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Biomedical subjects

E Lupi

Publications and source records attributed to E Lupi.

At least 19 recordsLinked to original sources
PubMed2006

Salivary glands tumours: a retrospective study of 454 patients.

AIM: Salivary glands tumors constitute a highly heterogeneous group in human oncological pathology. They show different clinical, epidemiological, histopathological and evolutionary characteristics. METHODS: In this paper we have analysed their epidemiological aspects in 454 patients with salivary glands tumors surgically treated at the Maxillofacial Surgical Unit of the Azienda Ospedaliero-Universitaria ''Ospedali Riuniti Umberto I-G.M. Lancisi-G. Salesi'', Ancona, Italy, from 1990 to 2002, to evaluate the incidence of the different types of neoplasia and their age and sex distribution. RESULTS: Our results show that 63.22% of salivary glands tumors occur in the parotid gland, with a predominance of benign tumours, pleomorphic adenoma being the most prevalent histological type. A higher prevalence was observed in the female sex. CONCLUSIONS: Malignant tumors were more common in the elderly than in young patients and the most common histological types were mucoepidermoid carcinoma and adenoid cystic carcinoma.

Age Distribution↗
PubMed1999

Single-bolus tenecteplase compared with front-loaded alteplase in acute myocardial infarction: the ASSENT-2 double-blind randomised trial.

BACKGROUND: Bolus fibrinolytic therapy facilitates early efficient institution of reperfusion therapy. Tenecteplase is a genetically engineered variant of alteplase with slower plasma clearance, better fibrin specificity, and high resistance to plasminogen-activator inhibitor-1. We did a double-blind, randomised, controlled trial to assess the efficacy and safety of tenecteplase compared with alteplase. METHODS: In 1021 hospitals, we randomly assigned 16,949 patients with acute myocardial infarction of less than 6 h duration rapid infusion of alteplase (< or = 100 mg) or single-bolus injection of tenecteplase (30-50 mg according to bodyweight). All patients received aspirin and heparin (target activated partial thromboplastin time 50-75 s). The primary outcome was equivalence in all-cause mortality at 30 days. FINDINGS: Covariate-adjusted 30-day mortality rates were almost identical for the two groups--6.18% for tenecteplase and 6.15% for alteplase. The 95% one-sided upper boundaries of the absolute and relative differences in 30-day mortality were 0.61% and 10.00%, respectively, which met the prespecified criteria of equivalence (1% absolute or 14% relative difference in 30-day mortality, whichever difference proved smaller). Rates of intracranial haemorrhage were similar (0.93% for tenecteplase and 0.94% for alteplase), but fewer non-cerebral bleeding complications (26.43 vs 28.95%, p=0.0003) and less need for blood transfusion (4.25 vs 5.49%, p=0.0002) were seen with tenecteplase. The rate of death or non-fatal stroke at 30 days was 7.11% with tenecteplase and 7.04% with alteplase (relative risk 1.01 [95% CI 0.91-1.13]). INTERPRETATION: Tenecteplase and alteplase were equivalent for 30-day mortality. The ease of administration of tenecteplase may facilitate more rapid treatment in and out of hospital.

Aged↗
PubMed1975

Pulmonary artery involvement in Takayasu's arteritis.

Although pulmonary artery disease in Takayasu's arteritis has been described since 1940, it has received little attention. The clinical, hemodynamic, and angiographic features of the pulmonary involvement were studied in 22 patients with systemic arterial disease. Pulmonary involvement was found in 50 percent of the cases. Moderate pulmonary hypertension was a common finding (73 percent). Lesions were generally localized to the large and medium pulmonary vessels. None of the patients had pulmonary symptoms, but in 63 percent there were clinical, radiologic and electrocardiographic findings suggesting pulmonary hypertension or right heart strain. We believe that the pulmonary circulation should be routinely studied in patients with Takayasu's arteritis and that pulmonary involvement should be included in the classification of the disease.

Adolescent↗
PubMed1975

A radiologic index of pulmonary arterial hypertension.

A new radiologic index indicative of pulmonary artery hypertension is presented. It was obtained by measuring the horizontal distances from the midline to the first divisions of the right and left pulmonary arteris, and dividing the sum of these distances by the maximum transverse diameter of the thorax. The index was significantly different in groups with and without pulmonary hypertension and was abnormal (above 38 percent in 111 of 150 patients with cardiovascular disease and pulmonary arterial hypertension (PAH). None of the cases with increased pulmonary flow from cardiac shunts but normal PAP had an anbormal index. Thus, an abnormal index suggested PAH but correlated poorly with the extent of hypertension.

Adolescent↗
PubMed1975

Electrocardiographic criteria for the diagnosis of left anterior fascicular block. Left axis deviation and delayed intraventricular conduction.

The two current criteria for diagnosis of left anterior fascicular block (LAFB) were evaluated; they are marked left axis deviation (LAD) and a delay in the time of inscription of the intrinsicoid deflection (ID) in lead aVL asynchronous to V6. From 400 electrocardiograms with a LAD of --30 degrees or greater, 62 percent showed asynchronous activation of the left ventricle. There was only a general relationship between the degree of LAD and delayed ID in aVL. The incidence of delayed ID in aVL was as follows: 2 percent with mean frontal QRS axis at 0 degrees; 9 percent at --15 degrees; 41 percent at --30 degrees; 69 percent at --45 degrees; 82 percent at --60 degrees; and 100 percent at --75 degrees or greater. The lack of correlation between both criteria in many instances questions their validity. The LAD alone should not be considered synonymous with LAFB. Recognition of delayed inscription of the ID in aVL is a useful supplemental criterion for diagnosis.

Bundle-Branch Block↗
PubMedDate not supplied

[Anti-chromatin antibodies in juvenile rheumatoid arthritis].

OBJECTIVE: to evaluate the prevalence and clinical significance of anti-chromatin antibodies (Abs) in juvenile rheumatoid arthritis (JRA). METHODS: IgG anti-chromatin Abs were detected by an enzyme-linked immunosorbent assay (ELISA), in sera of 94 children with JRA (10 children with systemic, 38 with polyarticular and 46 with oligoarticular disease onset). As control group, 33 age- and-sex-matched healthy children (HC) were also examined. RESULTS: Abs to chromatin were detected in 24/94 (25.5%) of children suffering from JRA. Particularly, the higher prevalence of anti-chromatin Abs has been found in children with oligoarticular (30,4%) and polyarticular (23.7%) onset JRA. In these groups Abs titers were significantly higher compared to systemic JRA and HC (p=0.003). Anti-chromatin Abs were observed more frequently in patients with oligoarticular disease and chronic uveitis (21.7%). Furthermore, higher levels of anti-chromatin Abs has been found in all the patients treated with anti-TNF-alpha therapy (p< 0.0001). CONCLUSIONS: our results confirm previous data about the prevalence of anti-chromatin Abs in JRA. These Abs were significantly higher in the group of patients with oligoarticular onset with past or present history of ocular involvement and in the group with polyarticular JRA treated with biologic therapy. A long-term follow-up study could be useful to evaluate the potential utility of these autoantibodies.

Arthritis, Rheumatoid↗
PubMedDate not supplied

[Comparative analysis of reperfusion time in primary angioplasty vs thrombolysis. Success vs time].

UNLABELLED: We studied 398 patients with diagnosis of acute myocardial infarction who arrived within the first six hours of symptom onset that were treated with thrombolysis or primary angioplasty, they were divided in two groups: Group 1 (n = 198), those treated with 1.5 million U of streptokinase over 60 min and Group 2 (n = 200), those treated with primary angioplasty. In Group 1 the "pain-door" time was 3.7 +/- 1.7 hs vs 3.8 +/- 2.4 hs in group 2 (p = NS). The "door-needle" time was 48 +/- 12 min. compared with the "door-balloon" time of 84 +/- 30 min (p < 0.001). In Group 1, 154 (77.6%) of the patients had clinical of reperfusion after thrombolysis, 58 of them underwent coronary angiography and had an infarct related artery (IRA) patency rate of 45.3%. In Group 2 the IRA patency rate was 85.5% (p < 0.005). CONCLUSION: Thrombolysis was achieved in a lesser period of time but our findings showed that primary angioplasty was more effective obtaining a TIMI 3 flow.

Acute Disease↗
PubMedDate not supplied

[Myocardial infarct following left ventriculography. Report of 2 cases and review of the literature].

Two cases, a sixteen-month-old girl and a 13 year-old bol, were presented who developed myocardial infarction as a consequence of angiocardiographic study. The boy (case 1) showed electrocardiographic signs of lower necrosis with elevation of the TGO and DHL and having a satisfactory clinic evolution. The girl (case 2), in the electrocardiogram, showed an inactivatable zone on the lateral wall and signs suggesting anteroseptal subendocardic necrosis, and enzymatic elevation. She died the fourth day following the hemodynamic study. The literature regarding this complication and the possible triggering causes are reviewed.

Adolescent↗
PubMedDate not supplied

[Efficacy of clopidogrel as ADP-dependent platelet aggregation inhibitor. Study on individuals with coronary artery disease].

Acetyl-salicylic acid inhibits thromboxane A2 production and reduces the risk of vascular occlusive events by 20 to 25%. Ticlopidine inhibits ADP-dependent platelet aggregation and reduces the same risk by 30 to 35%, but produces some adverse effects. Clopidogrel is a ticlopidin-derived antiplatelet-drug, with the same mechanism of action; reduces the expression of the glycoprotein IIb/IIIa, the fibrinogen receptor on the platelet surface. Clopidogrel has the same clinical efficacy of ticlopidin and lowers the incidence of adverse effects. In this study, we evaluated the effects of one daily dosis of 75 mg of clopidogrel on platelet function in 33 subjects with coronary artery disease. Before treatment and after the 6th and 12th week, the following parameters were evaluated: 5 microM-ADP and 20 micrograms/mL collagen-induced platelet aggregation, bleeding time and fibrinogen concentration. In basal and in the 6th and 12th week samples, ADP-induced platelet aggregation was 90.7% +/- 13.2, 54.6% +/- 23.2 and 49.2% +/- 23.7 respectively, that represents a significant reduction of 38.6% and 44.4%. Reduction of collagen-induced platelet aggregation was not significative. Plasmatic fibrinogen did not suffer variation during treatment. Bleeding time was significant prolonged from 4.1 minutes to 15.4 and 14.6 minutes (3.7-3.5 times compared with the test before treatment). There were no haemorrhagic complications, only digestive discomfort in fewer than 3% of patients. We concluded that clopidogrel is a safe and efficacious drug for patients, it efficiently reduces ADP-induced platelet aggregation and prolongs bleeding time.

Adenosine Diphosphate↗
PubMedDate not supplied

[Detection of early occlusion of aortocoronary by-passes. Usefulness of a non-angiographic method].

A total of 83 bypasses were studied. Angiographic results demonstrated occlusion in 3 of 24 bypass of internal mammary artery placed in the anterior descending artery, 2 in the right coronary artery, 1 in the posterolateral of the circumflex and 1 in the first diagonal branch, with a total occlusion average of 8.4% within the first 8 days. We found a good correlation between the coronarographic angiograms and the positivity or negativity of the echo-electrocardiographic tests, during atrial pacing. We believe that this simple method could be done routinely in all the patients after coronary surgery, to decide the need of a new coronary angiogram. Furthermore, this study shows that the occlusion of a single coronary bypass does not produce myocardial infarction, detectable by enzymatic measures or by resting EKG. This method also detects the early post-operatory sinus sick syndrome.

Adult↗
PubMedDate not supplied

Autoantibodies to chromatin: prevalence and clinical significance in juvenile rheumatoid arthritis.

OBJECTIVE: To determine the prevalence of anti-chromatin antibodies (Abs) in juvenile rheumatoid arthritis (JRA) and to assess any association between the presence of anti-chromatin Abs and clinical subsets of the disease. METHODS: IgG anti-chromatin Abs and anti-extractable nuclear antigens (ENA) Abs were detected by an enzyme-linked immunosorbent assay (ELISA), and antinuclear Abs (ANA) by indirect immunofluorescence in sera of 89 children with JRA. Ten children with systemic, 32 with polyarticular and 47 with pauciarticular disease onset (uveitis occurred in 17/47 children) were studied. As a control group, 12 sera of patients suffering from idiopathic uveitis and 31 age- and-sex-matched healthy children (HC) were examined. RESULTS: Abs to chromatin were detected in 14/47 (29.8%) of children suffering from pauciarticular onset JRA and in this group the higher prevalence of anti-chromatin Abs has been found in children with chronic uveitis (p = 0.002). Anti-chromatin positivity was observed in 2/10 (20%) of systemic and in 3/32 (9.3%) of polyarticular onset JRA. Furthermore, none of the patients with idiopathic uveitis and HC had Abs to chromatin. anti-chromatin Abs titers remained relatively stable over a 6-month control period. CONCLUSION: Our results confirm previous data about the presence of circulating anti-chromatin Abs in juvenile arthritis. Interestingly, anti-chromatin Abs were significantly higher in the group of patients with pauciarticular onset with past or present history of uveitis, than in patients without ocular involvement. A long-term follow-up study could be useful to demonstrate the potential utility of these autoantibodies in diagnosing, classifying and treating children affected.

Antibodies, Antinuclear↗
PubMedDate not supplied

[Effects of nifedipine in patients with unstable chronic obstructive pulmonary disease].

The hemodynamic and gas exchange effects of 20 mg of nifedipine (NFD), at rest and exercise were evaluated in seven patients with unstable COPD and pulmonary hypertension. The cause of instability was pulmonary infection (n = 6) and pulmonary emboli (n = 1). At rest, pulmonary hypertension (Pp = 40 +/- 3 mmHg), severe hypoxemia (PaO2 +/- 2 mmHg) and elevated pulmonary vascular resistance (Rp) = 9 +/- .6 u.sq.m, were found. At exercise, Pp raised to 52 +/- 5 mmHg with no change in cardiac index (CI), Rp or gas exchange. After NFD at rest, significant (p less than 0.05) increases in CI, oxygen transport and venous admixture occurred. Also, Rp and systemic arterial pressure and resistance decreased significantly. Pp and blood gas exchange did not vary. Rp and systemic resistance were lower at exercise after NFD than without the drug with no change in blood gas exchange. The pulmonary flow pressure relationship showed a right shift after NFD in both, rest and exercise conditions. We conclude that NFD can be of value for the management of pulmonary hypertension that aggravates COPD.

Adult↗
PubMedDate not supplied

[Effects of hydralazine in hypoxic vasoconstriction. Its study in a canine model of lobar atelectasis].

To determine whether hydralazine (H) a systemic vasodilator, inhibits hypoxic pulmonary vasoconstriction (HPV) we studied in a canine model of lobar atelectasis (LA) the circulatory changes during the following interventions: a) control 1 (LA = HPV), b) during the acute effect produced by opening bilateral arteriovenous fistulas (OF), c) after the closure of the fistulas (CF) (control 2), d) after infusing H (0.33 mg/kg) and e) bleeding the animal at the end of the experiment (control 3). Once HPV was stabilized (control 1), both opening the fistulas and infusing H produced a similar and significant increase in cardiac output and a decrease in resistance (p less than 0.05). Mixed venous oxygen tension (PvO2) closely followed the changes in cardiac output (Qt). Intrapulmonary shunt (Qs/Qt) significantly increased (p less than 0.05) with the fistulas open and with H infusion. CF and bleeding the animal at the end of the experiment reversed the changes in Qt and Qs/Qt. The similar increases in Qt and Qs/Qt by OF or infusing H seems to be related to the levels of pVO2. Our data suggest that hydralazine inhibits pulmonary vasoconstriction probably by raising the level of pVO2 although a direct pulmonary vasodilatory effect of the drug could not be ruled out.

Animals↗