Biomedical subjects

A Collacciani

Publications and source records attributed to A Collacciani.

28 records · Page 2Linked to original sources

PubMedDate not supplied

Circadian rhythms of fibrinogen antithrombin III and plasminogen in chronic liver diseases of increasing severity.

Acquired deficiencies of fibrinogen, antithrombin III and plasminogen are reported in liver disease, and it is known that their plasma levels fluctuate during the day. The aim of this study was to investigate the circadian rhythms of these three factors in chronic liver disease. Five groups of subjects were considered: (A) 15 healthy controls: (B) 15 patients with hepatic alcoholic steatosis; (C) 15 patients with chronic active hepatitis; (D) 15 patients with compensated cirrhosis of the liver, and (E) 15 patients with decompensated cirrhosis with ascites. The levels of fibrinogen, antithrombin III and plasminogen were determined in blood samples drawn in each subject during the span of a day every 3 h starting from midnight. The time-related values were analyzed using the 'population-mean cosinor' method. Groups A and B presented a significant (p < 0.05) circadian rhythm for each variable, group C a significant (p < 0.05) circadian rhythm for fibrinogen and antithrombin III and groups D and E no significant (p > 0.05) circadian rhythms. Statistically significant differences (p < 0.05) were demonstrated among the groups in the mean daily levels of the three variables by ANOVA, the concentrations decreasing with disease severity. These data confirm the existence of a significant diurnal periodicity in the circulating levels of fibrinogen, antithrombin III and plasminogen in controls and suggest that liver disease is associated with progressive circadian modifications in the temporal structure of fibrinogen, antithrombin III and plasminogen, related to the stage of the liver disease. The rhythm derangements may be considered markers of evolution in liver disease.

Adult↗

PubMedDate not supplied

Circadian rhythm of serum erythropoietin in myelodysplastic syndromes.

Myelodysplastic syndromes (MSD) are a group of clonal disorders of the hemopoietic stem cell, often evolving in acute leukemia. They are characterized by anemia, and it has been attributed either to a deficiency in erythropoietin (EPO) secretion or to a resistance to EPO itself. Since in healthy subjects the serum circulating EPO levels fluctuate during the day, the aim of the study was to investigate the diurnal rhythm of EPO in MDS. Two groups of subjects were admitted to the study: (A) 20 adult clinically healthy subjects, and (B) 20 patients with MDS without renal failure. After standard life conditions in hospital lasting one week, venous blood samples were drawn during the span of a whole day and every four hours, starting from midnight, for the measurement of serum EPO levels by RIA. Statistical analysis was carried out by means of the "cosinor" method. The results show that the controls present a significant (p < 0.05) circadian rhythms in serum EPO levels with acrophase in the late afternoon; on the contrary, no significant (p > 0.05) rhythm was detected in patients with MDS. Patients with MDS presented significantly higher (p < 0.05) MESOR and lower (p < 0.001) amplitude of EPO circadian rhythm in respect to the controls; moreover, a significant (p < 0.005) difference was found between the two groups in overall EPO rhythm. These data confirm the existence of a physiological circadian rhythm in serum EPO concentrations with maximum in the afternoon. Because EPO levels are increased in the patient group, EPO deficiency does not seem to be the cause of anemia in MDS. Reduced EPO amplitude may be a compensatory mechanism for enhancing its activity in MDS. Finally, the stimulatory therapy in MDS with recombinant human EPO should be administered in the late afternoon hours, in order to respecting and simulating the physiological circadian rhythm of endogenous EPO.

Aged↗

PubMedDate not supplied

Persistence of human growth hormone circadian rhythm in patients with homozygous beta-thalassemia.

Plasma levels of human growth hormone (hGH) were measured for an entire day every two hours, starting from midnight, in 6 healthy male subjects and in 6 male patients with homozygous beta-thalassemia, without evidence of any endocrine disease. The data were analyzed by the "cosinor" method, and the results show the presence of a significant (p < 0.05) circadian rhythm for hGH in both groups. Whereas no differences were found in mesors and acrophases between the two studied groups (p > 0.05), a statistically-significant (p < 0.05) difference was observed regarding amplitudes, being higher in the controls. These data suggest that in patients with beta-thalassemia major without evidence of any endocrine abnormality, the circadian secretory pattern of hGH is preserved, even if the rhythm amplitude is reduced: this could be a compensatory mechanism in order to stimulate growth.

Adolescent↗

PubMedDate not supplied

Multiple myeloma in L'Aquila and Avezzano, Italy, 1970-89. Changes in incidence rates, symptoms at diagnosis, and survival.

From 1970 to 1989, multiple myeloma was diagnosed in 184 residents in the counties of L'Aquila and Avezzano, two cities of the Region Abruzzo in Central Italy. The data were analysed for variations by sex, classes of age, urban and residence areas, symptoms and clinical stages at presentation, causes of death, and survival curves. The average annual incidence rate in the period 1970-89 was 5.8 per 100,000 residents. This increase in trend is statistically-significant (p less than 0.01). The average incidence was consistently higher among males, the age group 61-70 years old, and residents in urban areas for the decades 1970-79 and 1980-89. The increase in incidence rates of multiple myeloma was evident in all population categories, without significant differences (p greater than 0.05) in any evaluated class. The patients diagnosed in 1970-79 presented significantly (p less than 0.05) higher percentage of bone involvement at first diagnosis with respect to the patients diagnosed in 1980-89. A significant difference (p less than 0.05) was also observed in the clinical stage distribution. Patients from the 1980-89 decade survived for a significant (p less than 0.0001) longer period of time than the diagnosed between 1970-79. No differences (p greater than 0.05) were noted regarding causes of death. These results confirm the recent data of an increased incidence of multiple myeloma in the world. This trend could be due to an improvement in diagnosis and recording of multiple myeloma. On the other hand, environmental and occupational factors may play an important role in this increase.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMedDate not supplied

Classification and prognostic evaluation in multiple myeloma. A retrospective study of relationship of survivals and responses to chemotherapy to immunological types, 20 single prognostic factors, 15 clinical staging systems, and 6 morphological classifications.

In a group of 136 completely followed up patients with multiple myeloma, the prognostic significance of the immunological myeloma types, of 20 different single prognostic factors, of 15 clinical staging systems, and of 6 morphological classifications was retrospectively investigated by means of the calculation of mean survivals, survival curves, and responses to chemotherapy. A univariate analysis was employed in order to correlate each prognostic parameter at presentation with the survival in the whole group; a multivariate analysis according to the Cox's hazards regression model was used in order to select the most powerful prognostic variables. The patients were grouped according to the myeloma immunological types, to the mean value of each single prognostic factor, and to each stage of the clinical and morphological systems. Causes of death were also related to immunological multiple myeloma types. All single variables, except age and serum calcium, presented a significant relationship with the survival, even if at different significance levels. Cox's regression model selected among them, serum levels of beta 2-microglobulin, percentage of bone marrow plasma cells, hemoglobinemia, lytic bone lesions, and Bence-Jones proteinuria as the most significant factors related to survival. Each clinical and morphological staging system divided groups of patients with significant differences in mean survivals, or in survival curves, or in response to therapy. Multiple myeloma type IgA and micromolecular, with Bence-Jones proteinuria, and type lambda were associated with a poor prognosis, with low therapeutical response, and with the development of fatal renal failure. All these parameters, together with new prognostic factors, are useful in the prognostic evaluation, and, when applied in different steps of the diagnosis and the therapy, allow of studying the clinical course of multiple myeloma under different perspectives, in order to have a more complete picture of the disease and of the single patient.

Adult↗

PubMedDate not supplied

[Work activities and the risk of multiple myeloma. A case-control study].

The incidence of multiple myeloma is increasing in western countries, and several environmental and occupational risk factors have been suggested to explain this trend. A case-control study was conducted in order to investigate the relationship between occupation, exposure to chemicals, and risk of multiple myeloma. A total of 170 cases of multiple myeloma, 98 males and 72 females, aged 43-84 (mean age = 67 D.S. = 10), and 170 matched hospital controls (mean age = 68 D.S. = 9) were identified for the years 1970-1988. All subjects were interviewed about socioeconomic status, current or previous occupation, and if they had ever been exposed to one or more of a list of toxic substances. Exposure were grouped in 21 risk categories. Poor socioeconomic status was associated with a significant risk for multiple myeloma (OR = 2.8; 95% Confidence Interval: 1.61-3.05), as well as agricultural work (OR = 2.71; 95% CI: 1.87-4.42), and work in industry (OR = 3.20; 95% CI: 2.00-5.75). Regarding toxic substance exposure, a significant association was found for asbestos (OR = 4.00; 95% CI: 2.02-8.05), mineral oils (OR = 3.00; 95% CI: 1.98-5.08), pesticides (OR = 2.83; 95% CI: 1.87-4.78), and radiation (OR = 9.00; 95% CI: 0.81-21.73). No significant association was demonstrated for alcohol intake and tobacco smoking. High odds ratios were also found for fertilizers, paints, cosmetics and/or hairdressing products, and dust. These findings agree with previously reported studies, suggesting a relationship between some occupational exposures and the risk of multiple myeloma. The data, however, require clarification in prospective, larger, population-based studies.

Age Factors↗

PubMedDate not supplied

[Multiple myeloma: epidemiologic and clinical considerations].

Some epidemiological and clinical considerations on 184 cases of multiple myeloma, diagnosed in the period 1970-1989, are reported. The mean annual incidence rate for multiple myeloma was 5.1 per 100,000 residents, with a prevalence in male sex and in patients aged more than 65 years. The most frequent symptoms at presentation were bone pain and anemia, while the main cause of death was renal failure. The survival at three years was about 60%, and at five years about 45%. The subdivision of the patients according to the clinical staging system proposed by Durie and Salmon has demonstrated a significant difference in the three survival curves.

Adult↗

PubMedDate not supplied

[Prognostic evaluation in multiple myeloma. Relationship between immunological types, single prognostic factors, clinical staging systems, morphological classification systems and survival].

The prognostic value of the multiple myeloma (MM) immunological type, of 20 different single prognostic variables, of 11 clinical staging systems, and of 6 morphological classification systems was evaluated in 121 patients (71 males and 50 females, 75 MM IgG, 26 MM IgA, and 20 MM micromolecular), who were followed from diagnosis to demise. The values of the prognostic variables related to diagnosis were correlated with survival by means of univariate analysis; multivariate analysis according to Cox's model was employed to select highly-significant parameters correlated with survival among these variables. Every patient was retrospectively staged according to each clinical and morphological system. Mean survivals were computed for each group on the basis of immunological type, mean value of each prognostic factor, clinical and morphological stage. Survival curves were computed and compared. All prognostic parameters showed a significant relationship with survival, even though p-value differed. Multivariate analysis according to Cox's model has indicated the following variables as significantly correlated with survival: bone marrow plasma cell percentage, degree of lytic bone lesions, hemoglobinemia value, and serum levels of beta 2-microglobulin. Each clinical and morphological staging system, as well as immunological types and mean value of single prognostic parameters, have divided patients into separate groups with significant differences in mean survival and in survival curves. All of these factors could be taken into account for correct prognostic evaluation, and, if they were applied in different steps of diagnosis and therapy, it would be possible to study the MM patient under different perspectives, in order to have a more complete picture of the disease and of the patient.

Adult↗

PubMedDate not supplied

[Evaluation of a morphologic staging method (myeloma progression score) in multiple myeloma].

One hundred twentyone cases of multiple myeloma were classified according to a myeloma progression score based on the relative frequencies of plasma cells and plasma blasts in bone marrow aspirate. A significant correlation was observed between calculated myeloma progression score and survival (p less than 0.001). Moreover, significant differences were found between mean survivals and survival curves in the three stages (p less than 0.01). The value of the method was limited by the non-uniform distribution of the patients in the three stage groups, at least in our study. These results confirm that the morphological scoring staging system is useful and reliable and that it can be successfully used as an additional system, together with clinical staging systems, for predicting survival in patients with multiple myeloma.

Adult↗

PubMedDate not supplied

[Proposal of a new staging system using scoring of multiple myeloma].

A new simple scoring staging system was developed and evaluated in 121 cases of multiple myeloma, followed from first diagnosis to demise. A score of 1 was assigned to each of the following features: bone marrow plasma cells more than 30%, hemoglobinemia less than 11 g/dl, lytic bone lesions of degrees 2-3, presence of Bence Jones proteinuria and serum beta 2-microglobulin levels higher than 8.0 micrograms/ml. Therefore, the score for each patient ranged from 0 to 5, corresponding to six risk classes: score 0 = class I; score 1 = class II; score 2 = class III; score 3 = class IV; score 4 = class V; score 5 = class VI. Since no differences in mean survivals and in survival curves were found between classes I and II, between classes III and IV and between classes V and VI, three stages could be devised: stage A (good prognosis) corresponding to classes I and II; stage B (intermediate prognosis) corresponding to classes III and IV; stage C (poor prognosis) corresponding to classes V and VI. Significant differences were found among the three stages regarding mean survivals, survival curves, and response to treatment. This scoring staging system is very simple in its formulation; only five routine parameters and no calculations are necessary for obtaining a score and consequently a stage for each patient. Moreover, the system can identify categories of multiple myeloma patients with homogeneous characteristics since it appears to be correlated with response to treatment and survival.

Adult↗