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Biomedical subjects

G Banfi

Publications and source records attributed to G Banfi.

At least 55 records · Page 3Linked to original sources
PubMed1996

Pepsinogens and gastrointestinal symptoms in mountain marathon runners.

Although there are various descriptive reports concerning exercise-induced gastrointestinal distress, the role of gastrointestinal hormones and/or enzymes is not definitively established. In this study we investigated the behaviour of pepsinogens (PGI and PGII) after an endurance race performed at an altitude of 4,300 m by 13 well-trained marathon runners, with the aim to establish their interrelationship with gastrointestinal distress and with the modifications of gastrin and cortisol. The athletes showed a significant rise in gastrin (p < 0.01) and in cortisol (p < 0.01) and a significant decrease in PGI (p < 0.01) and PGII (p < 0.05) after the race. The PGI/PGII ratio presented small variations indicating that heavy exercise has less effects on PGs than those observed for gastrin. Gastrointestinal symptoms occurred in 6 athletes (46%) during the race and in 8 athletes (62%) after the race. No relationship was found between gastrointestinal symptoms and hormonal modifications after the race. A control group of 5 subjects was used: they (n = 5) did not show any significant modification of gastrin and PGs during the period spent at the above altitude, indicating that travel, altitude and acclimatization, food and beverages, do not influence the behaviour of these hormones. Conversely, they presented a significant decrease of cortisol (p < 0.05) linked to the circadian rhythm. The data of the present study indicate that the potential damage of gastrointestinal apparatus in mountain marathon runners is not related to the above mentioned hormones.

Adult↗
PubMed1996

Preanalytical phase in coagulation testing: state of the art in the laboratories of the Piedmont region, Italy.

The control of preanalytical variables is critical, particularly for coagulation assays, since this has a direct influence on the quality of results and on their clinical reliability. The aim of the study was to evaluate the extent of information about preanalysis in the laboratories of a large region of northern Italy that perform tests of haemostasis. A questionnaire was sent concerning the number of coagulation analyses per year, the system of blood drawing, the anticoagulants and the tubes in use, the amount of blood collected, the tendency to reject unsuitable specimens, the storage temperatures, the times between collection and analysis, the conditions of tube centrifugation and identification, and the presence of staff specifically occupied in coagulation testing. Complete answers were offered by 136 laboratories (81%; 69 private and 67 public) that reported a total amount of 3,648,000 determinations per year. Statistical analysis was carried out on the findings of the investigation, in order to assess their significance and to detect possible correlations between the variables under consideration. The results show significant attention being given by laboratories to the preanalytical phase. This is also indicated by the large percentage of complete answers obtained. Some of the important positive aspects shown in the study are: (1) the preference for the closed system for blood sampling; (2) the prevalent use of primary tubes for testing; (3) a strong tendency to reject incorrect samples for analysis. On the other hand, a major problem seems to lie in the delay, particularly in some big centres, in processing of specimens, which can be critical for the correct performance of coagulation assays. The data obtained reflect with good reliability the overall situation in coagulation-testing laboratories in northern Italy.

Anticoagulants↗
PubMed1996

X-linked Alport syndrome: an SSCP-based mutation survey over all 51 exons of the COL4A5 gene.

The COL4A5 gene encodes the alpha5 (type IV) collagen chain and is defective in X-linked Alport syndrome (AS). Here, we report the first systematic analysis of all 51 exons of COL4A5 gene in a series of 201 Italian AS patients. We have previously reported nine major rearrangements, as well as 18 small mutations identified in the same patient series by SSCP analysis of several exons. After systematic analysis of all 51 exons of COL4A5, we have now identified 30 different mutations: 10 glycine substitutions in the triple helical domain of the protein, 9 frameshift mutations, 4 in-frame deletions, 1 start codon, 1 nonsense, and 5 splice-site mutations. These mutations were either unique or found in two unrelated families, thus excluding the presence of a common mutation in the coding part of the gene. Overall, mutations were detected in only 45% of individuals with a certain or likely diagnosis of X-linked AS. This finding suggests that mutations in noncoding segments of COL4A5 account for a high number of X-linked AS cases. An alternative hypothesis is the presence of locus heterogeneity, even within the X-linked form of the disease. A genotype/phenotype comparison enabled us to better substantiate a significant correlation between the degree of predicted disruption of the alpha5 chain and the severity of phenotype in affected male individuals. Our study has significant implications in the diagnosis and follow-up of AS patients.

Adult↗
PubMed1996

Small pore size microporous membrane oxygenator reduces plasma leakage during prolonged extracorporeal circulation: a case report.

Plasma leakage has been regarded as the main technical problem during prolonged extracorporeal circulation (ECC) with microporous membrane oxygenators (MMOs). We report the case of a 15 year old male who underwent long term ECC for ARDS and in whom, by using new MMOs with reduced pore size, we were able to achieve prolonged artificial gas exchange efficiency with minimal plasma leakage. We conclude that reduced pore size MMOs might represent a valuable technical advance in extracorporeal oxygenation therapy.

Adolescent↗
PubMed1996

Osteocalcin production in vivo and in vitro after 1,25-dihydroxycholecalciferol stimulation comparison of different assays.

The study was designed to assess the sensitivity of three commercial assays (which differ in methodology, standard and antibodies) for osteocalcin, used for detecting changes in osteocalcin secretion induced by calcitriol (1,25-dihydroxycholecalciferol) in vivo and in vitro. Osteocalcin levels were determined in serum samples of 10 osteoporotic women after short term calcitriol treatment, and in the culture medium of human osteoblast-like cells (n = 22) after 48 h calcitriol exposure. All assays displayed similar sensitivity in detecting osteocalcin production in vivo after a 1 microgram daily dose of calcitriol. A novel IRMA (CIS), claimed to detect intact osteocalcin, showed higher osteocalcin values than the other assays, and in vitro showed the best sensitivity; it provides an appropriate index of the osteocalcin synthetic activity of cultured human osteoblasts.

Aged↗
PubMed1995

Platelet indices in athletes performing a race in altitude environment.

Physical activity could modify platelet count and platelet indices. Previous reports showed modifications after exercise linked to type and duration of sports performances. The shortage of studies in this field stems from the crucial methodological problem of EDTA (ethylenediaminetetraacetic acid)-dependent, mean platelet volume modifications: the published data on platelets count and indices were obtained by using a light-scattering system without standardization of the period elapsed from drawing to measurement. We present a study of platelet indices performed in athletes participating in an "extreme" performance, a race of 30 km in altitude (6,700 m of ascents and descents), using standardized measurement by an aperture-impedance instrument transferred in the field. The platelet count and mean platelet volume significantly increased in athletes, whereas platelet distribution width decreased. The mean initial values were 240.6*10(9)/L for platelet count, 8.79 fL for mean platelet volume, and 15.79% for platelet distribution width. The correspondent mean final values were 288.4*10(9)/L, 9.14 fL, and 15.48%. The modifications of platelet count and indices were always in the physiological reference range. The entity and the rapidity of platelet count and indices modifications suggest that the more probable source of variation is the recruitment of noncirculating pools of mature platelets. Strenuous exercise does not show abnormal changes of platelet parameters.

Adolescent↗
PubMed1995

Glomerulopathy associated with predominant fibronectin deposits: a newly recognized hereditary disease.

A newly recognized type of familial glomerulopathy observed in patients of both sexes in six families is reported. Proteinuria, often within the nephrotic range, microscopic hematuria, hypertension and a slowly decreasing renal function over several years were common. No underlying systemic diseases were identified. Generally, light microscopy showed enlarged glomeruli with minimal hypercellularity and with extensive deposits in the mesangium and subendothelial space. By electron microscopy, granular deposits with some admixture of fibrils were most common. In one family, the deposits were predominantly fibrillary. Immunoglobulins and complement factors were inconstant or lacking. A main finding was a strong immune reactivity to fibronectin, corresponding to the distribution of the deposits. In one patient, the deposits recurred in a renal transplant. There was no indication of systemic deposition. Abnormalities in the metabolism of circulating fibronectin may play a pathogenetic role in this disease of probably autosomal dominant inheritance.

Adolescent↗
PubMed1995

Long-term predictors of survival in essential mixed cryoglobulinemic glomerulonephritis.

We report the clinical outcome of 105 essential mixed cryoglobulinemia (EMC) patients with renal involvement collected throughout 25 years in three renal Units of Milan. The median follow-up was 72 months since renal biopsy and 131 months since the clinical onset of EMC. Patient survival was 49% at 10 years after renal biopsy. Forty-two patients died primarily from cardiovascular and liver disease or infection, whereas 15 patients developed chronic renal failure. Two patients had a complete remission of the disease while 15 had a remission only of renal signs. Thirty-one patients are alive with persistent renal and extrarenal manifestations. Anti-HCV antibodies were retrospectively detected in 34 patients and were present in 85% of them. This variable was not included in the statistical evaluation. At multivariate analysis, age older than 50 years, purpura, splenomegaly, cryocrit levels higher than 10%, C3 plasma levels lower than 54 mg/dl, and serum creatinine higher than 1.5 mg/dl were independent risk factors for death or dialysis. In conclusion, several factors may influence the outcome of patients with EMC nephritis. Markers of disease activity and an impaired renal function can herald a bad prognosis. It should be stressed, however, that only a minority of patients eventually develop renal failure, probably because in the most severe cases patients die earlier.

Adult↗
PubMed1995

State of the art of preanalysis in laboratories in Italy performing endocrinological tests.

We conducted an inquiry among Italian laboratories regarding the preanalytical phase for endocrinological tests. The form presented two questions: number of analyses per year and use of closed or open system for blood drawing. The laboratories were asked to insert the hormones' names in some boxes representing different materials for endocrinological tests, namely serum from plain tubes and from gel separator tubes, plasma from K3EDTA, Na2EDTA, lithium heparin with or without gel separator, sodium citrate, sodium fluoride and potassium oxalate, and citric acid-citrate-dextrose (ACD), and also the particular mode of storage of specimen, as addition of antiproteolytic substances and use of iced water. The analytes' list included the most common endocrinological assays. The data collected indicate that traditional, syringe-based systems are still widely used in Italy, particularly in private and small and medium-sized public laboratories. Serum is the most often used material for endocrinological tests. A very important finding was the use of gel separator tubes, wider than plan tubes, for obtaining serum. Finally, the laboratories demonstrated very good attention to the preanalytical phase, as judged from particular storage for some delicate analytes.

Chemistry, Clinical↗
PubMed1995

Renal disease and patient survival in light chain deposition disease.

We evaluated retrospectively the presenting clinical features, response to treatment and clinical course of 19 patients with LCDD, 11 of whom had multiple myeloma. At presentation, renal insufficiency was present in 18 patients and proteinuria in 16. Renal biopsy revealed typical LCDD in 16 patients, while in the remaining three LCDD was associated with other abnormal tissue deposits. Extrarenal signs were observed in 12 patients (63%), with the liver, heart and peripheral nerves being the most frequently involved organs. After diagnosis, 18 patients underwent therapy: 2 received steroids alone and 16 were treated with steroids and cytotoxic drugs; 7 patients also underwent plasma exchange. At the end of the first month of treatment renal function improved in 5 patients, worsened in 5 and remained unchanged in 8. All but 3 of the patients continued treatment beyond the first month: 7 patients developed end-stage renal disease, 5 an improvement and 4 a worsening in renal function. No effect on proteinuria was observed. Extrarenal symptoms developed in 4 previously unaffected patients and in 3 others they extended to more organs. Sixteen patients died: 12 during the first year of the follow-up, and 4 at 21st, 34th, 37th and 82nd month of observation. Five patients died from neoplastic cachexia, 4 from hypokinetic cardiopathy, 3 from hemorrhagic complications, 2 from pneumonia and one from unknown cause. Mean patient survival after presentation was 18.1 +/- 20.7 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Female↗
PubMed1995

Cardiologic abnormalities in patients with long-term lupus nephritis.

To assess the cardiological status of patients with long-term lupus nephritis we evaluated 30 patients (mean age 43 +/- 11 years) with lupus nephritis lasting from at least 10 years (mean 15 +/- 5 years). At the time of cardiological evaluation the mean plasma creatinine was 132.6 +/- 11.1 mumol/l and in 28 patients lupus had been quiescent for at least 3 years. Fourteen patients (46.6%) showed one or more cardiac abnormalities: 10 had valvular lesions (1 verrucous endocarditis, 9 thickening and stiffness of one or more valves)--4 patients had regional myocardial akinesis as a consequence of a previous cardiac infarct (one had valvular abnormalities too). One patient had pulmonary hypertension probably secondary to pulmonary vasculitis. No patient had pericarditis. These cardiac abnormalities proved to be statistically correlated with the number of ARA criteria (p = 0.045), the number of lupus flares (p = 0.004), the serum levels of cholesterol (p = 0.04) and of triglycerides (p = 0.025) as well as the duration of hypercholesterolemia (p = 0.005) and of hypertriglyceridemia (p = 0.007). In conclusion, in patients with long-term lupus nephritis cardiac lesions are frequent. The main lesions are non-verrucous valvulopathy (probably a consequence of healing verrucous endocarditis) and cardiac infarct (caused by an accelerated atherosclerosis). On the contrary cardiac lesions caused by active lupus as pericarditis, myocarditis and verrucous endocarditis are rare.

Adult↗
PubMed1995

Multicentre evaluation of Capture Assay Radim Liquid Allergen for measurement of specific IgE antibodies.

A multicentre trial of Capture Assay Radim Liquid Allergen was performed to define the sensitivity, specificity and clinical reliability of the system in diagnostic allergology. The results of the evaluation were compared with clinical data and in vivo testing. Good agreement was obtained for Dermatophagoides pteronyssinus (D1), Cat's epithelium (E1), Betula verrucosa (T3) and Olea europea (T9), Artemisia vulgaris (W6) and Parietaria officinalis (W19). Some spreading of data was observed for Artemisia absinthium (W5), Cynodon dactylon (G2), and Lolium perenne (G5). We found a high number of negative cases for Alternaria alternata (M6). The advantages offered by the system are the automation, the small quantity of serum requested, the supply of quantitative results in international units of specific IgE, the user-friendly software. The data are sufficiently reliable for the diagnostic system to be introduced into the clinical laboratory allergological routine.

Adolescent↗
PubMed1994

A randomized trial comparing triple-drug and double-drug therapy in renal transplantation. Analysis at 7 years.

This is the 7-year update of a randomized trial comparing triple (TT) and double (DT) immunosuppressive therapy in renal transplantation. At 7 years, patient survival rate was 85% in DT vs. 87% in TT (P = NS); graft survival rate was 73% in DT and 68% in TT (P = NS); pure graft survival was 86% in DT vs. 77% in TT (P = 0.096). The 7-year graft survival rate was 67% for cadaver graft recipients vs. 92% for living-related graft recipients (P = 0.044). No difference in the slopes of plasma creatinine between the two groups was observed. Ten DT and 13 TT patients changed their original therapy: statistical analysis, however, was carried out according to intention to treat. Both CsA levels and doses were significantly higher in DT than in TT group (P < 0.001) at any time point up to the 7th year. At univariate analysis, a living-related donor kidney (P = 0.044) and immediate recovery of renal function (P < 0.001) were the only two parameters associated with graft survival at 7 years. At multivariate analysis, only early graft function recovery was correlated with late graft survival (RR = 10.480). Thus, even in the longterm, there is no difference between DT and TT, either in patient or in graft survival: at the doses we used, TT had a lower prevalence of late side effects than DT, however, long-term pure graft survival was better, although not significantly, in DT than in TT. The possibility of a safe shift from one regimen to the other one makes the two treatments complementary rather than alternatives.

Adult↗
PubMed1994

Light chain deposition disease of the kidney. Morphological aspects in 24 patients.

Renal biopsies and autopsy specimens of 23 patients with light chain deposition disease (LCDD) and one with only heavy chain deposits, were studied by light (LM) and electron microscopy (EM) as well as immunohistology (IH). Thirteen patients had multiple myeloma; 1 had lymphoma, and 1 chronic myeloid leukaemia with polycythaemia vera. In nine patients, no lymphoproliferative disease was identified. The LM lesions most suggestive of LCDD, nodular glomerulosclerosis (NS) and thickening and wrinkling of the tubular basement membranes (TBM), were present in only ten and 13 patients, respectively. In five of seven specimens without NS or TBM thickening by LM, EM was negative, indicating a limited value of EM in confirming the diagnosis. Renal amyloidosis was not identified, but in one patient amyloid in the heart and tongue was seen at autopsy. One patient had both granular and extensive glomerular non-amyloid fibrillary deposits. In two patients myeloma casts were identified. Twenty-one patients showed renal LC immune reactivity, 1 had both alpha heavy and lambda LC, 1 had only detectable gamma heavy chain. One biopsy was negative by IH, but had characteristic electron dense deposits. In six patients with immune reactivity to LC, no electron dense deposits could be identified by EM. This study emphasizes the spectrum of renal changes by LM and EM in LCDD, the frequent lack of consistency between deposits detected by IH and EM and the difficulty in coming to a definite diagnosis without LM, EM and IH. The results of this study and examination of the literature indicates that extensive morphological changes are more often present in kappa than in lambda LCDD.

Adult↗
PubMed1994

Immunoelectron microscopy of different forms of glomerulonephritis in routine biopsy material.

Renal biopsies were investigated of patients with IgA or membraneous glomerulonephritis or with systemic lupus erythematosus by light microscopy, electron microscopy, light microscopic immunohistology and by immunoelectron microscopy using the post-embedding technique applied to LR-White embedded tissue. Aim of the study was to explore whether immunoelectron microscopy is reproduced on routine biopsy material and in accordance with light microscopic immunohistological findings. The study shows that immunoelectron microscopy can be applied to routine biopsy material and gives reproducible results. The applied method proved to be reliable, and, hence, routine biopsy material may be used for further studies concerning subcellular mechanisms in immunocomplex deposition and removal.

Biopsy, Needle↗
PubMed1994

Cortisol, testosterone, and free testosterone in athletes performing a marathon at 4,000 m altitude.

Cortisol, testosterone, free testosterone and the ratio between free testosterone and cortisol (FTCR) were monitored in six athletes participating in a marathon starting at 3,860 and finishing at 3,400 m, having reached the top at 5,100 m altitude. Blood was drawn at sea level before the departure for the mountain area, after a week of acclimatization, immediately after the marathon and after a 24-hour recovery period from the run. Cortisol increased after acclimatization and especially after the marathon; it decreased to normal values after recovery. Testosterone decreased after acclimatization, especially after the run; it presented a partial recovery 24 h after the race. Free testosterone did not decrease after acclimatization and presented partial recovery. FTCR could also be useful for monitoring fitness, overtraining and overstrain in strenuous and ultraendurance exercise.

Adult↗