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Biomedical subjects

A Collacciani

Publications and source records attributed to A Collacciani.

At least 19 recordsLinked to original sources
PubMed1998

Circadian rhythm of arginine vasopressin in hepatorenal syndrome.

The etiology of hepatorenal syndrome is still incompletely understood, but the nonosmotic release of arginine vasopressin (AVP) seems to have an important role. Since AVP presents a well-defined daily periodicity in its production and secretion, the aim of the study was to investigate the circadian rhythm in its circulating plasma concentrations in patients with hepatorenal syndrome, compared with healthy controls. Venous blood samples were drawn during a 24 hour period at 2 hourly intervals from a peripheral vein in 10 healthy subjects and in 10 patients with hepatorenal syndrome for the determination of the circulating plasma levels of AVP by radioimmunoassay. Statistical analysis was carried out by the 'cosinor' method. The controls presented a significant (p < 0.002) circadian rhythm in the AVP circulating levels, whereas no rhythm (p > 0.05) was found in patients. The circadian rhythms were significantly (p < 0.005) different between the two groups, patients having higher mean daily concentration and lower circadian variation of AVP. These results confirm the existence of a well-defined circadian rhythm of AVP in healthy subjects, whereas the hepatorenal syndrome patients present a complete loss of the circadian rhythm. It could be hypothesized that primitive damage in circadian time-keeping regulates the circadian rhythm of vasopressinergic neurons, or has a secondary effect on the peripheral vasodilatation in the course of advanced liver disease. This great upset in the temporal and functional organization, together with that of the renin-angiotensin-aldosterone system, could play an important role in promoting and/or in the maintenance of the hydroelectrolyte imbalance that characterizes the hepatorenal syndrome.

Arginine Vasopressin↗
PubMed1997

Circadian rhythms of plasma atriopeptin, plasma renin activity and plasma aldosterone in patients with hepatorenal syndrome.

The etiology of hepatorenal syndrome (HRS) is still incompletely understood, but the atriopeptin-renin-aldosterone system plays an important role in its pathogenesis. Since this system presents a circadian rhythmicity, the aim of the study was to investigate the circadian rhythm in the circulating concentrations of atriopeptin (atrial natriuretic peptide, pANP), plasma renin activity (PRA) and plasma aldosterone (pA) in patients with HRS, compared with healthy controls. Venous blood samples were drawn during the span of a whole day and every two hours from a peripheral vein in 10 healthy subjects and in 10 patients with HRS. The circulating concentrations of pANP, PRA and pA were determined by radioimmunoassay. Statistical analysis was carried out by the "cosinor" method. The controls presented a significant (p < 0.05) circadian rhythm for each variable, whereas no rhythm (p > 0.05) was found in HRS patients. The pANP, PRA and pA rhythms were significantly (p < 0.05) different between the two groups, HRS patients having higher mean daily concentrations and larger circadian variations of pANP, PRA and pA than controls. Significant relations (p < 0.05) were demonstrated between the mean daily concentrations of pANP and PRA (r = 0.79), PRA and pA (r = 0.73) and PRA and pA (r = 0.76) in the controls; on the contrary, the HRS patients showed only a significant (p < 0.05) positive relation between pANP and PRA (r = 0.71). These results confirm the previous observation that the atriopeptin-renin- aldosterone system presents a well-defined circadian time structure in healthy subjects, while the HRS patients present a complete loss of the secretory sequentiality and of the circadian rhythm, with desynchronization of the whole system. This great upset in the temporal and functional organizations of the system could play an important role in promoting and/or in maintaining the hydro-electrolyte unbalance of HRS.

Aldosterone↗
PubMed1997

Tobacco smoking and risk of haematological malignancies in adults: a case-control study.

A retrospective study was conducted in 1216 cases to investigate the possible association between tobacco smoking and the risk of haematological malignancies. A small, but not significant, increase in malignancy was observed in smokers. Significant association was demonstrated between tobacco smoking and acute nonlymphoblastic leukaemia, and myelodysplastic syndromes. The duration and amount smoked increased the risk; heavy smokers presented significant positive associations with overall malignancies, acute nonlymphoblastic leukaemia, myelodysplastic syndromes, and monoclonal gammopathy of undetermined significance, whereas light smokers did not present any significant association. These data support a causal relationship between certain haematological malignancies and tobacco smoking. Further research is needed to examine the risk according to dose-response effect, and the variation in risk according to the histological subtype of the malignancy.

Adolescent↗
PubMed1997

The natural history of monoclonal gammopathy of undetermined significance. A 5- to 20-year follow-up of 263 cases.

Patients with monoclonal gammopathy of undetermined significance (MGUS) have a serum monoclonal component (M-component), but no evidence of multiple myeloma, macroglobulinaemia, amyloidosis or other plasma cell proliferative disease. A long-term follow-up study (median 11.5 years) has been carried out in 263 cases of MGUS, 159 males (60.5%) and 104 females (39.5%), aged 40-89 years (median 66.5 years). The actuarial probability for malignant transformation was 6.1, 15.4 and 31.3% at 5, 10 and 20 years, respectively. At the final evaluation, 157 patients (59.7%), 119 (45.3%) of whom with no increase and 38 (14.4%) with an increase in serum M-component, died of causes unrelated to MGUS and without development of any plasma cell proliferative disease; 47 patients (17.9%) were still alive without increase in M-component; 11 patients (4.1%) were still alive and at follow-up presented values of serum M-component > 30 g/l without any evidence of plasma cell proliferative or lymphoproliferative disease; 48 patients (18.3%) developed multiple myeloma (35 cases, 13.1%), solitary plasmacytoma of the bone (2 cases, 0.8%), macroglobulinaemia (4 cases, 1.6%), malignant lymphoma (3 cases, 1.2%), amyloidosis (2 cases, 0.8%), chronic lymphocytic leukaemia (1 case, 0.4%), and plasma cell leukaemia (1 case, 0.4%). The patients developing multiple myeloma, solitary plasmacytoma, macroglobulinaemia and plasma cell leukaemia had an increase in serum M-component, whereas no increase was found in malignant lymphoma, amyloidosis and chronic lymphocytic leukaemia. These findings and the data in the literature suggest that MGUS could be considered a preneoplastic condition; since no clinical and laboratory features are able to identify in advance the patients at high risk of disease progression, each patient must be followed up indefinitely.

Adult↗
PubMed1996

Risk of monoclonal gammopathy of undetermined significance: a case-referent study.

A retrospective study was conducted in 285 cases of monoclonal gammopathy of undetermined significance (MGUS) and in 570 sex- and age-matched hospital controls in order to investigate the possible association between socioeconomic status, residence, alcohol and tobacco habits, occupation, occupational exposure to toxic substances, chronic antigenic stimulation, and risk of MGUS. Significant associations with the risk of MGUS were found for farmers (P < 0.005) and for workers in industry (P < 0.025). Occupational exposure to asbestos, fertilizers, mineral oils and petroleum, paints and related products, pesticides, and radiation was significantly (P < 0.05) associated with an increase in risk of MGUS. Chronic immune-stimulating conditions, when considered as a group, presented a significant (P < 0.025) association with the risk of MGUS, but no specific disease has been found to be significantly associated. These data are in agreement with the previous reports on multiple myeloma, suggesting that these factors may play an important role in the development of monoclonal gammopathies. However, these findings need to be confirmed in prospective larger population-based studies.

Adult↗
PubMed1996

Circadian rhythm of serum erythropoietin in multiple myeloma.

The diurnal rhythm in the circulating serum levels of erythropoietin (EPO) were determined in a group of 20 adult clinically-healthy subjects, in a group of 10 patients with myeloma without renal impairment and 10 patients with myeloma and renal failure. Venous blood samples were drawn during the span of a whole day and every 4 hr, starting from midnight, for the measurement of serum EPO levels by radioimmunoassay (RIA). Statistical analysis was carried out by means of the "cosinor" method. Results show that the controls and the myeloma patients without renal insufficiency present significant (P < 0.05) circadian rhythms in serum EPO levels; no rhythm (P < 0.05) was detected in patients with myeloma and renal failure. Patients with myeloma and renal failure have significant (P < 0.05) lower mean daily levels and diurnal fluctuations of EPO than the other groups, whereas the patients with myeloma without renal involvement present higher (P < 0.05) mean daily levels and lower (P < 0.05) diurnal variations of EPO than controls; no differences (P > 0.05) exist between the groups regarding peaks of rhythms. These data confirm the existence of a physiological circadian rhythm in serum EPO concentrations, with maximum in the afternoon, and they suggest that renal failure is an important cause of anemia and loss of EPO circadian rhythm in patients with myeloma.

Aged↗
PubMed1996

Prognostic factors in multiple myeloma: selection using Cox's proportional hazard model.

The pretreatment characteristics of 210 patients with multiple myeloma, observed between 1980 and 1994, were evaluated as potential prognostic factors for survival. Multivariate analysis according to Cox's proportional hazard model identified in the 160 dead patients with myeloma, among 26 different single prognostic variables, the following factors in order of importance: beta 2-microglobulin; bone marrow plasma cell percentage, hemoglobinemia, degree of lytic bone lesions, serum creatinine, and serum albumin. By analysis of these variables a prognostic index (PI), that considers the regression coefficients derived by Cox's model of all significant factors, was obtained. Using this it was possible to separate the whole patient group into three stages: stage I (PI < 1.485, 67 patients), stage II (PI: 1.485-2.090, 76 patients), and stage III (PI > 2.090, 67 patients), with a median survivals of 68, 36 and 13 months (P < 0.0001), respectively. Also the responses to therapy (P < 0.0001) and the survival curves (P < 0.00001) presented significant differences among the three subgroups. Knowledge of these factors could be of value in predicting prognosis and in planning therapy in patients with multiple myeloma.

Adult↗
PubMed1996

Plasma cell leukemia. A report on 11 patients and review of the literature.

OBJECTIVE: Plasma-cell leukemia (PCL) is considered the leukemic variant of multiple myeloma. The diagnosis is based on plasmocytosis exceeding 2,000/mm3 and any evidence of clonal plasma cell proliferation. There are two forms of PCL: the primary form occurring in patients without preceding multiple myeloma or monoclonal gammopathy of undetermined significance, and the secondary form arising as a late manifestation in patients with multiple myeloma. Aim of the study was to describe our series of PCL and to report the main clinical and laboratory findings from the largest series in the literature. METHODS: Review of all cases of PCL observed from 1976 to 1994 in our Medical Divisions. Med-line research of the largest (more than 5 cases reports) series of PCL from 1969 to 1994. RESULTS: Eleven cases of PCL were identified. We diagnosed 6 cases with primary PCL out of a total of 512 patients with monoclonal gammopathy (incidence, 1.2%), 4 cases of secondary PCL as terminal phase out of 220 patients with multiple myeloma (incidence, 1.8%), and 1 case of secondary PCL as evolution of monoclonal gammopathy of undertermined significance out of 226 cases (incidence, 0.4%). From our and literature review, that identified 203 cases of primary PCL and 157 cases of secondary PCL, the clinical and the laboratory features did not significantly differ between primary and secondary forms of PCL, whereas significant differences exist between the two forms regarding response to therapy and median survival. In our series, the mean survival was 14 months for primary PCL and 6.8 months for secondary PCL. Two of the 6 patients with primary PCL obtained a complete remission, with a duration of 28 and 23 months, respectively; only 1 patient with secondary PCL had a response to chemotherapy, with a remission of 6 months. CONCLUSION: Our observation and literature data indicate that PCL, both primary and secondary, is a very poor prognosis disease, that the response rate is higher with combination chemotherapy than single agents, and that primary PCL has a relatively better survival, since secondary plasma PCL usually shows resistance to any type of chemotherapy.

Aged↗
PubMed1992

Prognostic value of the plasma cell synthesis score in multiple myeloma.

The prognostic value of the Plasma Cell Synthesis Score (PCSS) has been tested in a group of 140 patients with multiple myeloma followed up from diagnosis to death. Calculation of PCSS, based on the regression coefficients obtained by multivariate regression analysis according to Cox's model, was performed according to the formula: [formula: see text] Substratification into three risk groups was performed as follows: low risk = PCSS more than 70; moderate risk = PCSS between 50 and 70; high risk = PCSS less than 50. Significant differences were found among the three stages regarding median survivals (p less than 0.005), survival curves (p less than 0.000000001), and response to therapy (p less than 0.00001). A positive significant relationship was demonstrated between calculated PCSS and survival in the whole group (p less than 0.000001). PCSS could be a good estimation of bone marrow plasma cell differentiation, and therefore could be a useful prognostic parameter in multiple myeloma.

Adult↗
PubMed1991

Occupational risk for hematological malignancies.

A case-control study was conducted in 620 cases of hematological malignancies and in 1,240 age- and sex-matched controls in order to verify the possible association between occupation, toxic substances exposure, and the risk of hematological neoplasias. The results demonstrate that farmers and industrial workers have a significant risk for hematological malignancies. Exposure to asbestos, aromatic hydrocarbons, fertilizers, mineral oils, pesticides, and radiations is associated with a significant increase in the risk for these malignant diseases. These data are in agreement with previously reported data, and require a confirmation in larger, prospective studies.

Adult↗
PubMed1991

Diurnal variations of serum beta 2-microglobulin in multiple myeloma.

The chronobiological circadian behaviour in serum levels of beta 2-microglobulin has been investigated in three groups of subjects: (A) 6 healthy controls; (B) 6 patients with untreated multiple myeloma; (C) 6 patients with multiple myeloma in complete remission after polychemotherapy. From all subjects, under the same standard life conditions, venous blood samples were drawn at 4-hour intervals starting from midnight during the span of a whole day. Circulating serum beta 2-microglobulin levels were determined by RIA method. The time-related data were analyzed by chronograms and the "mean-group cosinor" method. A significant circadian rhythm for serum beta 2-microglobulin was detected in the control group, with a peak in the morning hours, and in untreated patients, with a peak in the afternoon hours. No significant rhythm was found in treated patients with multiple myeloma. A significant mesor reduction was noted in patients with complete remission, correlated with the absence of circadian rhythm, in respect to untreated patients. These data suggest that serum levels of beta 2-microglobulin could be related to the neoplastic plasma cell proliferation and to the effect of therapy, and that the circadian evaluation could be used as a guide in monitoring myeloma patients.

Circadian Rhythm↗
PubMed1991

Prognostic factors in multiple myeloma: a new staging system based on clinical and morphological features.

A new staging system for multiple myeloma based on clinical and morphological features has been developed on the analysis of 190 patients. A score of "1" was assigned to each of the following clinical data, referred at the time of diagnosis, and selected by multivariate analysis: bone marrow plasma cells more than 30%, haemoglobin less than 110 milligrams, lytic bone lesions of degree 2 or 3, serum beta 2-microglobulin levels higher than 678 nmol/l, and presence of Bence-Jones proteinuria. Therefore, the score for each patient ranged from 0 to 5, and three clinical stages were provided: I = 0 or 1, II = 2 or 3 and III = 4 or 5. Substratification into A and B for each clinical stage was performed using multiple myeloma cellular score, calculated by the formula: total bone marrow myeloma cells per 500 cells x 0.752 + bone marrow plasmablasts per 500 cells x 0.709. Substage A corresponded to multiple myeloma cellular score value lower than 0.300, and substage B to a value greater than 0.300. Significant differences were found in median survivals (P less than 0.0001), in survival curves (P less than 0.0001), and in responses to treatment (P less than 0.0001) among the six staged groups. The use of this staging system for multiple myeloma could offer new prognostic information and could better quantify the picture of the disease in each patient. The substaging according to morphological criteria seems very useful in diminishing or eliminating the great prognostic variability observed within the same clinical stage. Confirmatory studies are required to validate this new staging system for multiple myeloma.

Adult↗
PubMed1990

Multiple myeloma: relationship between survival and cellular morphology.

Myeloma cells in bone marrow aspirates from 121 patients with multiple myeloma at time of diagnosis were evaluated, by assigning them into morphological categories. Cox's model was used to calculate the coefficients for total myeloma cells and "plasmablasts" in respect to survival. Applying these coefficients, the Multiple Myeloma Cellular Score (MMCS) was calculated. MMCS significantly divides the patients into three stages. In fact, there are significant differences both between mean survivals (P less than .001) and between survival curves (P less than .00001). There is also a significant correlation (P less than .00001) between the calculated MMCS and survival in the whole patient group.

Adult↗
PubMed1990

Circadian pattern of circulating plasma ACTH, cortisol, and aldosterone in patients with beta-thalassemia.

Plasma levels of ACTH, cortisol, and aldosterone were measured for an entire day every 2 h, starting from midnight, in 4 healthy subjects, and in 4 patients with beta-thalassemia, without evidence for any endocrine disease. The subjects, after synchronized standard life conditions for 10 days, were held in constant supine position during the study. The data were analysed by the "cosinor" method. The results show significant circadian rhythms for the three biological variables in healthy subjects. In the thalassemic patients a significant circadian rhythm was detected only for cortisol and aldosterone. No rhythm was demonstrated for ACTH in the patient group. While no differences were found in mesors and acrophases for the three hormones between the two groups, a significant difference was observed regarding amplitudes. These data suggest that in beta-thalassemia, the secretion rhythmicity of ACTH is modified, whereas the adrenal cortex maintains its own physiologic rhythmicity in hormone secretion.

Adolescent↗
PubMed1990

[Socioeconomic status and survival in multiple myeloma].

In order to investigate the relationship between socioeconomic status and survival in multiple myeloma, a group of 121 patients, followed from first diagnosis to their demise, was subdivided into three social classes: high, medium, and low. Social class subdivision was performed taking into account the degree of education, occupation, and income. Significant differences (p less than 0.05) exist regarding mean survivals, survival curves, clinical stages, and responses to therapy between the three considered classes. A low socioeconomic status is associated with shorter survival, higher frequence in poor clinical stage, and less percentage of positive responses to chemotherapy. In conclusion, the socioeconomic status is an important prognostic factor in patients with multiple myeloma, to be considered with other clinical and laboratory data.

Adult↗