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Biomedical subjects

F Stefanini

Publications and source records attributed to F Stefanini.

At least 19 recordsLinked to original sources
PubMed1996

Liver transplantation in HBsAg-positive HBV-DNA--negative cirrhotics: immunoprophylaxis and long-term outcome.

The presence of a positive hepatitis B surface antigen (HBsAg) has been considered a highly questionable indication for orthotopic liver transplantation. We report our experience in the treatment of HBsAg-positive HBV-DNA-negative cirrhotics with liver transplantation, whether or not followed by passive prophylaxis with specific immunoglobulins. Of the 123 cirrhotics who received transplants at our institution since May 1986, 39 (31.7%) were HBsAg positive; of these, 1 was HBV-DNA positive, and 4 were hepatitis Be antigen (HBeAg) positive. Since April 1991, 25 HBsAg-positive HBV-DNA-negative cirrhotics have undergone an original protocol with the periodical intramuscular administration of 5,000 IU of specific immunoglobulins starting in the anhepatic phase and lasting for at least 1 year. There were no differences among cirrhotics in terms of operative mortality and long-term survival with respect to the presence of the HBsAg. Of the 35 HBsAg-positive HBV-DNA-negative patients having a follow-up of 1 month or longer, 12 (34.3%) developed HBsAg recurrence; of them, 4 (33.3%) had received a complete prophylaxis, whereas 8 (66.7%) had not. The recurrence rate was 80% (8 out of 10) in the group of patients who had not received the prophylaxis and 16% (4 out of 25) in the group who had received the prophylaxis (P = .0003). The actuarial recurrence rate in the treated patients was 20.2% and 20.2% after 1 and 3 years, respectively, whereas in the untreated group it was 60.0% and 70.0% (P < .01). The hazard of recurrence of treated patients was reduced to 24.9% compared with untreated patients. Liver transplantation can be performed in HBsAg-positive HBV DNA negative patients without an increase in the operative risk or a worsening of long-term results. Immunoglobulin prophylaxis seems to be effective in preventing hepatitis recurrence after transplantation.

Adolescent↗
PubMed1996

Increased prevalence of aortic calcification in chronic pancreatitis.

OBJECTIVES: The seemingly frequent radiological observation of aortic calcification in patients with chronic pancreatitis seen in our clinic prompted us to assess the prevalence of this lesion in this disease. METHODS: Fifty-seven consecutive patients with chronic pancreatitis (52 male, five female; mean age 44.2 yr, range 26-59 yr), and 66 healthy controls, matched for sex and age, were studied. Of the 66 controls, 40 were both smokers and drinkers, as were most of the patients. The presence of aortic calcification was determined by performing anteroposterior and lateral radiograms of the prelumbar region. RESULTS: Radiological evidence of aortic calcification was found in 35 of the 57 patients with chronic pancreatitis (61.4%) and in 12 of the 40 smoker control (30.0%) (p < 0.005); none of the nonsmoker controls had aortic calcification. The increased frequency was more pronounced among the patients under 50 yr of age (40.0% vs. 0% and 70.4% vs. 35.3% in the 30-39 and 40-49 yr age groups, respectively). No significant differences in serum levels of cholesterol and triglycerides, blood pressure, alcohol, and smoking habits were observed between chronic pancreatitis patients with aortic calcification and those without, or between patients with aortic calcification and controls. CONCLUSIONS: The results indicate that patients with chronic pancreatitis have a significantly higher prevalence of aortic calcification than controls. The reason for the increased prevalence of this advanced atherosclerotic lesion is nuclear.

Adult↗
PubMed1994

Differential expression of matrix-metalloproteinase-1 and -2 genes in normal and fibrotic human liver.

Altered degradation of extracellular matrix has been implicated in the pathogenesis of hepatic fibrosis. We investigated levels and cellular sites of gene expression of two major collagen-degrading enzymes, matrix-metalloproteinase (MMP)-1 (fibroblast type-interstitial collagenase) and MMP-2 (72-kd gelatinase, type IV collagenase) in five normal and 18 fibrotic human livers as well as in cultured human hepatic fat-storing cells by Northern blot analysis and in situ hybridization. Fat-storing cells expressed both MMP-1 and MMP-2 RNA in vitro. In vivo, MMP-1 was undetectable in mesenchymal and parenchymal cells of all liver specimens, whereas MMP-2 transcripts were expressed in all livers by vimentin-positive, CD68-negative mesenchymal cells. Mesenchymal cells of all fibrotic livers displayed high transcript levels of transforming growth factor-beta 1, which is known to modulate MMP expression. Along with de novo fibrogenesis and possibly influenced by transforming growth factor-beta 1, expression of MMP-2 in the absence of MMP-1 expression may be responsible for the quantitative and qualitative changes of extracellular matrix observed in chronic liver disease.

Autoradiography↗
PubMed1993

Effect of carbamazepine on EEG background activity and on interictal epileptiform abnormalities in focal epilepsy.

The effect of carbamazepine (CBZ) on EEG background activity and on interictal epileptiform abnormalities (IEA) was studied in 15 patients with focal epilepsy who started antiepileptic drug treatment (AED) for the first time. A computerized EEG study, performed before and two months after starting therapy, utilized spectral analysis and automatic recognition of IEA. The occurrence of seizures was considered in order to clarify the relationship between IEA and the seizures themselves. Statistical evaluation of EEG spectral values was calculated through analysis of variance (ANOVA), while for IEA the non parametric Wilcoxon test was utilized. In 13 patients who remained seizure-free during the two month-period of observation, IEA was unchanged or decreased. In one of the two patients who continued to have seizures, IEA significantly increased. During therapy, the background activity presented significant increase of slow activity in approximately half the patients. This increase was more evident in those patients showing active epileptic foci before treatment, rather than in those with rare or no spikes. The changes in IEA seem to be related to the occurrence of seizures rather than to a direct action of CBZ on spikes.

Adolescent↗
PubMed1992

EEG changes induced by carbamazepine therapy at rest and during mental processes.

The effects of carbamazepine (CBZ) on EEG background activity have been studied, at rest and during mental processes, in 18 epileptic patients suffering from focal epilepsy and starting antiepileptic treatment for the first time. The EEGs were recorded before and after CBZ therapy, at rest with eyes closed (EC), during blocking reaction (BR), fixation (FIX) and mental arithmetic (MA) tasks, and then evaluated by spectral analysis. All data underwent statistical evaluation utilizing the ANOVA and correlation coefficient. The following parameters were evaluated: mean absolute and relative power and mean frequency. The results have shown that CBZ induced a significant increase of slow activity at rest with EC, which was represented by delta potentials, and was correlated with CBZ plasma levels. In evaluating the different cortical activation patterns, a decrease of the alpha reactivity was noted during BR and FIX, while a significant increase of beta activity was observed during the performance of all tasks. The relationship between the increased beta power, possibly reflecting an increase of cognitive activity for processing information, and the lack of a significant decrease of alpha activity are discussed.

Adolescent↗
PubMed1992

Effect of carbamazepine treatment on EEG changes induced by different cortical activation patterns in newly referred epileptic patients.

Sixteen epileptic patients suffering from focal epilepsy who underwent antiepileptic drug treatment with carbamazepine (CBZ) for the first time were studied. The EEG was recorded at rest with eyes closed, during blocking reaction (BR), fixation (FIX) and mental arithmetic tasks. The computerized EEG study, performed before and after CBZ therapy, utilized spectral analysis. Data underwent statistical evaluation through Anova and correlation analysis. The parameters evaluated were the mean frequency and the mean absolute and relative power. The results have shown that after CBZ treatment there is a decrease in the alpha reactivity during BR and FIX, while a significant increase in beta activity was observed during all tasks. The effect of CBZ therapy on EEG activity during cortical activation patterns are discussed.

Adult↗
PubMed1992

Lateralization of the epileptogenic focus by computerized EEG study and neuropsychological evaluation.

The localization of the epileptogenic focus relies on different factors. In patients with partial seizures, asymmetries in EEG background activity were measured by a statistical evaluation of spectral data. Neurophysiological results were compared with neuropsychological findings and MRI. Fifteen of 22 patients showed asymmetries in EEG background activity. The most prominent abnormality was a statistically significant increase of slow activity observed in 59% of cases. Delta asymmetry coincided with the site of lesions, evidenced by MRI, in 83% of patients; with the site of decreased beta activity in 60% and with the maximum level of spiking activity in 58% of cases. Neuropsychological tests showed a lateralization of the hemispheric function which coincided with delta asymmetry in 33% of patients. These results suggest that the EEG background activity, when compared with other parameters, may represent a useful method in lateralizing the epileptogenic focus.

Adolescent↗
PubMed1991

An APL procedure to estimate genotype by environment interaction when two environments are considered.

Genotype by environment interaction (GEI) is a relevant topic in many fields of applied biology. Normal parametric approaches following analysis of variance are not suitable when large differences between error variances within environments are present. We illustrate an APL program following Yamada's approach to estimate GEIs and ancillary statistics when two environments are considered. The choice of APL environment is based on its value as a useful tool in algorithm implementation and problem-solving. Its use is suggested in biological applications where matrix algebra is involved and an understanding of the computing complexity of problems is generally not required.

Algorithms↗
PubMed1990

Intracerebral metastasis in Ewing's sarcoma.

The evidence of CNS involvement in Ewing's sarcoma is uncommon and very often due to a direct extension of the tumor to extradural space and meninges. We report a case of a 14-year old girl with a primary ischio-pubic localization of Ewing's sarcoma. Body CT scan showed a bone lesion involving the left fronto-temporal region of the skull without affecting the brain. After chemotherapy radiological findings showed complete recovery. Ten months after treatment, the patient had neurological symptoms. Cerebral CT scan evidenced a large tumor mass localized in the right temporal lobe. Following radiotherapy the tumor mass was no longer visible. This case shows that late intraparenchymal CNS metastasis occurs independently from the previous skull lesion. Therefore these data, even through based on a single observation, lead to believe that in some cases prophylactic chemotherapy and radiotherapy of CNS may not be necessary.

Adolescent↗
PubMed1986

Effect of ethanol intake on human erythrocyte membrane fluidity and lipid composition.

Erythrocyte membrane fluidity was evaluated in chronic alcoholic patients without any liver alteration, assuming different daily ethanol amounts, and in normal subjects and related to ghost fatty acid and total lipid composition obtained by high resolution gas chromatography. Erythrocyte membrane fluidity was significantly increased in a dose dependent manner in chronic alcoholic patients respect to normal subjects. This real fluidizing effect of ethanol "in vivo" was attributed mainly to a significant increase in the polyunsaturated fatty acids amount in patient ghosts in comparison with control subjects. On the other hand the cholesterol/phospholipid ratio was not significantly affected by chronic ethanol assumption.

Adult↗