological tests revealed a slight deficit of episodic memory. Brain MRI showed an aneurysm at the left middle cerebral artery bifurcation. Cerebral angiography confirmed the presence of a saccular aneurysm at the left middle cerebral artery bifurcation, with a maximum diameter of 12 mm. This case had two main characteristic features: seizures had a quite late onset and were the only symptom the patient experienced.

Aged↗
PubMed2003

Autonomic dysfunction in Parkinson's disease.

Autonomic dysfunction in patients with Parkinson's disease (PD) has been recognized since the original description by James Parkinson in 1817. Autonomic failure can be the clinical presentation of other diseases like pure autonomic failure (PAF) and multiple system atrophy (MSA). Both the central and peripheral autonomic nervous systems can be affected in PD. Rajput and Rozdilsky described cell loss and Lewy bodies within the sympathetic ganglia and antibodies to sympathetic neurons have been detected in PD patients. Lewy bodies can be seen in autonomic regulatory regions, including the hypothalamus, sympathetic (intermediolateral nucleus of the thoracic cord and sympathetic ganglia), and parasympathetic system (dorsal, vagal, and sacral parasympathetic nuclei). Lewy bodies were also found in the adrenal medulla and in the neural plexi innervating the gut, heart and pelvis. Symptoms of dysautonomia are variable, and include cardiovascular symptoms, gastrointestinal, urogenital, sudomotor and thermoregulatory dysfunction, pupillary abnormalities and sleep and respiratory disorders. They may represent a useful tool in the differential diagnosis of "atypical" or "complicated" parkinsonisms.

Autonomic Nervous System Diseases↗
PubMed2002

Sequence variability of a dehydrin gene within Helianthus annuus.

Dehydrins are proteins produced during the late stages of plant embryo development and following any environmental stimulus involving dehydration. In order to investigate the variability of a dehydrin-encoding gene (Dhn1) in cultivated and wild sunflower (Helianthus annuus) genotypes, near-complete alleles were isolated by the polymerase chain reaction and sequenced. All of the isolated sequences were found to contain the typical dehydrin domains, and interrupted by an intron. The number of nucleotide substitutions and indels per site was calculated. With respect to the overall sequence, variation in both the coding and noncoding [intron and 3'-UTR (untranslated region)] sequences was much larger among wild accessions than among cultivars. No variation was observed in 3'-UTRs from cultivated sunflowers. Different coding regions showed a different numbers of synonymous and nonsynonymous substitutions. The Y and K domains were the most conserved in both wild and cultivated genotypes. Sequence analysis of the deduced dehydrin proteins showed that nucleotide substitutions in wild accessions should also determine large biochemical differences at the protein level. All of the isolated alleles were however functional, at least at the transcription level. To our knowledge these are the first data on intraspecific genetic variability of such a stress response gene. The low variability of dehydrin genes from cultivated sunflower is discussed in relation to the origin of sunflower cultivars. The possibility of rescuing general genetic variability through crosses to wild accessions of H. annuus rather than using wild Helianthus species is also discussed.

Amino Acid Sequence↗
PubMed2002

Ty1 /copia- and Ty3 /gypsy-like DNA sequences in Helianthus species.

Two repeated DNA sequences isolated from a partial genomic DNA library of Helianthus annuus, p HaS13 and p HaS211, were shown to represent portions of the int gene of a Ty3 /gypsy retroelement and of the RNase-Hgene of a Ty1 /copia retroelement, respectively. Southern blotting patterns obtained by hybridizing the two probes to BglII- or DraI-digested genomic DNA from different Helianthus species showed p HaS13 and p HaS211 were parts of dispersed repeats at least 8 and 7 kb in length, respectively, that were conserved in all species studied. Comparable hybridization patterns were obtained in all species with p HaS13. By contrast, the patterns obtained by hybridizing p HaS211 clearly differentiated annual species from perennials. The frequencies of p HaS13- and p HaS211-related sequences in different species were 4.3x10(4)-1.3x10(5) copies and 9.9x10(2)-8.1x10(3) copies per picogram of DNA, respectively. The frequency of p HaS13-related sequences varied widely within annual species, while no significant difference was observed among perennial species. Conversely, the frequency variation of p HaS211-related sequences was as large within annual species as within perennials. Sequences of both families were found to be dispersed along the length of all chromosomes in all species studied. However, Ty3 /gypsy-like sequences were localized preferentially at the centromeric regions, whereas Ty1/ copia-like sequences were less represented or absent around the centromeres and plentiful at the chromosome ends. These findings suggest that the two sequence families played a role in Helianthusgenome evolution and species divergence, evolved independently in the same genomic backgrounds and in annual or perennial species, and acquired different possible functions in the host genomes.

Amino Acid Sequence↗
PubMed2001

Hepatitis C virus genotypes and risk of cirrhosis in southern Italy.

Because hepatitis C virus (HCV) genotypes have raised considerable interest as variables that influence chronic hepatitis C progression, a case-control study was conducted to estimate their effects on patients with cirrhosis. Case patients (n = 46) had tested positive for anti-HCV antibody and HCV RNA and were residents of the study area who had cirrhosis recently diagnosed. Controls (n = 138) were drawn randomly from a residents' cohort from the same area. Demographic and other information were recorded. Presence of HCV infection, presence of HCV RNA, and HCV genotypes were assessed. Crude, stratified, and logistic regression analyses were performed. HCV genotype 2a/c occurred in 84 controls (60.9%) and 9 case patients (19.6%); HCV genotype 1b was found in 45 controls (32.6%) and 34 case patients (73.9%). HCV 1b genotype showed an independent effect on the risk of cirrhosis (odds ratio, 7.49; 95% confidence interval, 3.15--17.81). No significant effects related to other variables were observed. These results indicate that the genetic diversity of HCV phylogenetic variants may explain differences in biological behaviors.

Adult↗