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Biomedical subjects

F Taggi

Publications and source records attributed to F Taggi.

At least 37 records · Page 2Linked to original sources

Renal bone disease in 76 patients with varying degrees of predialysis chronic renal failure: a cross-sectional study.

BACKGROUND: Renal osteodystrophy has been studied less extensively in predialysis than in dialysis patients. Different types or histological patterns in their natural evolution from moderate to advanced severity of renal insufficiency are only partially known, with special regard to adynamic bone disease and its relationship with osteomalacia. METHODS: We conducted a cross-sectional retrospective study on 76 unselected patients with chronic renal failure undergoing conservative treatment, with a wide range of severity of renal insufficiency. All the patients were subjected to bone biopsy for histological and histomorphometric evaluation. The patients, 44 males and 32 females ranging in age from 18 to 72 years and with serum creatinine 1.2-11.4 mg/dl, had not been exposed to aluminium-containing drugs and had never been treated with vitamin D or calcitriol. RESULTS: Ten patients had normal bone, nine were diagnosed with adynamic bone disease, 26 with mild mixed osteodystrophy, seven with predominant osteomalacia, 22 with advance mixed osteodystrophy, and two with predominant hyperparathyroidism. Patients with adynamic bone disease had less severe chronic renal failure than the other pathological subgroups, intact PTH above the upper limit of normal, normocalcaemia, and reduced serum osteocalcin in line with a significantly lower ObS/BS. Osteomalacia was found in a more advanced stage of chronic renal failure with relative hypocalcaemia and more severe metabolic acidosis. A creatinine clearance of 20 ml/min served as a clear demarcation between this histological group and adynamic bone disease. CONCLUSIONS: It is postulated that adynamic bone disease is a form of renal osteodystrophy, separate from osteomalacia, appearing when bone resistance to PTH develops, probably a transient stage to more hyperparathyroid histological classes with increasing severity of chronic renal failure.

Adolescent↗

Capodanno Senza Danno: the effects of an intervention program on fireworks injuries in Naples.

To study the effects of a comprehensive, multifaceted intervention program to reduce fireworks-related injuries during the Italian New Year's holiday season, active surveillance was conducted in the 18 public emergency rooms of Naples, Italy, before and after implementation of the program. Preintervention data collected between December 24, 1992, and January 6, 1993, were compared with data collected during the same period in 1993-1994. The number of injuries decreased by 48% from 353 to 183, with the greatest declines seen among 10- to 12-year-olds. The broad-based intervention implemented during the 1993-1994 holiday season appears to have substantially reduced the number of injuries.

Adult↗

In vivo 31P spectroscopy study of treated and untreated recovery of rat partial brain ischemia.

Quantitative 31P NMR was used to follow the time variation of the hypometabolic response to hypoxic partial ischemia in an animal model. The purpose of the study was to establish the value of this repeated spectroscopy operating by means of a surface coil. It aimed at determining whether a therapeutic intervention could influence the transient changes occurring during the insult or early recovery. A pharmacological substance was thus used during a reversible forebrain ischemia, induced by a combination of vascular occlusion and mild hypoxia in two groups of rats. As an available and convenient example, L-carnitine was chosen. Statistical analysis of the experimental results revealed a significant difference of the Pi and PCr levels between treated and untreated animals.

Adenosine Triphosphate↗

Extent of alkaline phosphatase cytochemistry vs. extent of tetracycline fluorescence in the evaluation of histodynamic variables of bone formation.

Alkaline phosphatase (ALP) activity is a new histomorphometric index of the extent of osteoblastic surfaces involved in mineralization. To assess its validity in the evaluation of bone formation, we carried out a comparative study between histomorphometric values obtained on the basis of the extent of tetracycline labeling and of the length of ALP-positive endosteal surfaces. The following variables were compared (indicated by ALP when based on the extent of ALP positivity): trabecular mineralizing surface (MS/BS vs. ALP.S/BS); osteoid mineralizing surface (MS/OS vs. ALP.S/OS); bone formation rate (BFR/BS vs. ALP.BFR/BS); and adjusted appositional rate (Aj.AR vs. ALP.Aj.AR). Bone biopsies from 39 patients with chronic renal failure and different types of renal osteodystrophy were considered (48 +/- 12 years of age; 19 men and 20 women). Patients were double labeled with tetracycline and biopsies were embedded in glycol-methacrylate at +4 degrees C. Patients showed various types of renal osteodystrophy and were assigned to different groups of pathologies. Although it differed in incidence according to the different groups, ALP activity was found in typical plump osteoblasts bordering osteoid seams and in flat cells, either in contact with osteoid or along the quiescent surfaces of bone in continuity with it. Tetracycline codistributed with all these features to variable extents, according to groups. In all patients, however, ALP.S/BS and ALP.S/OS respectively exceeded MS/BS and MS/OS. In consequence of this, ALP.BFR/BS and ALP.Aj.AR were greater than BFR/BS and Aj.AR, respectively. For each of the variable considered, differences among groups of patients with different types of renal osteodystrophy were highly significant. Good correlations were found between the variables measured with the two methods.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Diagnostic value of serum peptides of collagen synthesis and degradation in dialysis renal osteodystrophy.

The assay of serum peptides of bone collagen formation and degradation could potentially provide an indirect estimate of the rate of bone turnover. In our study we have measured serum levels of the carboxy-terminal propeptide of type I procollagen (PICP) as a marker of bone formation and serum levels of the pyridinoline cross-linked telopeptide domain of type I collagen (ICTP) as a marker of bone resorption in 53 patients (47.7 +/- 10 years, M +/- SD) on haemodialysis (for 9.5 +/- 3.8 years) and affected by renal osteodystrophy. Besides PICP and ICTP, patients were also sampled for serum intact and C-terminal PTH, osteocalcin (BGP) and alkaline phosphatase (AP). A transiliac bone biopsy for histomorphometry was also performed in all. As expected both PTH assays, BGP and AP, were correlated reciprocally and to histomorphometric parameters. As for serum levels of PICP, they were on average increased (268.5 +/- 104.9 ng/ml, M +/- SD) compared to normals (range 66-176), but not correlated to classical humoral markers of hyperparathyroidism (PTH and AP), with the exception of BGP (with a rather low r value: 0.365, P < 0.01), nor to histomorphometric indices of bone resorption and formation.(ABSTRACT TRUNCATED AT 250 WORDS)

Alkaline Phosphatase↗

Intravenous versus oral calcitriol therapy in renal osteodystrophy: results of a prospective, pulsed and dose-comparable study.

Intravenous calcitriol is generally considered to be more efficient than oral administration in the treatment of secondary hyperparathyroidism of chronic renal failure, although a comparative and prospective study employing the same doses and modality of drug administration is lacking. We therefore evaluated 12 hemodialysis (HD) patients (51.7 +/- 9.4 years, mean +/- SD, HD for 8.7 +/- 4.7 years) with marked secondary hyperparathyroidism. Based on basal humoral and bone histologic parameters, we divided these patients into 2 comparable groups. Calcitriol (0.015 micrograms/kg) was given at the end of each dialysis intravenously in group A and orally in group B. Humoral parameters were evaluated basally and after 1, 2, 4 and 8 months. Ax bone biopsy was taken at the start and at the end of the study. From the first month of treatment, group A showed an increment in ionized calcium (from 1.28 +/- 0.08 to 1.37 +/- 0.12 mmol/l, p < 0.01), with a reduction in intact parathyroid hormone (from 470.1 +/- 349.5 to 255.5 +/- 256.5 pg/ml; p < 0.0003) and alkaline phosphatase (from 615.1 +/- 696.3 to 445.3 +/- 577.7 mU/ml, p < 0.001). The occurrence of hypercalcemia prompted a reduction in dialysate calcium content in 4 of 6 patients after 4 months, and of the calcitriol dose in 2 of 4 patients after 6 months. Ionized calcium then turned to 1.32 +/- 0.11 (p = n.s. compared to basal) while the intact parathyroid hormone concentration tended to revert (363.3 +/- 360 pg/ml, p = n.s. compared to basal) and alkaline phosphatase remained low (420 +/- 638 mU/ml, p < 0.0005).(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗

Biologic effect of 1,24(R)(OH)2D3 versus 1,25(OH)2D3 administration in chronic renal failure.

1,24(R)(OH)2D3 is a synthetic analogue of 1,25(OH)2D3 which binds to the same receptors as the physiologic metabolite with a lower affinity. The aim of the present study was to compare the activity of 1,24(R)(OH)2D3 and 1,25(OH)2D3 on several target organs in patients with chronic renal failure. Treatment with 1,24(R)(OH)2D3 at doses of either 1 or 2 micrograms daily was carried out in two groups of 9 patients, with serum creatinine of 4.61 +/- 1.59 and 4.66 +/- 1.46 mg/dl, respectively. Doses of 1,25(OH)2D3 were 0.5 and 1 microgram daily and were administered to 9 and 13 patients, serum creatinine of 4.52 +/- 1.67 and 4.3 +/- 1.16 mg/dl, respectively. Treatment periods were of 2 weeks. Administration of 1,25(OH)2D3, 1 microgram, induced significant increments of intestinal calcium absorption (ICA), ionized calcium, osteocalcin, serum creatinine, urine Ca/GFR, and a decrease in iPTH. 1,25(OH)2D3, 0.5 microgram, induced a significant increase in ICA and osteocalcin and a decrease in iPTH. Similarly 1,24(OH)2D3, 2 micrograms daily, significantly stimulated ICA and raised serum levels of osteocalcin and creatinine while lowering serum iPTH. In addition, 1,24(R)(OH)2D3 administration induced a significant fall of serum 1,25(OH)2D3. Following 1 microgram, only osteocalcin increased. Therefore, the dose of 2 micrograms of 1,24(R)(OH)2D3 has biologic activity similar to 0.5 microgram 1,25(OH)2D3 (4:1). However the activity ratio on osteocalcin production appears to be 2:1. In addition, 1,24(R)(OH)2D3 is able to inhibit renal tubular 1 alpha-hydroxylase. In conclusion 1,24(R)(OH)2D3 may prove to be useful in the treatment of metabolic bone disease.

Adult↗

Ovarian cancer and dietary habits.

One hundred seven patients with epithelial ovarian cancer and one hundred fifty healthy women, categorized according to age, were evaluated for constitutional characteristics and also for dietary habits. No significant differences were observed between patients and controls in menarchal and menopausal history. Daily intake of proteins, glycides, lipids and calories was significantly higher in patients than in controls. However obesity was not confirmed as a risk factor for ovarian cancer. These conflicting data confirm that in ovarian neoplasia, although the exact mechanism is unknown (direct action or indirect effect), dietary factors may play an important role, suggesting a new mechanism in the etiology of this disease.

Case-Control Studies↗

Plasma catecholamine responses during a personalized physical stress as a dynamic characterization of essential hypertension.

High performance liquid chromatography (HPLC) with electrochemical detection proves to be a reliable method for determination of plasma catecholamines (CA) to assess the possible role of the sympathetic nervous system (SNS) in essential hypertension (EH). The present investigation in a group of 15 normotensive (N) and 13 stable EH patients, homogeneous for age and duration of hypertension, was carried out without treatment in the supine position, up-right position and during a personalized bicycle exercise. Mean blood pressure, mean heart rate, plasma renin activity and plasma aldosterone were also evaluated at the various exertion phases. Norepinephrine (NE) and epinephrine (E) showed a progressive increase in N and in EH patients, reaching the highest values at maximum effort. However, EH patients showed higher E plasma levels than N before maximum effort. Dopamine (DA) reached the highest values in N at maximum effort and in EH patients at recovery time. These findings allow us to foresee the possibility of a better characterization of the SNS role in EH.

Adult↗

Osteocalcin, iPTH, alkaline phosphatase and hand X-ray scores as predictive indices of histomorphometric parameters in renal osteodystrophy.

To evaluate the relationship between hyperparathyroid bone X-ray lesion, biochemical parameters and bone histology in chronic renal failure, 59 patients (52 +/- 14.9 years; Crs 4.7 +/- 2.2 mg/dl, mean +/- SD) on conservative treatment and 103 (48 +/- 14 years) on hemodialysis (from 48.4 +/- 36.7 months) were studied. Right-hand X-ray was carried out for evaluation of the scores (0-3) of acroosteolysis (score A) and subperiosteal resorption (score B). Serum iPTH, osteocalcin and alkaline phosphatase (AP) were measured. In addition in a subset of 53 patients, 30 in predialysis and 23 in dialysis, a bone biopsy was performed for histomorphometry. In predialysis the scores A and B correlated with bone GLA protein (BGP) (p less than 0.01), AP (p less than 0.05) and osteoid surface (p less than 0.05) and 0.01 respectively). In hemodialysis the same level of significant correlation (p less than 0.001) was found between the scores and the three humoral parameters. Score A correlated with active osteoblastic surface and active resorption surface while score B correlated with active osteoblastic surface (p less than 0.01), osteoid surface and active resorption surface (p less than 0.05). Multiple regression analysis carried out to establish the predictive variables of bone histologic lesions (active resorption surface and active osteoblastic surface) singled out BGP in predialysis and AP and the two scores in dialysis. We conclude that serum BGP, as compared to PTH and AP, prevails as a valid marker of hyperparathyroid bone lesion in predialysis, while in dialysis it does not seem to add further information to that carried by other variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Asymptomatic extradural haematomas. Results of a multicenter study of 158 cases in minor head injury.

The authors report a study conducted in three Italian neurosurgical centres on 158 patients admitted after a minor head injury and with CT findings of a hitherto asymptomatic significant extradural haematoma. All patients were examined both prospectively by means of a computerized record containing 18 clinical and radiological parameters, and retrospectively by logistical regression analysis, in order to ascertain which factors influenced most the choice of surgical vs. conservative management. The size of the haematoma, rather than its location, and the degree of midline shift were the factors most influential in deciding in favour of surgical treatment, with a specificity of 0.83 and a sensitivity of 0.92. Conservative management of haematomas having a maximum thickness of less than 10 mm with a midline shift of less than 5 mm appears as safe. Outcome was "good recovery" in both the surgical and the nonsurgical patients, with only one death in the whole series, unrelated to the extradural lesion. This study focuses attention on a group of patients who are seldom examined by CT scan, but who can harbour potentially lethal lesions. Extension of CT scan examination to all adult patients with a minor head injury and a skull fracture can be recommended in order to identify significant haematomas in an asymptomatic phase.

Adolescent↗

Age and sex specific reference serum selenium levels estimated for the Italian population.

The association between the concentration of selenium in serum and the risk of degenerative processes of the cardiovascular apparatus or of neoplastic disease remains still uncertain. An inaccurate selection of the study populations, and above all the lack of age, sex and area of residence specific reference values could have contributed to create confusion on the biological relevance of selenium in human diseases. In our present work the serum selenium levels for the Italian population have been studied, adopting standardized methods. The study population (4201 adult subjects and 1217 children) was derived from samples of populations previously enrolled in epidemiological preventive programs. The mean observed values for the various adult populations examined varied between 87 and 93 micrograms/l and resulted approximately 5 micrograms/l higher than the mean observed values in ten European countries. The mean observed values for the paediatric population (less than 15 years of age) were slightly lower (78-83 micrograms/l). A decreasing trend of the values with age, above 60 years, especially in males, has been observed. No significant difference has been observed for sex and geographic area of residence. A preliminary study of the variations of the serum selenium levels during certain diseases has shown a sharp reduction in children with phenylketonuria and undergoing dietary restrictions, in subject with active systemic Lupus erythematosus, and in certain neoplasias.

Adolescent↗

The interlaboratorial quality assurance program for blood lead determination. An evaluation of methods and results.

For over five years a national program, promoted by a working group of the Istituto Superiore di Sanità (Italian National Institute of Health), has been active in Italy for the quality control of the blood lead levels determination. The program is based on the adoption, by the laboratories, of the same known-titre materials, for the internal quality control, and on the participation in periodical collaborative exercises for the external quality evaluation. The promoting laboratory prepared the control samples, verified their homogeneity and stability and distributed them to the laboratories following a randomized procedure; then, it provided a preliminary elaboration of the results (precision, difference from the median, distribution) after each exercise, and carried out the global evaluation of the performances of each laboratory after at least one year of activity in the program using parametric (regression analysis) and non-parametric (evaluation of the results according to pre-determined acceptability criteria) statistical methods. After four years of activity, the results obtained show that the adopted scheme and the procedures used turned out to be adequate. The study of the regression parameters between the results of each laboratory and the medians of the results of all the laboratories has confirmed the validity of the graphic criterion adopted, also yielding specific information on the relative contribution of the different kinds of error (systematic, constant and/or proportional and casual) to the global error. Furthermore, the proportion of the laboratories with "good level" performances (i.e., acceptable results in at least 80% of the examined samples) has increased from approximately 30% in the first phase to approximately 50% in the fourth phase.

Animals↗

Comparable laboratory performances in the analysis of lead in control samples and in fresh human blood.

The validity of quality control programs is based on the assumption that the control samples can be commuted with the real samples, so that, according to the results obtained by a given laboratory on control samples, it is possible to produce reasonable predictions about the reliability of results obtained on real samples. During the implementation of a program of biological monitoring of the general population against the risk of saturnism, a great number of data have been collected allowing the evaluation--as far as blood lead determination is concerned--of the real predictive power of the results obtained by a laboratory during a quality control program, according to its specific level of analytical reliability. The results obtained by eleven laboratories in the analysis of control samples have been compared, by regression analysis, with the results obtained on the same samples by the reference laboratory. The same procedure has been adopted for the results obtained by each laboratory and by the reference laboratory in the duplicate analysis of about 10% of the real samples collected by each center during the biological monitoring program. The comparison between the regression parameters obtained, in both cases, for each laboratory has not produced evidence of systematic differences. Furthermore, a non-parametric evaluation of the data (based on the magnitude of the differences between the results of the laboratories and the results of the reference center) shows, in most cases, similar laboratory performances in the analysis of control samples and of real samples.

Blood Chemical Analysis↗

Lead exposure: assessment of the risk for the general Italian population.

According to the regulations contained in the presidential decree DPR 496/82 certain Italian regions have carried out investigations--based on the blood lead level measurement--for the biological surveillance of the general population against the risk of saturnism. A work-group from the Istituto Superiore di Sanità (Italian National Institute of Health) coordinated the activity of the various centers and organized an appropriate quality control program to guarantee the quality of the analytical data collected. A total of 8635 subjects (4864 females and 3771 males) have been examined, 1968 of which (1058 females and 910 males) were under 14 years of age. The median values of the observed blood lead levels were, for the adults, 153 micrograms/l in males and 100 micrograms/l in females; and, for the children, 94 micrograms/l in males and 86 micrograms/l in females. The reference limit decreed by law for the 98th percentile is exceeded by the adult-males group, while both limits, at the 90th and 98th percentiles are exceeded by the population residing in the Portoscuso (CA) municipality. Our investigation confirms the correlation between blood lead levels, alcohol consumption, and cigarette smoking; in both sexes and in all age groups (except for females 15-25 years of age) a positive correlation of blood lead levels with alcohol consumption and cigarette smoking is clearly evident. The association of blood lead levels with alcohol seems to be stronger than that with cigarette smoking. The comparison with the results of previous investigations shows a 25% reduction of blood lead levels in the general Italian population during the 1979-1985 period.

Adolescent↗