Biomedical subjects

Giampaolo Trevi

Publications and source records attributed to Giampaolo Trevi.

4 recordsLinked to original sources

PubMed2006

Thrombopoietin contributes to enhanced platelet activation in patients with unstable angina.

OBJECTIVES: We sought to investigate the potential role of elevated levels of thrombopoietin (TPO) in platelet activation during unstable angina (UA). BACKGROUND: Thrombopoietin is a humoral growth factor that does not induce platelet aggregation per se, but primes platelet activation in response to several agonists. No data concerning its contribution to platelet function abnormalities described in patients with UA are available. METHODS: We studied 15 patients with UA and, as controls, 15 patients with stable angina (SA) and 15 healthy subjects. We measured TPO and C-reactive protein (CRP), as well as monocyte-platelet binding and the platelet expression of P-selectin and of the TPO receptor, c-Mpl. The priming activity of patient or control plasma on platelet aggregation and monocyte-platelet binding and the role of TPO in this effect also were studied. RESULTS: Patients with UA showed higher circulating TPO levels, as well as increased monocyte-platelet binding, platelet P-selectin expression, and CRP levels, than those with SA and healthy control subjects. The UA patients also showed reduced platelet expression of the TPO receptor, c-Mpl. In vitro, the plasma from UA patients, but not from SA patients or healthy controls, primed platelet aggregation and monocyte-platelet binding, which were both reduced when an inhibitor of TPO was used. CONCLUSIONS: Thrombopoietin may enhance platelet activation in the early phases of UA, potentially participating in the pathogenesis of acute coronary syndromes.

Aged↗

PubMed2005

[Hospital admissions for congestive heart failure in Piedmont, Italy: 1996-2001 trend].

BACKGROUND: Since epidemiological studies on congestive heart failure (CHF) have shown somewhat contradictory results, detailed analyses of local trends may be useful in order to plan health strategies. METHODS: All patients discharged from public hospitals between 1996 and 2001 with a DRG 127 were evaluated. For patients living in the city of Turin, 1- and 12-month survival analysis was performed. Multivariate analysis was performed for both the total DRG 127 discharges and patients without acute CHF (ICD9CM 785). RESULTS: During the 6-year period 56292 discharges were classified as DRG 127. Hospital discharges for CHF increased until 1999, and then remained stable. Because of the progressive decrease of total number of hospital discharges, the percentage of DRG 127 increased from 1.3 to 2%. Mean age increased from 72.8 to 75.4 years in men and from 77.9 to 80.0 years in women. The average hospital stay decreased from 10.8 to 9.9 days in men, from 11.5 to 10.7 days in women. Within 12 months 17.4% of patients were re-hospitalized. The in-hospital mortality decreased from 17.3 to 14.3% in men and from 20.1 to 14.6% in women. For urban population both 1-month and 12-month mortality (from 40.5 to 35.5% in men, from 33.5 to 28.7% in women) decreased. The subgroup with acute CHF within DRG 127 decreased from 11.8 to 4.8%. At multivariate analysis in-hospital mortality is logically correlated with the age of patients and an increase of the mortality, both in women and men, is shown for patients not admitted in a cardiology department. CONCLUSIONS: The number of CHF hospital discharges, between 1998 and 2001, remained stable, but increased with respect to total admissions. The reduction of in-hospital, 1-month, and 12-month mortality seems to be more dependent on different patient characteristics than to a real effect.

Age Factors↗

PubMed2004

Drug-eluting stent implantation in primary angioplasty of an anomalous left main coronary artery: diagnostic and technical considerations.

The presence of an anomalous origin and/or distribution of a coronary artery as the infarct-related vessel during primary angioplasty for acute myocardial infarction might represent a clinical and technical challenge. We report on a case of a patient with an acute anterior myocardial infarction who was referred to our hospital for primary angioplasty and whose culprit lesion was located on an aberrant left main coronary artery. The purpose of this case report was to review the incidence and angiographic evaluation of an anomalous coronary vessel and to discuss the technical approach to an anomalous left main intervention and its impact on clinical outcome.

Angioplasty, Balloon↗

PubMed2003

Vasculitis mimicking bacterial endocarditis.

Fever of unknown origin is one of the most intriguing issues in clinical practice. One of the most feared diagnoses, especially in patients with known valvular disease, is endocarditis. The differential diagnosis of fever is often complicated by the clinical-pathological overlap between the systemic inflammatory response in different types of pathologies such as infectious, autoimmune or neoplastic disorders. We report a case of a patient presenting with fever, cutaneous nodules and malaise, with a known mitral valve prolapse and moderate regurgitation, in which the diagnosis of Wegener's granulomatosis was finally made.

Diagnosis, Differential↗