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Biomedical subjects

G Giuffrida

Publications and source records attributed to G Giuffrida.

At least 55 records · Page 3Linked to original sources
PubMed1994

Assessment of the relevance of zona pellucida antibodies in follicular fluid of in-vitro fertilization (IVF) patients.

The presence of anti-zona pellucida antibodies in the follicular fluid of 11 women who underwent in-vitro fertilization (IVF) and embryo transfer was analysed. Only infertile couples with tubal or unexplained pathologies were included in our study, which was aimed at investigating the relationship between anti-zona pellucida antibodies in follicular fluid and failed fertilization. Whether or not these antibodies were present in some or all follicles in the same patient was also investigated. Out of 55 follicular fluids analysed, 36.3% were positive to the test and no fertilization was observed in oocytes from these follicles, while 63.6% were negative, and the oocyte fertilization rate associated with these was 51.4%. The presence of anti-zona pellucida antibodies was positively correlated with the degree of fertilization failure (P < 0.001 chi 2 test).

Adult↗
PubMed1994

Human alpha S1-casein like protein: purification and N-terminal sequence determination.

Casein components of human milk are generally reported to belong to the beta- and kappa-groups. In this research human casein fraction was obtained from pooled mature milk, either by ultracentrifugation or by acid precipitation. In both cases a minor component with a slightly higher mobility in SDS-PAGE than beta-casein was identified. The protein was purified to homogeneity, the N-terminal sequence of the first 14 amino acid residues of this new human casein subunit shows a high degree of homology with the alpha s1-casein sequences from other species.

Amino Acid Sequence↗
PubMed1994

[Coronary recanalization in acute myocardial infarction: early coronary angiography].

In acute myocardial infarction the early patency of the infarct-related artery is positively correlated with improved left ventricular function and survival. Coronary artery reperfusion is commonly achieved by intravenous administration of thrombolytic agents. Methods of mechanical recanalization, mainly percutaneous transluminal coronary angioplasty (PTCA), have been proposed and tested as alternative or adjunctive ways to thrombolysis. Early coronary angiography provides reliable and irreplaceable information concerning mechanical intervention utility and feasibility. Therefore, it is incorporated in the mechanical revascularization strategies at various stages in the setting of acute myocardial infarction. In the primary, direct PTCA strategy early coronary arteriography is done for planning and carrying out mechanical revascularization as an alternative to intravenous thrombolytic therapy. This strategy may be particularly effective in patients presenting with cardiogenic shock, large infarctions, contraindications to thrombolytic therapy, and prior bypass surgery. Coronary angiography in evolving myocardial infarction has also been proposed to set the stage for rescue PTCA when thrombolysis has proved to be ineffective. Nevertheless, there are currently no unequivocal data to judge the value of the rescue PTCA strategy. After unsuccessful thrombolysis, this approach should be considered in patients with a large infarction, with cardiogenic shock, with left ventricular dysfunction and with refractory ischemia. Early, routine coronary angiography after lytic recanalization is not recommended. In fact, the strategy of immediate arteriography plus PTCA after thrombolytic therapy does not improve outcome but leads to several deleterious effects.

Angioplasty, Balloon, Coronary↗
PubMed1993

[Imaging in atherosclerosis: coronary arteriography].

Arteriography is still today the best imaging technique to evaluate coronary atherosclerosis. Some limitations have nonetheless been documented by pathologic studies (underestimated lesions), and by physiologic studies (poor correlation between stenosis and coronary flow reserve). Such limitations are due to the nature of the technique, as it provides the "silhouette" of the artery lumen, but does not provide any information on the artery wall, where the atherosclerotic plaque is located. Moreover, very often the vessel segment used as reference for stenosis calculation could also be affected by atherosclerosis; this occurrence plagues measurement of percent stenosis. On the other hand, a better usage of radiological techniques has also allowed a better assessment of certain stenosis shapes, such as eccentric or slit-like lesions. The introduction of quantitative coronary arteriography has overcome the problems related to visual assessment, such as the inter and intra observer variability. Furthermore, the recognized value of morphology analysis allows today a better characterization of the lesion. Coronary arteriography remains today a non-replaceable technique with regard to the choice of the most suitable revascularization procedures (coronary artery bypass graft, percutaneous transluminal coronary angioplasty) and supplies fundamental information for the interventional procedures.

Coronary Angiography↗
PubMed1993

[Mitral valvuloplasty: immediate results and 2-year follow-up].

Since May 1991 to July 1993, 121 patients (mean age 50 +/- 13 years, 23 males and 98 females) underwent 122 percutaneous mitral valvuloplasty according to Inoue's technique. Following Wilkins criteria the indications for the procedure were given on the basis of the echo-score (ideal cases with score < or = 8). Echo-score was > 8 in 59 patients (49%), and < or = 8 in 62 (51%); 19 patients (16%) had previous surgical mitral commissurotomy and 36 (30%) had previous embolic events. All patients were successfully treated except for 5 who developed mitral regurgitation 3+/4+. In 1 patient the procedure was unsuccessfully performed for the low increase in mitral valve area. All these patients except 1 were referred to elective surgery. Mitral valve area increased from 1.1 +/- 0.2 to 2.1 +/- 0.4 cm2 (p < 0.001) and transvalvular gradient fell from 15 +/- 6 to 6 +/- 3 mmHg (p < 0.001). Patients with previous surgical commissurotomy had a lower increase in the mitral valve area than patients without previous surgery (p < 0.006). Patients with echo-score > 8 presented a lower, but not significant, increase in mitral valve area after valvuloplasty; patients with mono-commissural calcifications had worse results than those without calcifications (p < 0.03). At 12 and 24 month follow-up 9 and 3 restenosis respectively occurred, but in 10 of these cases the residual valvular area was > 1.5 cm2. The Authors conclude that in patients with good anatomy percutaneous mitral valvuloplasty is an effective and safe treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Percutaneous transluminal coronary angioplasty of oversized saphenous coronary bypass grafts: 'hugging balloons' or single peripheral dilatation catheter technique?

The use of angioplasty in patients with previous coronary bypass grafts (CABG) has been described in several reports. CABG diameter often exceeds the size of the available coronary balloon dilatation catheters. Simultaneous inflation of two side-by-side balloons or a peripheral angioplasty catheter have been used to achieve optimal balloon-vessel ratio. We describe our experience with the two-balloon technique (case 1) and with a single peripheral angioplasty balloon (case 2) to dilate oversized CABG.

Aged↗
PubMed1992

[Silent ischemic cardiopathy: a study with dynamic electrocardiogram and ergometric test].

Ninety-two patients with effort angina were retrospectively studied to define the prevalence, the daily distribution and the prognostic value of silent ischemic attacks. All patients had positive Holter monitoring and exercise test; coronary angiography, performed in 75/92 patients, showed 1, 2 or 3-vessels disease. Six hundred ninety-three ischemic episodes, 481 (69.5%) silent and 212 (30.5%) symptomatic, were recorded by Holter monitoring, with the highest incidence in the morning; 74/92 patients (80%) showed silent ischemic attacks. Mean duration of the symptomatic and silent ischemic attacks was respectively 9.8 +/- 5.2 and 6.4 +/- 4.2 min (p less than 0.0001); mean ST-segment depression was respectively 2.8 +/- 1.2 and 2.3 +/- 0.8 mm (p less than 0.0001). During exercise testing 86 patients (93%) had both chest pain and ST-segment changes, 2 patients (2%) only angina and 4 patients (5%) only ST-segment depression. Mean heart rate at onset of ischemia was higher during exercise testing compared with Holter monitoring (119 +/- 20 vs 95 +/- 22 b/min; p less than 0.0001). No significant difference was shown between patients with and without silent ischemia about the prevalence of 1, 2 and 3-vessels disease; 1-year cardiovascular mortality in the 2 groups of patients was respectively 6.8% and 5.5% (p:NS). In patients with effort angina, silent ischemia has not a poor prognostic value; Holter monitoring is very useful to the correct assessment of these patients.

Coronary Disease↗
PubMed1992

[Ambulatory coronary arteriography with 5 French catheters: experience with 604 procedures].

Ambulatory coronary arteriography was carried out in 604 patients, 143 women and 461 men, mean age 53 +/- 14 years. An absolutely stable clinical condition was the main criterion of selection for this investigation and the protocol consisted in day-hospital admission, absence of routine anticoagulation, small calibre (5 French = 1.7 mm diameter) catheters, mobilization 4 hours and discharge 6 hours after the end of the procedure. The percutaneous femoral approach was used in 95% of cases; 56% of patients presented significant single-or multi-vessel coronary artery disease: there were 7 cases of left main coronary artery narrowing; 31 patients required full hospital admission, mainly because of the severity of coronary lesions. Minor complications occurred in 2% of cases.

Adult↗
PubMed1991

Pulmonary edema during cardiac catheterization successfully treated with bolus administration of nicardipine.

This report describes a 62-year-old patient with ischemic dilated cardiomyopathy who presented pulmonary edema during cardiac catheterization. Bolus administration of nicardipine (5 mg in 5 min) into the pulmonary artery determined prompt recovery from the crisis and optimal hemodynamic conditions for completion of the catheterization. The action of the drug was mediated by the rapid reduction of the left ventricular preload and afterload. We believe that bolus administration of nicardipine is useful in treating episodes of acute left ventricular insufficiency.

Cardiac Catheterization↗
PubMed1991

Isolated, anomalous origin of the left anterior descending coronary artery from the right coronary artery with angina pectoris.

The case of a 51-year-old woman with exertional angina pectoris and isolated anomalous origin of the left anterior descending coronary artery from the right coronary artery is reported. This anomalous artery was not narrowed, coursed in front of the pulmonary artery and did not present either anatomical derangement at the take off or intramyocardial course. The mechanism of ischaemia could not be identified.

Angina Pectoris↗
PubMed1991

[Bolus nicardipine in the hemodynamic assessment for heart transplantation of patients with severe failure of ischemic origin and high pulmonary resistance].

Nicardipine i.v. bolus (5 mg/5 min) was administered in the pulmonary artery trunk in 13 patients (2 f, 11 m), mean age 48 +/- 8 yrs, affected by ischemia congestive heart failure, with pulmonary hypertension (pulmonary vascular resistances greater than 6 U.W. and/or systolic pulmonary artery blood pressure greater than or equal to 60 mmHg). The vasodilatation induced by nicardipine caused a rapid improvement of all hemodynamic parameters, with a significant reduction of systemic and pulmonary pressures and resistances; in addition, cardiac output increased significantly. Even if heart rate decreased and mean right atrial pressure fell, their variation did not reach statistical significance. These beneficial effects are attributable to the vasodilator action of nicardipine on the systemic and pulmonary vascular districts. Therefore, in the hemodynamic evaluation of patients with ischemic cardiomyopathy proposed for heart transplantation, we propose the employment of nicardipine in testing the vascular reactivity in cases with secondary pulmonary hypertension.

Adult↗
PubMed1990

Diagnosis of left atrial thrombi in mitral valve disease by coronary arteriography.

Arteriographic findings of neovascularity and fistula formation between coronary arteries and left atrium have occasionally been described in association with left atrial thrombosis in patients with mitral valve disease. The validity of these coronary arteriographic findings in diagnosis of atrial thrombi has been evaluated in 112 patients with mitral valve disease. Comparison was made with surgery. The study furnished these diagnostic values: sensitivity 70%, specificity 85%, positive predictive value 72%. Even if this angiographic finding is complementary in diagnosis of atrial thrombosis, its identification during coronary arteriography in patients with mitral valve disease is useful. Its detection could improve diagnostic prediction of thrombosis, especially in patients without previous embolic events or where echocardiography failed to reveal thrombi.

Angiography↗
PubMed1990

Baseline and post-atrial pacing release of atrial natriuretic factor in mitral stenosis.

To investigate the release of atrial natriuretic factor (ANF) in mitral stenosis and the influence of the increase on the frequency of atrial contraction or atrial distention on ANF secretion, we studied 10 patients with symptoms of congestive heart failure (New York Heart Association classes II and III) in sinus rhythm, who were undergoing cardiac catheterization as part of an evaluation workup for mitral stenosis. Echocardiographic tracings, repeat determinations of mean pulmonary artery wedge pressure (MPAWP) and mean right atrial pressure, and blood sampling from the pulmonary artery for measurements of ANF were performed at baseline, during atrial pacing (pacing rate of 125 beats/min for 5 minutes), and 5 minutes after the pacing protocol was completed. Baseline ANF levels were closely related to right atrial pressure (r = 0.89; p less than 0.001) and increased markedly after atrial pacing from 205.6 +/- 39.8 (SEM) to 343.9 +/- 57.9 (SEM) pg/ml. A similar pacing-induced increase was shown for MPAWP and left atrial size. Our data indicate that pacing-induced increases in atrial distention and intracavitary pressure further stimulate release of ANF. However, an independent effect of frequency of atrial pacing on plasma ANF in humans could not be identified.

Adult↗
PubMed1990

Echocardiographic detection of aortic valve ring abscesses.

Valve ring abscess complication of infective endocarditis increases the expected morbidity and mortality rates of patients, but is seldom recognized by available noninvasive techniques. In our study, two-dimensional echocardiography successfully detected valve ring abscesses in eight patients with infective endocarditis affecting aortic valve prosthesis. Echocardiography showed the perivalvular abscess as an echo-free space in all patients. Prosthetic vegetations were seen in the only patient who had a biological prosthesis and excessive prosthetic rocking was observed in cases with severe aortic regurgitation. In two patients, the first echocardiographic examination showed an echo-free space without evident clinical signs of endocarditis or significant valve regurgitation. Severe aortic insufficiency and congestive heart failure followed the enlargement of the echo-free space. Valve replacement was required in all but one patient. The echocardiographic findings were confirmed at surgery. In one patient, the extension of the abscess to the interventricular septum was not detected by the echocardiography.

Abscess↗
PubMed1990

[Value of coronary angiography in the diagnosis of left atrial thrombosis in mitral valve disease].

Arteriographic findings of neovascularity and fistula formation between coronary arteries and left atrium have occasionally been described in association with left atrial thrombosis in patients with mitral valve disease. The validity of these coronary arteriographic findings in diagnosis of atrial thrombi has been evaluated in 164 patients with mitral valve disease. Comparison was made with surgery. The study provided these diagnostic values: sensitivity 65%, specificity 85%, positive predictive value 72%. Even if this angiographic finding is complementary in diagnosis of atrial thrombosis, its identification during coronary arteriography in patients with mitral valve disease is useful. Its detection could improve diagnostic prediction of thrombosis especially in patients without previous embolic events or where echocardiography failed to show thrombi.

Angiography↗
PubMed1990

[Multiple coronary-pulmonary fistulas: description of a case].

An uncommon case of multiple coronary artery-pulmonary artery fistulas, associated with a mitral valve disease, is reported. The coronary fistulas presence was suspected on the ground of Doppler-echocardiography and the diagnosis was subsequently defined by coronary angiography. The utility of Doppler-echocardiography in the differential diagnosis from patent ductus arteriosus is discussed.

Angiography↗