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Biomedical subjects

C Manotti

Publications and source records attributed to C Manotti.

52 records · Page 3Linked to original sources
PubMed1981

Human platelet aggregation tests in vitro. Effects of dilazep.

The effect of 1,4-bis-[3(3,4,,5-trimethoxybenzoyl-oxy)-propyl]-perhydro-1,4-diazepine (dilazep, Cormelian), a coronaroactive drug, was studied by various tests of hemostasis in vitro on human plasma. The antiplatelet action of the drug was clearly demonstrated: it inhibited, in appropriate concentrations, ADP, adrenaline and collagen induced aggregation platelet factor 3 (PF3) availability and clot retraction induced by ADP-reptilase. Conversely, coagulation tests as well as the lysis time of diluted whole blood were unaffected by the drug.

Adenosine Diphosphate↗
PubMed1979

Predictive value of preoperative in vitro and in vivo studies for correct individual heparinization in cardiac surgery.

Heparin administration for operations with extracorporeal circulation (ECC) usually is performed following prefixed, standardized protocols. These regimens secure an adequate level of anticoagulation, but they often involve prolonged periods of overheparinization associated with an undue risk of hemorrhage. The predictive value of preoperative studies in the anticoagulant effect of heparin was investigated in 10 patients. The study was performed both in vitro and in vivo using the Xa inhibitor assay as an index of the anticoagulation induced by heparin. Adding variable amounts of heparin in vitro to patient's plasma resulted in straight (at least up to 7 U. per milliliter) and parallel, but not coincident, dose/response curves, so confirming a different individual sensitivity to heparin. Disappearance curves of the anticoagulant effect in plasma following intravenous administration of a single standard dose of heparin in the same patients showed an even greater patient-to-patient variability, with "half-life" times ranging from 30 to 150 minutes. No relationship was found between the parameters (in vitro sensitivity to heparin and clearance rate from plasma in vivo). Moreover, neither of them could be correlated with the response to heparin, subsequently observed during ECC in the same patients. Preoperative investigations with the methods presently available are not adequate to choose individual heparin administration regimens for cardiac operations.

Adult↗
PubMedDate not supplied

Effect of diet and weight loss on whole blood filterability and plasma fibrinogen values in hypertensive obese postmenopausal women.

The authors evaluated whole blood filterability (VB) in 29 post-menopausal obese women with (n = 14) or without (n = 15) hypertension, and in 22 age matched women with normal body weight. After 3 months of a low-calorie (18 kcal/kg IBW) and moderately low-salt (max 6 g NaCl/day) diet, the obese subjects were restudied. In all women plasma fibrinogen values and various indices of metabolic status were evaluated before and after the diet and correlated to VB values. VB values and plasma fibrinogen concentrations were similar in normal controls and in women with simple obesity, whereas they were, respectively, significantly lower and higher in obese subjects with hypertension. Three months of diet significantly improved whole blood filterability and decreased fibrinogen levels in these patients. Before the diet a significant negative correlation was found between VB and plasma fibrinogen values in hypertensive obese patients. Metabolic parameters did not change in the different groups before and after the diet and did not correlate with VB values. The present study indicates that low-calorie, low-salt diet decreases plasma fibrinogen levels and improves whole blood filterability in elderly obese women with hypertension.

Adult↗
PubMedDate not supplied

Computer assisted anticoagulant therapy.

The constantly workload increase has led to the development of Computerised Decision Support Systems (CDSS) for a better management of patient care. Many clinical situations have been investigated to verify the utility of CDSS: few have demonstrated stable effects. One area where success has been reported is the field of oral anticoagulation management. CDSS system has demonstrated to be able to improve the treatment quality in comparison to manual method. In the future scenario of oral anticoagulant management CDSS will have a pivotal part, the constant increase of patients number and their pressure on thrombosis centres had led to the development of alternative models for delivery OAT: Primary care, General Practitioner, Patient self testing and self management and the use of CDSS has been central to the decentralisation process and may be useful in maintaining the efficacy and quality of anticoagulant control. GP with the aid of CDSS are able to deliver OAT as well as expert physician of Thrombosis Centre in terms of time spent by patient in therapeutic range.

Anticoagulants↗
PubMedDate not supplied

Warfarin induced dermatitis and venous thrombosis in a patient with Protein S deficiency.

A case of warfarin-induced dermatitis in a 79 year-old patient with Protein S deficiency is described. Both total Protein S antigen and free Protein S were moderately reduced (about 50%). The skin lesion did not progress to frank necrosis and it was associated with elevated creatin phosphokinase (CPK) levels in plasma and with thrombosis of the anterior tibial vein localized to the area of dermatitis (probably warfarin-induced deep venous thrombosis). After warfarin withdrawal and beginning of heparin therapy, serum CPK rapidly normalized and the skin lesion improved.

Aged↗
PubMedDate not supplied

A computerized regulation of dosage in oral anticoagulant therapy.

The results of a cooperative study on the quality of treatment of patients with prosthetic heart valves (PHV) on long-term oral anticoagulants (OA) are reported. The study was carried out on 695 patients bearing PHV (with an overall 8,340 checks carried out in 1988) through a computer-assisted system for monitoring the laboratory and treatment follow-up. The specifications of the software are described in detail in the text. The mean INR slightly differed in the two participating centers (Rome and Parma) (3.25 vs 3.19) as did the weekly mean dosage (18.2 vs 20.7 mg) of oral anticoagulant, which was always Acenocoumarol. More than 70% of the checks were within the range in both centers as evaluated by a check randomly chosen once a month for each single patient. Considering the whole bunch of data, about 80% of the patients had greater than 50% of their checks within the therapeutic range and more than 30% had greater than 75% of the checks within the range. This study demonstrates that the availability of a computerized program for monitoring oral anticoagulant therapy allows to perform multicenter studies and to obtain data which can improve the quality of treatment of patients on OA.

Administration, Oral↗
PubMedDate not supplied

Low molecular weight heparin (Alfa LHWH) compared with unfractionated heparin in prevention of deep-vein thrombosis after hip fractures.

Efficacy and safety of a low molecular weight heparin (Alfa LMWH) was compared with unfractionated heparin (UFH) in the prevention of post-operative venous thromboembolism after hip fractures. Forty-nine patients were randomized to treatment with Alfa LMWH 7500 anti-Xa coagulometric units twice daily or with UFH 5000 IU t.i.d. Screening for thrombosis was performed with 125-I-fibrinogen leg scanning and strain-gauge plethysmography. Positive results were confirmed by venography. Five patients in the Alfa LMWH group (20 per cent) developed venographycally proven deep vein thrombosis (DVT) versus seven (29 per cent) in the UFH group. One pulmonary embolism and two deaths occurred in the UFH group and none in the LMWH group. No differences in haemorrhagic complications and blood loss indices were observed. Alfa LMWH appears to be a promising drug for prevention of venous thromboembolism after orthopaedic surgery. A "flexible" schedule of administration is proposed on the basis of the results of plasma anti-Xa assays.

Aged↗
PubMedDate not supplied

Risk of venous thromboembolism and stroke associated with oral contraceptives. Role of congenital thrombophilias.

To assess the risk of thromboembolism in women using oral contraceptives (OCs), we identified through computer search in the hospitals of the province of Parma, Italy, all women aged 15-44 who were resident in the province and had a documented thromboembolic event in the years 1989-93. The number of users and nonusers of OCs was estimated by the drug sale data for the province and by the demographic statistics. In cases with venous thromboembolism (VT) the prevalence of concomitant deficiency of antithrombin III, protein C, protein S, and of factor V gene mutation Arg506GIn was evaluated. The incidence rate of VT was 37/59,603 woman-years in users (0.62 per 1000) and 13/303,954 woman-years in nonusers (0.042 per 1000), for a relative risk (RR) of 14.5 (95% confidence interval: 7.8-27.1; P < 0.001); the rate of stroke per 1000 woman-years was 0.17 in users and 0.036 in nonusers (RR = 4.6; 2.9-10.7; P < 0.01). A congenital thrombophilia involving the protein C anticoagulant system was documented in about 25% of young women developing venous thromboembolism while on OCs.

Adolescent↗