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Biomedical subjects

D Cattaneo

Publications and source records attributed to D Cattaneo.

At least 19 recordsLinked to original sources
PubMed2002

Do static or dynamic AFOs improve balance?

OBJECTIVE: To verify if partial or total limitation of degrees of freedom at ankle joints could help patients with balance disorders in standing and walking. DESIGN: A cross-over design was chosen. Patients with multiple sclerosis (MS) were tested in three experimental conditions: barefooted, wearing ankle foot orthoses (AFOs), and wearing AFOs that allowed plantar flexion. SETTING: Neurorehabilitation unit in a rehabilitation centre. SUBJECTS: Fourteen patients suffering from MS with mild strength problems and balance disorders that required them to use walking aids outside. MAIN OUTCOME MEASURES: Tests inferring static and dynamic skills were carried out in the three experimental conditions described above. RESULTS: Improvements were obtained in static balance tests especially wearing dynamic AFOs; the number of patients who were able to pass tasks on balance in upright position such as 'standing with feet together, head extended' increased from three to nine. Dynamic balance was impaired especially with static AFOs; the time spent walking 10 metres with these orthoses increased by 172% with respect to barefoot; less difference (113%) has been reported wearing dynamic AFOs. CONCLUSION: Static and dynamic AFOs improved static balance, while dynamic balance was impaired especially by static AFOs; less negative influence on dynamic balance has been found while wearing dynamic AFOs.

Adolescent↗
PubMed2001

Pharmacokinetics help optimizing mycophenolate mofetil dosing in kidney transplant patients.

BACKGROUND: Mycophenolic acid (MPA), the active metabolite of mycophenolate mofetil (MMF), is now routinely used as immunosuppressant in solid organ transplantation in a fixed daily dose regimen (2 g/d) in association with cyclosporine (CsA) and steroids. However, no correlation has been shown between fixed MMF dose and clinical outcome. METHODS: Here we examined the possibility of optimizing MMF dosing by drug pharmacokinetic monitoring in 46 stable kidney transplant recipients. MPA plasma concentration profiles were measured by a reverse-phase high-performance liquid chromatography method 6-9 months after transplantation and related with routine laboratory analysis tests. Since MPA is extensively bound to serum albumin and only the free fraction is pharmacologically active, in a subgroup of 23 patients free plasma MPA was also determined. RESULTS: Despite a comparable MMF dose, a large interindividual variability in both MPA area under the curve (AUC) from 0 to 12 h (range 10.1-99.8 microg/mL. h) and in trough levels (range 0.24-7.04 microg/mL) was found. Patients with AUC >40 microg/mL. h showed a better (p<0.05) renal function than patients with lower AUC (creatinine clearance 85.7+/-23.2 versus 64.5+/-17.5 mL/min), despite no difference in CsA dose, CsA AUC and blood CsA trough level. The percentage of free plasma MPA but not total MPA correlated with the red blood cell and leukocyte count. CONCLUSIONS: Therapeutic MMF drug monitoring might contribute to a better management of kidney transplant recipient with the goal of optimizing drug dosing and limiting the risk of MMF-related toxicity.

Adult↗
PubMed2001

Computerized system to improve voluntary control of balance in neurological patients.

The treatment of acquired impairments of balance is one of the most elusive problems that rehabilitative medicine faces. Computerized systems to measure how patients control their balance in static conditions were introduced long ago into clinical practice and proved to be useful; we have designed and developed a computerized system called "BioGP," which combines features of a classic stabilometric platform with those of a retraining device based on visual feedback The aim of this study was to identify homogeneous groups of patients and to provide objective proof of effectiveness for the rehabilitation of patients with balance disorders. The findings confirm that the new equipment provides clinically valid and sensitive information concerning subjects' ability to control voluntary shifts of center of pressure (COP) while standing. The information is relevant to applications using basically the same approach (1) and are encouraging for possible use of the system as a rehabilitation instrument.

Adult↗
PubMed2001

Whole-blood calcineurin activity is not predicted by cyclosporine blood concentration in renal transplant recipients.

BACKGROUND: In transplant patients, current cyclosporine (CsA) dose monitoring with classic pharmacokinetics has demonstrated limitations. Evaluation of the activity of calcineurin (CN), the serine-threonine phosphatase enzyme target of CsA, has been proposed as a reliable way to optimize CsA dosing. METHODS: CN activity was measured in whole blood in an attempt to overcome the high variability of results obtained previously with peripheral blood mononuclear cells (PBMCs). We also explored, in vitro, a possible relationship between the CsA concentration and CN inhibition in whole blood. Finally, we assessed whether the CsA blood trough concentration correlates with whole-blood CN activity in kidney transplant recipients (n = 15) on maintenance immunosuppression with CsA. RESULTS: In 14 healthy individuals, less scattered CN activity values were documented in whole blood than in the PBMC fraction. Whole-blood CN activity was higher than the sum of the enzyme activity in each cell blood fraction. After ex vivo incubation of whole blood from healthy subjects (n = 5) with increasing concentrations of CsA (50-1000 microg/L for 1 h), a concentration-dependent inhibition of CN activity was found comparable to that in the PBMC fraction. Moreover, in 15 kidney transplant recipients, no relationship was found between CsA pharmacokinetic parameters and CN activity at time 0. However, a highly significant correlation was found between CN area under the CN activity-time curve, which represents the extent of the CN daily inhibition, and CN activity at time 0 (r = 0.79; P <0.01) and at 12 h postdosing (r = 0.96; P <0.01). CONCLUSIONS: Measuring CN activity in whole-blood samples is a reproducible method. In kidney transplant recipients, CsA trough concentrations do not predict baseline CN activity. Moreover, a single CN activity monitoring at baseline or at time 12 h post-CsA dosing may be a useful surrogate for the inhibition of this enzyme by CsA during 12 h.

Buffers↗
PubMed2000

Growth hormone receptor gene expression in porcine skeletal and cardiac muscles is selectively regulated by postnatal undernutrition.

During mild postnatal undernutrition, growth hormone receptor (GHR) mRNA abundance decreases in liver but increases in longissimus dorsi muscle. We tested the following hypotheses: 1) GHR gene expression is related to the metabolic and contractile characteristics of different muscles, and 2) the GHR response to nutrition depends on muscle type. Eight pairs of littermate pigs were weaned at 3 wk and given an optimal [60 g/(kg.d)] or low [(20 g/(kg.d)] food intake for the next 3 wk. All pigs grew, but at a slower rate in the low food intake group (P: < 0.001). Functionally distinct muscles were assessed for GHR mRNA (RNase protection analysis), oxidative myofibers (succinate dehydrogenase histochemistry) and type I slow myofibers (myosin immunocytochemistry). There were striking muscle-specific differences in GHR gene expression (P: < 0.001) and in its regulation by nutritional status. Relative expression of GHR mRNA in the optimal food intake group occurred in ascending order as follows: longissimus < diaphragm approximately rhomboideus < cardiac < soleus. There was a positive correlation with the proportion of oxidative myofibers (P: < 0.001) but not with type I myofibers (P: > 0.10). Compared with the high intake pigs, hepatic GHR mRNA was downregulated in the low intake pigs by 59% (P: < 0.01), whereas in the four muscles examined it was upregulated as follows: longissimus, 124% (P: < 0.05); rhomboideus, 19% (P: > 0.4); soleus, 65% (P: < 0. 05); cardiac, 51% (P: < 0.05). Moreover, the proportion of skeletal muscle fibers with high oxidative capacity was also greater in the low intake group (P: < 0.05). We conclude that postnatal GHR gene expression and its regulation by mild undernutrition are related to the metabolic, contractile and specific functional properties of different muscles.

Animals↗
PubMed2000

Update on multiple sclerosis rehabilitation.

The neuromotor rehabilitative treatment should be joined in the global individualised project. The rehabilitation project is developed by an interdisciplinary. Hence, the clinicians have to promote an appropriate compensation process in the daily living activities with a rapid insertion of new or recovered motor-postural patterns. The model of neuromotor intervention on patients suffering from MS provides a series of important moments: (1) a specific evaluation of the motor and postural behaviour; (2) the identification of targets and consequently the treatment planning; (3) the carrying out of a therapeutic program in different kinds of management; (4) the dynamic monitoring; (5) the experimentation of new therapeutic models and new rehabilitative hypothesis; (6) the placing of a neuro-psycho-motor treatment in a global therapeutic project. Recently we have investigated the performances and the efficiency of a particular therapeutic manoeuvre for the evocation of absent motor components in an experimental group of patients with paretic-atactic features and we have studied the correlations with the results observed in a control group of patients with similar pictures, treated with stretching exercises: the study is described and the first results are reported. Furthermore we have studied the therapeutical use of a stabilometric platform, 'BIOGP', on patients with ataxia. The platform is described and the first clinical experience is reported with the protocol of evaluation.

Ataxia↗
PubMed2000

Postnatal regulation of myosin heavy chain isoform expression and metabolic enzyme activity by nutrition.

Development of muscle is critically dependent on several hormones which in turn are regulated by nutritional status. We therefore determined the impact of mild postnatal undernutrition on key markers of myofibre function: type I slow myosin heavy chain (MyHC) isoform, myosin ATPase, succinate dehydrogenase and alpha-glycerophosphate dehydrogenase. In situ hybridization, immunocytochemistry and enzyme histochemistry were used to assess functionally distinct muscles from 6-week-old pigs which had been fed an optimal (6% (60 g food/kg body weight per d)) or low (2% (20 g food/kg per d)) intake for 3 weeks, and kept at 26 degrees C. Nutritional status had striking muscle-specific influences on contractile and metabolic properties of myofibres, and especially on myosin isoform expression. A low food intake upregulated slow MyHC mRNA and protein levels in rhomboideus by 53% (P < 0.01) and 18% (P < 0.05) respectively; effects in longissimus dorsi, soleus and diaphragm were not significant. The oxidative capacity of all muscles increased on the low intake, albeit to varying extents: longissimus dorsi (55%), rhomboideus (30%), soleus (21%), diaphragm (7%). Proportions of slow oxidative fibres increased at the expense of fast glycolytic fibres. These novel findings suggest a critical role for postnatal nutrition in regulating myosin gene expression and muscle phenotype. They have important implications for optimal development of human infants: on a low intake, energetic efficiency will increase and the integrated response to many metabolic and growth hormones will alter, since both are dependent on myofibre type. Mechanisms underlying these changes probably involve complex interactions between hormones acting as nutritional signals and differential effects on their cell membrane receptors or nuclear receptors.

Animals↗
PubMed1998

Changes of plasma insulin, urea, amino acids and rumen metabolites in somatotropin treated dairy cows.

An experiment was performed to evaluate the effects of somatotropin on plasma free amino acid, urea and insulin concentrations and rumen fermentation pattern and to assess their relationships. Four Italian Friesian dairy cows fitted with rumen cannulae were used in a switch-back design. Slow releasing recombinant bovine somatotropin (640 mg/cow) was injected every 28 days for two consecutive periods. Rumen fluid and blood samples were collected before and after feeding at 0, 7 and 21 days after rbST injection. Exogenous rbST increased plasma insulin concentration and the insulin response to feeding, and decreased plasma urea and free essential and branched chain amino acid concentrations. rbST did not affect rumen fermentation pattern. No correlation was found between rumen and plasma parameters measured after feeding. Our results are consistent with the notion that the main effect of somatotropin is post-absorptive.

Amino Acids↗
PubMed1994

Retrospective analysis of 156 cases of metastatic renal cell carcinoma: evaluation of prognostic factors and response to different treatments.

BACKGROUND: Metastatic renal cell carcinoma is a "capricious" tumor. Many prognostic factors have been evaluated, treatment is still controversial, and results are not coincident. METHODS: We reviewed 156 patients with metastatic renal cell carcinoma. Survival from the time of diagnosis was the end point of the study. The influence on survival of age, sex, nephrectomy, disease-free interval, performance status, site and number of metastases was analyzed. Univariate and multivariate analysis were done. Survival according to different therapies was also evaluated. RESULTS: In our study, no nephrectomy, a disease-free interval < 24 months, > 2 metastatic sites and a performance status > 2 proved to be risk factors. According to the number of risk factors, 3 groups of patients were identified (low, intermediate and high risk). We observed 3 kinds of responses to treatments: 1) in untreated patients (n = 48), median overall survival was 6 months, and the 24-month survival rate was 8%; 2) in patients treated with hormone therapy and/or chemotherapy (n = 73), median overall survival was 13 months, and the 24-month survival rate was 24%; 3) in patients treated with interferon and/or interleukin-2 (n = 35), median overall survival was 16 months and the 24-month survival rate was 34%. CONCLUSIONS: Our results are only partially in accordance with those observed by other authors. Risk factors and treatment must be determined in more defined and selected studies.

Adult↗
PubMed1994

Nutritional regulation of growth hormone receptor gene expression.

The role of energy intake in regulating growth hormone receptor (GHR) gene expression has been assessed in young growing pigs living at thermal neutrality (26 degrees C) for a 4-wk period. To determine the importance of altering metabolic demand while maintaining food intake constant, littermates were also studied in a cold environment (10 degrees C). Results were tissue-specific: the level of GHR mRNA per unit total RNA in liver was greater on high than low (high = 2 x low) food intake (P < 0.001), whereas in muscle it was elevated on the low compared with the high intake diet (P < 0.02) and also at 10 degrees C compared with 26 degrees C (P < 0.04). When results for GHR mRNA were expressed per unit weight of tissue, only the effects of diet on liver and temperature on muscle remained significant. The changes in hepatic GHR mRNA may have been driven in part by nutritionally induced changes in thyroid status, because both plasma 3,5,3'-triiodothyronine concentration and liver 5'-deiodinase activity were greater on the high than the low intake diet (P < 0.001). Levels of liver GHR mRNA probably had a direct influence on growth of the animals, as they were positively correlated with plasma IGF-I and growth rate (P < 0.001), whereas muscle GHR mRNA may have had a metabolic role when energy supplies were limited.

Animal Nutritional Physiological Phenomena↗
PubMed1993

Aggressive course of angiofibroma in an HIV-positive patient.

We report nasopharyngeal angiofibroma in a 13 year old boy treated with embolization, surgical excision and radiotherapy, which recurred 13 years later. No features of sarcomatous transformation were found, but the tumor had a locally aggressive course, possibly due to the HIV-positivity of the patient who then died of AIDS. The relations between the clinical course of the tumor and severe immunodeficiency are discussed.

Adolescent↗
PubMed1992

Antithrombin III supplementation during orthotopic liver transplantation in cirrhotic patients: a randomized trial.

Severe intraoperative bleeding is one of the main problems during liver transplantation. Acquired hemostatic defects, namely primary or secondary hyperfibrinolysis, are considered significant pathogenetic events. Antithrombin III (ATIII), the main physiological serine protease inhibitor, has a critical role in the regulation of hemostasis. 29 patients with post necrotic cirrhosis undergoing liver transplantation were randomized to receive or not ATIII replacement therapy before the induction of anaesthesia and thereafter throughout surgery. Activation of both coagulation and fibrinolysis (increase of thrombin-antithrombin complexes, fibrin and fibrinogen degradation products) were demonstrated in both groups. Blood loss and transfusion requirements were not affected by ATIII administration.

Adult↗
PubMed1992

The multimeric pattern of von Willebrand's factor (vWF) can be demonstrated also in the severe form of the disease.

The multimeric analysis was carried out on the plasma of 18 patients with severe von Willebrand's disease (vWD) using two different types of agarose: Seakem HGT(P) and Seaplaque LGT. No pattern was found in any of the patients using Seakem HGT(P). On the contrary, by Seaplaque LGT, a multimeric pattern was found in four patients belonging to three different families, indicating that it is possible to identify and characterize variable multimeric patterns also in type III vWD.

Biopolymers↗
PubMed1991

Acquired selective factor X deficiency in acute nonlymphocytic leukemia.

A case of acute nonlymphocytic leukemia (ANLL) and selective acquired FX deficiency at presentation is reported. The deficiency was not corrected by the infusion of fresh frozen plasma, but the patient's plasma had no neutralizing activity in vitro. The cause of the deficiency is unknown.

Adult↗