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Biomedical subjects

D Libertucci

Publications and source records attributed to D Libertucci.

At least 19 recordsLinked to original sources
PubMed2006

Usefulness of sequential Aspergillus galactomannan antigen detection combined with early radiologic evaluation for diagnosis of invasive pulmonary aspergillosis in patients undergoing allogeneic stem cell transplantation.

BACKGROUND: Early diagnosis of invasive pulmonary aspergillosis (IPA) is important as prompt treatment with antifungal drugs may increase patient survival. Our study investigated the efficiency of routine testing of the Aspergillus galactomannan antigen (AGA) test in combination with chest CT scans for IPA diagnosis. PATIENTS AND METHODS: From February 2002 to June 2004, 74 hemato-oncologic patients undergoing allogeneic stem cell transplantation were prospectively studied with serum AGA twice weekly from admission until death or discharge and weekly afterward when possible. Chest CT scans were performed when fever of unknown origin had lasted beyond 3 days of antibacterial therapy. RESULTS: Seven patients were classified with possible IPA and two patients, proven IPA. Fourteen patients showed positive results for AGA (OD index>or=1.0 on two subsequent sera). The sensitivity and specificity of the test were 100% and 93%, respectively; the positive and negative predictive values were 64% and 100%, respectively. All patients with possible/proven IPA showed abnormal CT signs; in four cases, imaging signs followed AGA positivity (median 5 days), whereas in five cases they preceded serologic positivity (median, 8 days). In the nine patients with IPA, antifungal therapy was promptly instituted, including lipid formulations of amphotericin B (n=5) or caspofungin (n=4). In only two of the nine patients (22%) with IPA, the primary cause of death was fungal infection. CONCLUSIONS: The combination of AGA detection and early chest CT scans might be considered useful tools to detect minimal changes of IPA. Based on these findings, aggressive antifungal therapy should be initiated.

Adult↗
PubMed1995

Primary biliary cirrhosis: lung involvement.

Sub-clinical lung impairment, mostly represented by a reduced diffusion of alveolar gases, is a recognised complication of advanced primary biliary cirrhosis. The aim of the study was to evaluate the prevalence and type of pulmonary involvement in primary biliary cirrhosis and the relationship between lung function abnormalities and selected epidemiological and clinical variables. Sixty-one patients with different stages of primary biliary cirrhosis consecutively seen in our outpatient clinic were evaluated. The advancement of primary biliary cirrhosis was characterised by the histological stage, the presence of signs of portal hypertension and the Mayo Risk Score: a Cox regression model using serum bilirubin and albumin levels, prothrombin time, age and degree of oedema as selected variables. We measured static and dynamic lung volumes, by means of a spirometer, and diffusing capacity for carbon monoxide. Rheumatological disorders were evaluated by an independent rheumatologist. No patient complained of respiratory symptoms. Airway obstruction was present in one patient. In 24 patients (39%) the alveolar diffusion capacity was reduced. We did not find any significant relationship between diffusing capacity and smoking habits, advancement of liver disease and concomitant Sjogren syndrome. Reduced diffusion capacity showed a significant correlation with the presence of complete or incomplete CREST syndrome (p < 0.01) and with the presence of circulating anti-centromere antibodies (p < 0.05). Alveolar diffusion capacity is frequently impaired in patients with primary biliary cirrhosis, usually in the absence of clinical manifestations. These alterations mostly affect patients with concomitant CREST syndrome.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Development of a high-performance liquid chromatographic-mass spectrometric technique, with an ionspray interface, for the determination of platelet-activating factor (PAF) and lyso-PAF in biological samples.

An HPLC-mass spectrometric technique with an ionspray interface was developed for the determination of platelet-activating factor (PAF) and PAF-related compounds in biological samples. HPLC separations were performed using a reversed-phase column. The mass spectra showed intense [M + H]+ ions. Collision-induced dissociation of protonated molecular ions gave characteristic daughter ions corresponding to the phosphorylcholine group. By selective-ion monitoring, a detection limit of 0.3 ng was obtained for all molecules; by multiple reaction monitoring, the same sensitivity was achieved for PAF whereas for lyso-PAF the limit was 3 ng. Finally, PAF was comparatively determined by bioassay and HPLC-MS after extraction from the cell pellets and the supernatants of human polymorphonuclear neutrophils unstimulated or stimulated with opsonized zymosan. The good correlation observed between these techniques indicated the reliability of HPLC-MS for biochemical studies on PAF and PAF-related molecules.

Chromatography, High Pressure Liquid↗
PubMed1992

Preoperative evaluation in non-cardiac surgery: cardiac risk assessment.

Nine hundred and ninety patients, ages 20 years or older, undergoing non-cardiac elective surgery were prospectively studied to identify high cardiac risk preoperative factors in a case-mix population and to assess cardiological risk. The prevalence of major cardiac complications was 2.3%, including 0.8% mortality. Univariate analysis showed that: age; history of chest pain; dyspnea; hypertension; presence of systolic murmur and third sound; diastolic pressure greater than 95 mmHg; electrocardiogram left ventricular hypertrophy; cardiothoracic ratio greater than 0.5 and valvular calcifications are associated with cardiac complications (p = 0.001-0.02), with low sensitivity (range: 14-38%) and high specificity (range: 85-98%). Cardiological referral was required for 169 patients (17%) that showed a higher prevalence of cardiovascular diseases (85%) and of cardiac complications (5.3%). Cardiologists required further tests for 13 patients (7.7%) and modified therapy for 93 (55%). High cardiac risk patients are identified preoperatively in current practice and cardiological referral is frequent; further studies are mandatory to evaluate the most effective and efficacious procedures.

Adolescent↗
PubMed1992

Platelet-activating factor in bronchoalveolar lavage from patients with sarcoidosis.

Platelet-activating factor (PAF), a lipid mediator of inflammation and anaphylaxis, may play a role in several physiopathologic alterations of the lung. A lipid compound with physicochemical and biologic characteristics similar to synthetic PAF was extracted and purified from bronchoalveolar lavage (BAL) fluid of 15 of 34 patients with sarcoidosis. PAF was quantitated by a bioassay on washed rabbit platelets. The specificity of platelet aggregation was assessed by using two different PAF receptor antagonists. The incidence of detectable amounts of PAF in BAL fluid of sarcoid patients was statistically significant (chi 2 = 4.064, p = 0.044) when compared with the 14 normal control subjects. The results demonstrated an increased production of PAF in the lower respiratory tract of patients with sarcoidosis. The presence of PAF in BAL fluid, however, did not correlate with radiologic stage, intensity of alveolitis, gallium scanning positivity, angiotensin-converting enzyme serum level, or lung function tests. Therefore, a direct relationship between presence of PAF in BAL fluid and activity of lung disease in patients with sarcoidosis was not directly established.

Adult↗
PubMed1991

Tumor-associated trypsin inhibitor (TATI) in the diagnosis of lung cancer.

To evaluate the usefulness of tumor-associated trypsin inhibitor (TATI) as a marker for the diagnosis of lung cancer we determined serum levels of this peptide in 255 patients with lung cancer and in 74 patients with chronic obstructive lung disease. A reference population consisting of 151 healthy volunteers was also studied. TATI concentrations were measured by radioimmunoassay. As a cut-off point we used the 99th percentile of the TATI concentrations in a reference population, which was 32 micrograms/l. TATI does not appear to be a good tumor marker in lung cancer. Its sensitivity is poor in comparison with CEA and TPA. The correlation between TATI levels and stage of the disease and histological type was weak.

Biomarkers, Tumor↗
PubMed1991

Tumor-associated trypsin inhibitor (TATI) in bone diseases.

The casual observation of high serum levels in (TATI) of tumor associated trypsin inhibitor in patients with osteosarcoma inspired us to evaluate the use of this peptide in the diagnosis of various bone diseases. We determined the serum concentrations of TATI in 35 patients with various bone diseases, i.e. degenerative diseases, bone metastasis and osteosarcomas. The cut off, determined as the 99th percentile of TATI serum levels in healthy volunteers was 32 micrograms/l. TATI has a better sensitivity in osteosarcomas (83%) than in metastatic bone diseases (33%). Its specificity in non-malignant bone diseases was not exceptional (82%). This is probably because TATI may also behave as on acute phase protein, the levels of which can rise in non-malignant diseases and also as a result of a tissue reaction in primary bone tumors.

Biomarkers, Tumor↗
PubMed1988

[Respiratory function evaluation in esophageal surgery. Predictive value of tests].

In the context of major surgery the predictive significance of respiratory function tests in relation to postoperative pleuro-pulmonary complications is assessed. A statistical analysis is performed on a series of 85 oesophagectomy after thoracotomy and laparotomy. The most significant respiratory function indices are found to be those relating to volume restriction and the Mottley index.

Adult↗
PubMed1987

[Collageno-vascular diseases and interstitial pulmonary fibrosis. An analysis of diagnostic tests].

Collagenovascular diseases, particularly rheumatoid arthritis, LES and scleroderma frequently involve the lung. A group of 15 patients with collagen vasculopathies was analysed with a view to identifying the most suitable invasive and noninvasive tests for the diagnosis of the interstitial fibrosis of the lung that often accompanies such disorders. Among the noninvasive tests only the respiratory function tests (especially DLCO) are adequately sensitive, while chest X-rays, gallium scintigraphy of the lung and ACE are relatively unreliable. Bronchoalveolar lavage is often altered (though the intensity varies considerably) and transbronchial biopsy appears to be the ideal diagnostic examination.

Aged↗
PubMed1987

[Usefulness of the determination of CEA and Ca 19-9 in the diagnosis and staging of bronchial carcinoma].

The value of CEA and Ca 19-9 assays in the diagnosis and staging of lung cancer is examined. The particular sensitivity of CEA especially in extensive or metastasised tumours is demonstrated. The minimal sensitivity of Ca 19-9 is pointed out but also its absolute specificity in high risk control groups (smokers and BPCO). It is therefore concluded that Ca 19-9 might be used together with CEA in the diagnosis and staging of lung cancer.

Antigens, Neoplasm↗
PubMedDate not supplied

Alpha-fetoprotein and mediastinal germ cell tumors.

The Authors discuss the utility of alpha-fetoprotein (AFP) determination in mediastinal dysembryomas. AFP should be determined in all cases of mediastinal lesion. High levels of up to 500 ng/ml are a sure sign of germ cell tumors. An extremely high level (greater than 1,000 ng/ml) is an indication that the lesion is a mesoblastoma. An increase in the AFP level in the follow-up of patients affected by germ cell tumors is a sure sign of the recurrence of the disease.

Humans↗
PubMedDate not supplied

Alpha-fetoprotein as tumor marker in lung cancer diagnosis.

Authors have studied AFP serum levels in 289 lung cancer. Only 2 cases (0.7%) showed little increase of this glycoprotein and liver pathologies were present in both patients, authors believe immunohistochemical study is necessary in lung cancers that show AFP increase.

Biomarkers, Tumor↗
PubMedDate not supplied

Cardiac arrhythmias following lung resection in patients treated and untreated with digitalis prophylaxis.

Cardiac arrhythmias and failure following lung resection in patients treated and untreated with digitalis prophylaxis have been evaluated. In 82 patients without digitalis (1st group) 11% tachyarrhythmias and 5.7% cardiac failures were noted. In 100 patients treated with digitalis (2nd group) 7% arrhythmias and no cardiac failures were registered. Among cardiac complications only one death in the first group was observed. The mean period of incidence of arrhythmias appears dilated in the digitalis group (3rd vs. 5th postoperative day) and this could be attributed to the early suspension of the drug.

Aged↗