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Biomedical subjects

A Pelliccia

Publications and source records attributed to A Pelliccia.

At least 19 recordsLinked to original sources
PubMed2003

Novel antitenascin antibody with increased tumour localisation for Pretargeted Antibody-Guided RadioImmunoTherapy (PAGRIT).

The Pretargeted Antibody-Guided RadioImmunoTherapy (PAGRIT) method is based on intravenous, sequential administration of a biotinylated antibody, avidin/streptavidin and (90)Y-labelled biotin. The hybridoma clone producing the monoclonal antitenascin antibody BC4, previously used for clinical applications, was found not suitable for further development because of the production of an additional, nonfunctional light chain. In order to solve this problem, the new cST2146 hybridoma clone was generated. The monoclonal antibody ST2146, produced by this hybridoma, having the same specificity as BC4 but lacking the nonfunctional light chain, was characterised. ST2146 was found able to bind human tenascin at an epitope strictly related, if not identical, to the antigenic epitope of BC4. It showed, compared to BC4, higher affinity and immunoreactivity and similar selectivity by immunohistochemistry. Biodistribution studies of biotinylated ST2146 and three other monoclonal antitenascin antibodies showed for ST2146 the highest and more specific tumour localisation in HT29-grafted nude mice. On the overall, ST2146 appears to be a good alternative to BC4 for further clinical development of PAGRIT.

Animals↗
PubMed2002

Exercise-related syncope in young competitive athletes without evidence of structural heart disease. Clinical presentation and long-term outcome.

AIMS: Exercise-related syncopal spells in athletes receive great attention and are a source of anxiety in the sporting world. The aim of the present study is to describe the clinical presentation, the yield of the initial diagnostic work-up and the long-term outcome of a series of consecutive competitive athletes with recurrent exercise-related syncopal spells. METHODS AND RESULTS: The study cohort included 33 athletes (20 females, mean age 21.4+/-3.2 years) referred for recurrent unexplained episodes of exercise-related syncope (mean number of spells before evaluation 4.66+/-1.97). All athletes underwent an extensive evaluation, including echocardiography, 24-h electrocardiographic monitoring, exercise testing, cardiac electrophysiological study and head-up tilt testing. The echocardiographic examination revealed the presence of a mitral valve prolapse in two cases (6.0%). During maximal exercise testing, four athletes (12.1%) developed hypotension associated with pre-syncope. Twenty-two subjects (66.6%) showed a positive response to head-up tilt testing. During follow-up (33.5+/-17.2 months) 11/33 athletes (33.3%) showed at least one recurrence of exercise-related syncope (mean time to first recurrence 20.4+/-14.5 months). No other adverse event of any kind was noted during follow-up. The Kaplan-Meier estimates of first recurrence of exercise-related syncope after 12, 36 and 60 months were 9.1%, 24.4% and 42.9%. The number and frequency of exercise-related syncopal spells before evaluation were found to be univariate predictors of syncope recurrence (P<0.001). However, in the multivariate analysis, the number of exercise-related syncopal spells before evaluation was found to be the only independent predictor of syncope recurrence (P<0.05). CONCLUSIONS: These findings support the idea that recurrent exercise related-syncope is not associated with an adverse outcome in athletes without cardiac disease.

Adult↗
PubMed2002

Perforated aneurysms of left side valves during active infective endocarditis complicating hypertrophic obstructive cardiomyopathy.

The most frequent site of vegetative lesion in patients with hypertrophic cardiomyopathy is anterior mitral leaflet, due to chronic endocardial trauma arising from systolic anterior motion. We describe three cases of serious infective endocarditis complicated lesions (vegetation, aneurysm and perforation) on aortic and mitral valves, in patients with obstructive hypertrophic cardiomyopathy. In particular, we observed how severe valvular damage and dysfunction, combined with particular hemodynamic conditions, are followed by adverse clinical outcome. We performed transthoracic echocardiogram and transoesophageal echocardiography studies to define morphologic and hemodynamic features of infection, deciding the proper therapy and we planned the echocardiographic follow-up.

Adult↗
PubMed2001

Athlete's heart electrocardiogram mimicking hypertrophic cardiomyopathy.

Highly trained athletes show a variety of electrocardiographic (ECG) changes, including a striking increase of R or S wave voltage, either flat or deeply inverted T waves, and deep Q waves, that suggest the presence of structural cardiovascular disease, such as hypertrophic cardiomyopathy or arrhythmogenic right ventricular cardiomyopathy, which represent the most common causes of sudden death in young competitive athletes. Despite a number of previous observational surveys, the determinants and clinical significance of these abnormal ECG patterns in trained athletes are still uncertain. Therefore, ECG patterns were compared with cardiac morphology (by echocardiography) in a large population of 1005 athletes, who were engaged in a variety of 38 sporting disciplines. We found abnormal ECGs in 40% of our athletes, but structural cardiac diseases were identified in only 5%. In the absence of cardiac disease, other determinants were recognized as responsible for abnormal ECG patterns, including the extent of morphologic cardiac remodeling, participation in an endurance type of sport, and male gender. Finally, a small but important subset of athletes showed striking ECG abnormalities that strongly suggested the presence of cardiovascular disease in the absence of pathologic cardiac conditions or morphologic changes, suggesting that these ECG alterations may be the consequence of athletic conditioning itself.

Cardiomyopathy, Hypertrophic↗
PubMed2001

Arrhythmogenic right ventricular cardiomyopathy.

Arrhythmogenic right ventricular (RV) cardiomyopathy (ARVC) is a cardiomyopathy characterized pathologically by fibrofatty replacement primarily of the RV and clinically by life-threatening ventricular arrhythmias in apparently healthy young people. The prevalence of the disease has been estimated at 1 in 5,000 individuals, although this estimate will likely increase as awareness of the condition increases among physicians. Arrhythmogenic RV cardiomyopathy is recognized as a cause of sudden death during athletic activity because of its association with ventricular arrhythmias that are provoked by exercise-induced catecholamine discharge. Diagnosis may be difficult because many of the electrocardiographic abnormalities mimic patterns seen in normal children, and the disease often involves only patchy areas of the RV. For this reason, international diagnostic criteria for ARVC were proposed by an expert consensus panel in 1996. Treatment is directed to preventing life-threatening cardiac arrhythmias with medications and the use of implantable defibrillators. This article will present in detail the etiology, clinical presentation, diagnosis and management of this condition.

Anti-Arrhythmia Agents↗
PubMed2001

Allergy and childhood epilepsy: a close relationship?

OBJECTIVES: The possibility that certain foods or allergens may induce convulsions has already been reported in the literature. None of the relevant studies has, however, shown a close correlation between allergy and epilepsy, most reports being anecdotal and open to various causal hypotheses. The case-control study reported here was undertaken to test the hypothesis that epilepsy is linked to allergy. MATERIAL AND METHODS: Seventy-two epileptic children and a group of 202 controls in the same age bracket were investigated for allergy together with their immediate families. RESULTS: The study revealed significantly higher rates of eczema in the mothers and rhinitis in the siblings of the patients studied as well as generally higher incidence of allergic pathologies in both of these groups with respect to the relevant controls. A significantly higher incidence of allergy to cow's milk and asthma was also documented in the epileptic children with respect to the control group. Prick tests gave a significantly higher rate of positive results for cow's milk proteins in the cases examined with respect to the controls. The total serum IgE of a random sample of cases and controls showed no difference in mean values. CONCLUSION: The study appears to bear out the hypothesis of a higher incidence of allergy in the children with epilepsy and their immediate families than in the controls and their families.

Adolescent↗
PubMed2000

Global left ventricular shape is not altered as a consequence of physiologic remodeling in highly trained athletes.

It is uncertain whether left ventricular (LV) shape is altered as a consequence of intensive athletic conditioning. We assessed LV dimensions and shape by Fourier analysis from digitized LV endocardial borders in 22 elite rowers and 14 untrained controls. Athletes had greatly increased LV cavity dimension, wall thickness, volume, and mass; however, LV shape was normal in athletes, and associated with normal ejection fraction and diastolic filling pattern.

Adolescent↗
PubMed2000

Clinical significance of abnormal electrocardiographic patterns in trained athletes.

BACKGROUND-The prevalence, clinical significance, and determinants of abnormal ECG patterns in trained athletes remain largely unresolved. METHODS AND RESULTS-We compared ECG patterns with cardiac morphology (as assessed by echocardiography) in 1005 consecutive athletes (aged 24+/-6 years; 75% male) who were participating in 38 sporting disciplines. ECG patterns were distinctly abnormal in 145 athletes (14%), mildly abnormal in 257 (26%), and normal or with minor alterations in 603 (60%). Structural cardiovascular abnormalities were identified in only 53 athletes (5%). Larger cardiac dimensions were associated with abnormal ECG patterns: left ventricular end-diastolic cavity dimensions were 56. 0+/-5.6, 55.4+/-5.7, and 53.7+/-5.7 mm (P<0.001) and maximum wall thicknesses were 10.1+/-1.4, 9.8+/-1.3, and 9.3+/-1.4 mm (P<0.001) in distinctly abnormal, mildly abnormal, and normal ECGs, respectively. Abnormal ECGs were also most associated with male sex, younger age (<20 years), and endurance sports (cycling, rowing/canoeing, and cross-country skiing). A subset of athletes (5% of the 1005) showed particularly abnormal or bizarre ECG patterns, but no evidence of structural cardiovascular abnormalities or an increase in cardiac dimensions. CONCLUSIONS-Most athletes (60%) in this large cohort had ECGs that were completely normal or showed only minor alterations. A variety of abnormal ECG patterns occurred in 40%; this was usually indicative of physiological cardiac remodeling. A small but important subgroup of athletes without cardiac morphological changes showed striking ECG abnormalities that suggested cardiovascular disease; however, these changes were likely an innocent consequence of long-term, intense athletic training and, therefore, another component of athlete heart syndrome. Such false-positive ECGs represent a potential limitation to routine ECG testing as part of preparticipation screening.

Adolescent↗
PubMed2000

Cyclic vomiting syndrome and food allergy/intolerance in seven children: a possible association.

UNLABELLED: Cyclic vomiting syndrome (CVS) is characterized by repeated unpredictable, explosive and unexplained bouts of vomiting. The episodes have a rapid onset, persist over a number of hours or days, and are separated by symptom-free intervals. Despite the recent interest in this disorder, its aetiology, pathogenesis and even its target organ remain unknown. The purpose of this study is to investigate the role played by food allergy in CVS. The report concerns eight children (five male, three female), mean age 8 years (3-13 years), suffering from CVS for 2 years at least. The diagnosis of CVS was based on characteristic history, normal physical examination and negative laboratory, radiographic, neurological and endoscopic studies. Despite the absence of clinical signs typical of food allergy, skin prick tests were positive in six of the eight patients (75%). Specific IgE were present in 4/8 (50%) of the patients. Skin tests and specific IgE were positive for cow's milk proteins, egg white and soya. IgE levels were higher than the mean + 2SD in 5/8 (63%) of the patients. A double blind placebo controlled food challenge (DBPCFC) was carried out on seven of the eight patients who displayed clinical improvement after an elimination diet for cow's milk (and other foodstuffs indicated by positive skin tests). The DBPCFC was positive in all seven children. Clinical follow-up revealed a state of well-being over the 6 months of observation. CONCLUSION: It appears reasonable to suggest that food allergy plays a role in cyclic vomiting syndrome.

Adolescent↗
PubMed2000

Athlete"s heart and hypertrophic cardiomyopathy.

Long-term athletic training is associated with morphologic left ventricular (LV) remodeling, that in elite athletes may be substantial and raise differential diagnosis with structural heart disease, ie, hypertrophic cardiomyopathy (HCM). Several criteria for differential diagnosis are discussed here, including the morphologic features of LV hypertrophy in athletes (ie, the symmetric distribution of LV wall thickening, the enlarged cavity with normal shape) and normal diastolic LV filling pattern. The most definitive criterion for differential diagnosis is the response to deconditioning, which is associated with a substantial reduction in LV wall thickness (by 2-5 mm, mean 3 mm) in athlete's heart; no substantial morphologic changes occur in patients with HCM. Finally, genetic screening for DNA abnormalities, although at present limited to research-oriented genotyping of family HCM pedigrees and are not yet available for clinical purposes, in the near future may offer the most definitive diagnosis of HCM, regardless of the morphologic expression and clinical presentation of the disease.

Cardiomyopathy, Hypertrophic↗
PubMed2000

Sandifer's syndrome in a breast-fed infant.

Sandifer's syndrome is a rare manifestation of gastroesophageal reflux (GER) in children, occurring in association with abnormal movements of the head, neck, and upper part of the trunk. Out of 65 children with Sandifer's syndrome described in literature, only 2 were breast-fed. We report on a 15-day-old breast-fed girl affected by Sandifer's syndrome. Pathological GER was diagnosed with 24 h pH esophageal monitoring. In our patient, all the symptoms of Sandifer's syndrome disappeared when she was cow's milk formula-fed. The role of food allergy to dietary proteins ingested by a lactating mother is discussed.

Breast Feeding↗
PubMed1999

Physiologic left ventricular cavity dilatation in elite athletes.

BACKGROUND: Absolute left ventricular cavity dimension may be substantially increased in some highly trained athletes. This raises questions about the differential diagnosis between athlete's heart and dilated cardiomyopathy as well as possible disqualification from competitive sports. OBJECTIVE: To evaluate the morphologic characteristics and physiologic limits of left ventricular cavity enlargement associated with intensive, long-term athletic conditioning. DESIGN: Evaluation of left ventricular cavity dimension in a large sample of highly trained athletes. SETTING: Institute of Sports Science, Rome, Italy. PARTICIPANTS: 1309 elite Italian athletes (957 men and 352 women), 13 to 59 years of age (mean, 24 years), participating in 38 different sports. MEASUREMENTS: Echocardiographic assessment of left ventricular cavity dimension and multivariate statistical analysis of the determinants. RESULTS: Left ventricular end-diastolic cavity dimensions varied widely (38 to 66 mm [mean, 48 mm] in women and 43 to 70 mm [mean, 55 mm] in men) and was within generally accepted normal limits for most participants (< or = 54 mm in 725 athletes [55%]). According to an arbitrary clinical cut-point of 60 mm, the left ventricular cavity was substantially enlarged in 185 participants (14%). These athletes had global left ventricular systolic function within normal limits and no regional wall-motion abnormalities; participants remained free of cardiac symptoms and impaired performance over 1 to 12 years (mean, 4.7 years). The major determinants of cavity dimension were greater body surface area and participation in certain endurance sports (cycling, cross-country skiing, and canoeing). CONCLUSIONS: In a sample of highly trained athletes, left ventricular cavity dimension varied widely but was strikingly increased to a degree compatible with primary dilated cardiomyopathy in almost 15% of participants. In the absence of systolic dysfunction, this cavity dilatation is most likely an extreme physiologic adaptation to intensive athletic conditioning. The long-term consequences and significance of this marked left ventricular remodeling of the athlete's heart is not known.

Adolescent↗
PubMed1999

Partial cryptogenetic epilepsy and food allergy/intolerance. A causal or a chance relationship? Reflections on three clinical cases.

The possibility that certain foods or allergens may induce convulsions has already been reported in the literature. None of these studies has, however, shown a close correlation between food allergy and epilepsy, most reports being anecdotal and open to various aetiological hypotheses. The present report concerns 3 children with cryptogenetic partial epilepsy, diagnosed by means of electroencephalography, with behavioural disorders (hyperactivity, sleep disorders and writing difficulties). In these patients, instead of using anticonvulsive agents, treatment was based upon a cows milk-free diet, working on the hypothesis that there could be a casual relationship between intolerance to this food item and the epileptic symptoms. An improvement was observed in the children's behaviour and moreover, the electroencephalographic anomalies disappeared. Upon double blind oral provocation tests, these patients did not present an immediate reaction, but only after a few days. starting the controlled diet again led, in all cases, to disappearance of the electroencephalogram. In conclusion, it would appear feasible to hypothesize the role of food intolerance in the onset of convulsive crises, even if limited to certain types of epilepsy such as the cryptogenetic partial form.

Age Factors↗