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Biomedical subjects

D Galli

Publications and source records attributed to D Galli.

At least 19 recordsLinked to original sources
PubMed2006

Early stroke care in Italy--a steep way ahead: an observational study.

OBJECTIVES: To measure the performance of selected Italian emergency medical system (EMS) dispatch centres managing calls for patients suffering from stroke. Data on outcome and on early treatment in the ED were collected. METHODS: Prospective data collection for a trimester from interventions for a suspected stroke in 13 EMS dispatch centres over five Italian regions. RESULTS: Altogether, 1041 calls for a suspected stroke were analysed. Mean intervals of the sequential phases were 2.3+/-2 minutes between call and ambulance dispatch, 8.4+/-5.5 minutes to reach the patient, 14.5+/-8.5 minutes on the scene, and 40.2+/-16.2 minutes between call and arrival at the ED. Interventions were performed in 56% of cases by a basic life support (BLS) crew, advanced life support (ALS) crews intervened in 28% of cases, and a combination of ALS and BLS in the remaining 16%. Mean diagnostic interval was 99+/-85 minutes between emergency system call and the first CT scan. This was performed 71+/-27 minutes after ED admission. Only 1.6% were admitted to a stroke unit. One month outcome according to GCS was good recovery in 32%, moderate disability in 28%, severe disability in 14%, and death in 25% of the patients. CONCLUSIONS: Mean times show a rapid response of the selected EMS dispatch centres to calls for a suspected stroke. Nevertheless, mean times of the ED phase are still unacceptable according to international guidelines such as Brain Attack Coalition and American Stroke Association guidelines. Efforts should be spent to reduce the time between the arrival and the CT scan and more patients should be admitted to a stroke unit.

Aged↗
PubMed2006

How to improve ischemic stroke treatment in the fibrinolysis era.

In the last 15 years new therapeutic approaches have influenced the treatment of ischemic stroke victims. Aim of this review is to point out the elements of a modern approach to the acute stroke patient. The likelihood of saving ischemic cerebral tissue is time-dependent and the treatment goal is to minimise brain damage. The NINDS trial has documented a higher likelihood of better outcome if the fibrinolytic therapy is administered within 3 h of onset of symptoms. To reach this target several interventions are necessary. First of all, education is needed to diffuse public awareness of stroke warning signs. Moreover, out-of-hospital treatment should be optimised with rapid triage and transport to an hospital with a comprehensive stroke approach. The early hospital phase should comprehend a rapid evaluation and an urgent CT scan. After the verification of the inclusion/exclusion criteria, in a authorised SITS-MOST centre, the patient should receive fibrinolytic therapy. The diagnostic and the therapeutic phase should include rapid identification and treatment of secondary insults, as hyperthermia and hyperglycaemia, that have a negative influence on outcome. Despite advances in diagnosis and monitoring, fibrinolytic therapy is the only treatment with a proven efficacy in achieving a higher functional outcome. The narrow time-window is the reason for the need of rapid and well-organised out-of-hospital and in-hospital systems.

Brain Ischemia↗
PubMed2005

Stress response in mesoangioblast stem cells.

Stem cells are presumed to survive various stresses, since they are recruited to areas of tissue damage and regeneration, where inflammatory cytokines and cytotoxic cells may result in severe cell injury. We explored the ability of mesoangioblasts to respond to different cell stresses such as heat, heavy metals and osmotic stress, by analyzing heat shock protein (HSP)70 synthesis as a stress indicator. We found that the A6 mesoangioblast stem cells constitutively synthesize HSP70 in a heat shock transcription factor (HSF)-independent way. However, A6 respond to heat shock and cadmium treatment by synthesizing HSP70 over the constitutive expression and this synthesis is HSF1 dependent. The exposure of A6 to copper or to a hypertonic medium does neither induce HSP70 synthesis nor activation of HSF1, while a constitutive binding of constitutive heat shock element binding factor was found. Together, these data suggest that mesoangioblasts constitutively express HSP70 as an 'a priori' activation mechanism, while they maintain the ability to respond to stress stimuli.

Animals↗
PubMed2004

Bench test assessment of the new Raumedic Neurovent-P ICP sensor: a technical report by the BrainIT group.

BACKGROUND: In clinical practice, fiberberoptic and piezo-electric ICP probes are often used for measuring intracranial pressure (ICP). A number of similar technologies, although performing well in bench test studies, have been shown to exhibit unacceptable zero drift, fragility or both during trials conducted under clinical conditions. Recently, a new technology has become available, the Neurovent-P (Raumedic AG + CO, Raumedic, Germany). As a pre-requisite for a clinical trial, we have conducted and report on bench test studies to confirm the manufacturer's long term zero-drift performance for this technology. METHOD: In a test rig static tests (recording of 20 mmHg pressure) and dynamic tests, ranging from 5 to 50 mmHg have been performed. FINDINGS: 10 ICP probes have been tested for a total of 60 days. All the catheters, after the connection with the ICU monitor displayed a static pressure of 0 +/- 1 mmHg and did not required pre-insertion alteration. At five days, mean zero drift was 0.6 +/- 0.9 mmHg. Overall, zero drift ranged from 0 to 2 mmHg. At a fixed static pressure of 20 mmHg, the mean recorded value was 20.6 +/- 0.8 mmHg, ranging from 19 to 23 mmHg. A regression analysis of the relationship between the applied pressure and the recorded pressure during the dynamic tests of the 10 catheters yielded a correlation coefficient R2 of 0.997. Applying the Altman and Bland method to assess the bias and confidence limits for the Raumedic catheter responses during the dynamic tests against the applied gold-standard hydrostatic column pressures, the average bias of -0.66 +/- 0.85 mmHg, with 95% CLs of -2 mmHg and 1 mmHg. CONCLUSIONS: Mean zero drift, after five days, was very small and long-term continuous recording of a stable pressure was very precise. The response at dynamic tests, i.e. the changes of pressure in a wide range, was excellent. The average bias of the Raumedic catheter compared with the hydrostatic column is very small. After this bench test, the next and most critical step will be to conduct a trial of this promising technology under more demanding clinical environment.

Calibration↗
PubMed2002

Barkas effect for antiproton stopping in H2.

We report the stopping power of molecular hydrogen for antiprotons of kinetic energy above the maximum (approximately 100 keV) with the purpose of comparing with the proton one. Our result is consistent with a positive difference in antiproton-proton stopping powers above approximately 250 keV and with a maximum difference between the stopping powers of 21%+/-3% at around 600 keV.

Journal Article↗
PubMed2002

Emergency system prospective performance evaluation for cardiac arrest in Lombardia, an Italian region.

BACKGROUND: The aim of this research is to evaluate quality of out-of-hospital medical services in our country, using performance indicators and a new computerised database. METHODS: (a) EXPERIMENTAL DESIGN: Data were collected prospectively in three emergency dispatch centres for 90 days. Follow-up was evaluated at 1 day and 1 month after the event. This paper presents data on the cardiac arrest cohort only. (b) SETTING: Three emergency dispatch centres in Lombardia. (c) PATIENTS: One hundred and seventy-eight patients in non-traumatic cardiac arrest were enrolled. (d) INTERVENTIONS: None. The study was observational only. RESULTS: Mean interval between phone call and arrival on scene was 8.5+/-3.5 min. BLS manoeuvres were carried out from bystanders only in 15% of the cohort; this was associated with significant mortality reduction (85.7 versus 95.8%, chi(2) P<0.05). One hundred and thirty-three patients (75%) received assistance from BLS crews while only 45 patients (25%) were assisted by ALS medical personel, with a significant mortality reduction (ALS deaths 86.7%, BLS deaths 97%). Total 24 h survival was 9% and survival at 1 month declined to 6.17%. CONCLUSIONS: Quality monitoring produces objective information on interventions and outcomes. Only with this information, is it possible to implement improvement programmes that are planned according to the data presented.

Aged↗
PubMed1998

Jugular saturation (SjvO2) monitoring in subarachnoid hemorrhage (SAH).

Jugular saturation (SjvO2) monitoring was performed in 26 SAH patients to evaluate the incidence of normal (0.56-0.74) and pathological SjvO2 values in this population and to describe its time course in the first 12 days. We also attempt to quantify the influence of systemic and cerebral hemodynamics on SjvO2 and to assess the relationship between cerebral injury volume measured on CT scan and SjvO2. Mean SjvO2 was 0.66 +/- 0.07 (354 samples, median 0.67, range 0.43-0.89). 73% of the observations (259/354) were in the normal range. On serial measurements, we identified only 37/354 (10%) desaturation episodes (D.E.). ICP was significantly higher during low SjvO2 observation (p = 0.008). No statistical differences were noted regarding the influence of MAP, CPP, PaCO2, PaO2 on SjvO2 but during D.E., lower PaCO2 and CPP were more frequently observed. CT scan lesions > 25 ml were associated initially with lower SjvO2 values and with higher values at second CT.

Adult↗
PubMed1998

Roles in dimerization and blue light photoresponse of the PAS and LOV domains of Neurospora crassa white collar proteins.

The genes coding for white collar-1 and white collar-2 (wc-1 and wc-2) have been isolated previously, and their products characterized as Zn-finger transcription factors involved in the control of blue light-induced genes. Here, we show that the PAS dimerization domains present in both proteins enable the WC-1 and WC-2 proteins to dimerize in vitro. Homodimers and heterodimers are formed between the white collar (WC) proteins. A computer analysis of WC-1 reveals a second domain, called LOV, also identified in NPH1, a putative blue light photoreceptor in plants and conserved in redox-sensitive proteins and in the phytochromes. The WC-1 LOV domain does not dimerize with canonical PAS domains, but it is able to self-dimerize. The isolation of three blind wc-1 strains, each with a single amino acid substitution only in the LOV domain, reveals that this region is essential for blue light responses in Neurospora. The demonstration that the WC-1 proteins in these LOV mutants are still able to self-dimerize suggests that this domain plays an additional role, essential in blue light signal transduction.

Amino Acid Sequence↗
PubMed1998

Cimetidine-induced climacteric symptoms in a young man maintained on chronic hemodialysis.

We present the case of a young man on maintenance hemodialysis who developed frequent episodes of 'fluttering, racing heartbeats', hot flashes, profuse sweating, anxiety, dizziness, and shortness of breath. These symptoms started approximately 1 month after taking cimetidine 400 mg/day with an occasional extra dose. His workup included a total of 72 h of cardiac monitoring, two-dimensional echocardiogram, and thyroid function tests, all of which were essentially unremarkable. When the drug cimetidine was temporarily discontinued, and on another occasion after the drug was totally withdrawn, the patient noticed marked improvement in his symptoms at 48 h with total resolution on the 5th day after discontinuation. This is the 2nd such case reported in the literature.

Adult↗
PubMed1998

[The use of jugular saturation in monitoring patients with subarachnoid hemorrhage ].

We evaluated the usefulness of monitoring jugular saturation (SjO2) in subarachnoid haemorrhage patients. SjO2 is an index of the global ratio between cerebral blood flow and metabolism. Low SjO2 identified global cerebral flow reduction, as due to low cerebral perfusion pressures or hypocapnia, but not regional ischemic phenomena related to vasospasm.

Adult↗
PubMed1997

[Selective episiotomy. Comparison of two suture technics].

AIMS: The study aimed to highlight any differences between the sequelae of episiorrhaphy performed using the Blair-Donatti and Guilmen-Pontonnier techniques. METHODS: A total of 202 pregnant women were recruited in the Obstetrics Ward of Codogno Civic Hospital in 1994 and 1995. Subjects were randomly divided into two groups matched for socioeconomic status, age and parity (group A: Guilmen-Pontonnier suture, group B: Blair-Donatti suture). The following parameters were evaluated: pain twenty-four hours, sixty-six hours and one, two and three months after labour, pain during sexual relations, the onset of infection, hematoma, dehiscence of the wound, and lastly the cosmetic results. RESULTS: No significant differences were found between the parameters examined in both groups, barring the improved cosmetic result in group A.

Adult↗
PubMed1993

Sex pheromone plasmid pAD1-encoded aggregation substance of Enterococcus faecalis is positively regulated in trans by traE1.

Sex-pheromone-plasmid-bearing strains of Enterococcus faecalis react with sex pheromone to induce the expression of an adhesin, the so-called aggregation substance, on their cell surface. Here we show that, by complementation studies, for sex-pheromone plasmid pAD1, expression of the structural gene asa1, coding for an aggregation substance, is mediated by a diffusible factor encoded on pAD1. We were able to demonstrate that a small open reading frame, traE1, is sufficient for transcription of the operon containing asa1. A model for expression of asa1 under the influence of the positive regulator is presented, which is supported by our observation that regulation involves an all-or-nothing induction phenomenon, leading to cells either fully expressing asa1 or not at all.

Bacterial Proteins↗
PubMed1993

Biochemical, immunological and ultrastructural characterization of aggregation substances encoded by Enterococcus faecalis sex-pheromone plasmids.

The sex-pheromone system of Enterococcus faecalis can be viewed as a unique and highly efficient plasmid-collection mechanism. The contact needed for transfer of the conjugative sex-pheromone plasmids is mediated by an adhesin, called aggregation substance, which is encoded by these plasmids. We show here that for 17 of the 18 sex-pheromone plasmids (pAM373 being the exception) described to date, their adhesins are immunologically related to each other. In each case, we observed the presence of an N-terminal fragment of about 78 kDa in addition to the 137-kDa form of mature aggregation substance. The cross-reactions were different for the various plasmids. In the case of pPD1 the 78-kDa fragment reacted only weakly. The aggregation substance encoded by sex-pheromone plasmid pAD1 (Asa1) was characterized in detail. The conditions used for SDS/PAGE had a drastic influence on the migration behavior of mature aggregation substance and differently migrating, interconvertible forms were identified. Preliminary data indicate that Asa1 might be a glycoprotein. Antibodies were isolated which are directed against the N- and C-terminal parts of aggregation substance. They showed about the same reactivity on Western blots; however, only antibodies directed against the N-terminal part of the aggregation substance could inhibit the bacterial cell/cell contact. The reactions of the two antibody preparations with induced cells of E. faecalis was analyzed by transmission electron microscopy. The results indicated that especially the N-terminal part of aggregation substance is exposed on the cell surface of E. faecalis; the C-terminal part seems to be much less exposed.

Antibodies↗
PubMed1993

[Ultrasonic evaluation of the uterus during puerperium].

The aim of this study was to evaluate morphological and volumetric changes in the uterus during the first eight days postpartum in a sample of 229 patients using ultrasonography. Both pregnancies and postpartum were physiological in all the women examined. Fifty patients underwent cesarean section. A sectorial 3.5 MHz probe was used to measure the longitudinal, antero-posterior and latero-lateral diameter of the uterus and its volume. Involution was gradual both in relation to the diameters and uterine volume up until day 8 and was most evident during days 1-4. Longitudinal and antero-posterior diameter reduced more quickly in relation to the latero-lateral diameter. Uterine volume, calculated by considering the uterus as an ellipsoid, diminished 42% from 730 cc to 421 cc. No differences were observed between uterine diameters in primiparas and those in pluriparas, nor between patients undergoing cesarean section and those after normal childbirth. However, there was a clear difference between those patients who breastfed immediately after birth and those who resorted to artificial methods; uterine volume diminished more rapidly in the former, especially between days 1-4, confirming that early breastfeeding plays an important role in uterine involution in the very early days of postpartum. The physiological characteristics of the postpartum uterus were useful in formulating a medical or surgical treatment strategy in the few cases of postpartum metrorrhagia observed during the study.

Adult↗
PubMed1992

Sex pheromone plasmid pAD1-encoded surface exclusion protein of Enterococcus faecalis.

During conjugative transfer of sex pheromone plasmids of Enterococcus faecalis a so-called surface exclusion protein reduces the frequency with which these plasmids are transferred to cells already possessing the same plasmid. We report here the DNA sequence of a 3.8 kb fragment of the sex pheromone plasmid pAD1 containing the structural gene sea1 for surface exclusion protein and a small open reading frame (ORF) upstream of sea1. Surface exclusion protein Sea1 was found to be highly homologous to the surface exclusion protein Sec10 encoded by the sex pheromone plasmid pCF10. Hybridization studies with DNA probes derived from the structural gene sea1 demonstrated that, with the exception of pAM373, all known sex pheromone plasmids carry a homologous gene. These studies also indicated that the genetic organization is similar in these plasmids, with the structural gene for surface exclusion protein being located 5' to that for aggregation substance.

Amino Acid Sequence↗