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Biomedical subjects

M Furnari

Publications and source records attributed to M Furnari.

6 recordsLinked to original sources
PubMed2001

Neonatal screening for cystic fibrosis: long-term clinical balance.

BACKGROUND/AIMS: Very few studies have been performed on the long-term clinical advantages of neonatal screening programs for cystic fibrosis (CF) and these have been inconclusive. This is a preliminary report of two observational cohort studies on this subject. METHODS: In the first study, CF patients born between 1973 and 1981 in northeastern Italy were split into 4 groups according to the modality of diagnosis: screening by meconium test (58 patients); meconium ileus (45 patients); symptoms and pancreatic insufficiency (PI; 75 patients), or symptoms and pancreatic sufficiency (PS; 19 patients). The patients were followed for up to 26 years by three CF centers sharing common treatment protocols. In the second study, two cohorts of CF patients born between 1983 and 1992 were compared. Patients from one cohort (126 patients) were born in the Veneto region, where a neonatal screening program had been established based on immunoreactive trypsinogen. Patients from the other cohort (152 patients) were born in Sicily, where an intensive program of early diagnosis by symptoms was implemented. The cohorts were comparable for CF incidence, CFTR genotypes, gender proportion and common treatment protocols. Statistical analyses were performed by Kaplan-Meier survival curves, a Cox proportional hazard model for survival and cross-sectional comparisons by 2-year periods for weight z score, height z score and body mass index. RESULTS: In the first study, the patients detected by newborn screening (PI) showed better survival and nutritional status compared to patients diagnosed through meconium ileus or symptom presentation with PI. PS patients diagnosed by symptoms showed the best outcome, but most of them had a mild genotype. In the second study, the Veneto cohort showed better outcome with regard to survival and nutritional status over 16 years of follow-up. CONCLUSIONS: Observational cohort studies cannot give definitive evidence of the clinical benefit of neonatal CF screening; however, data have been accumulated which strongly suggest a better clinical outcome for CF patients born in an area where a screening program is performed.

Adolescent↗
PubMed1996

Vasorelaxant properties of norbormide, a selective vasoconstrictor agent for the rat microvasculature.

1. The effects of norbormide on the contractility of endothelium-deprived rat, guinea-pig, mouse, and human artery rings, and of freshly isolated smooth muscle cells of rat caudal artery were investigated. In addition, the effect of norbormide on intracellular calcium levels of A7r5 cells was evaluated. 2. In resting rat mesenteric, renal, and caudal arteries, norbormide (0.5-50 microM) induced a concentration-dependent contractile effect. In rat caudal artery, the contraction was very slowly reversible on washing, completely abolished in the absence of extracellular calcium, and antagonized by high concentrations (10-800 microM) of verapamil. The norbormide effect persisted upon removal of either extracellular Na+ or K+. The contractile effect of norbormide was observed also in single, freshly isolated smooth muscle cells from rat caudal artery. 3. In resting rat and guinea-pig aortae, guinea-pig mesenteric artery, mouse caudal artery, and human subcutaneous resistance arteries, norbormide did not induce contraction. When these vessels were contracted by 80 mM KCl, norbormide (10-100 microM) caused relaxation. Norbormide inhibited the response to Ca2+ of rat aorta incubated in 80 mM KCl/Ca2(+)-free medium. Norbormide (up to 100 microM) was ineffective in phenylephrine-contracted guinea-pig and rat aorta. 4. In A7r5 cells, a cell line from rat aorta, norbormide prevented high K(+)- but not 5-hydroxytryptamine-induced intracellular calcium transients. 5. These findings indicate that in vitro, norbormide induces a myogenic contraction, selective for the rat small vessels, by promoting calcium entry in smooth muscle cells, presumably through calcium channels. In rat aorta and arteries from other mammals, norbormide behaves like a calcium channel entry blocker.

Animals↗
PubMed1982

Risk factors for peripheral atherosclerosis in non insulin dependent diabetes.

Peripheral Atherosclerosis (PA) is a frequent complication of longstanding diabetes. Nevertheless uncertainty exists on defining risk factors (RF) for PA in diabetics. In order to elucidate this matter, at an early stage of the vascular complication, 54 non insulin dependent diabetic (NIDDM) patients, males, age range 40-59 years, without clinical signs of PA, were investigated by digital pulse plethysmography, measuring the inclination time (IT) of the pulse wave. A significant correlation was found between systolic blood pressure (BP) or fasting serum cholesterol (FSC) and IT (r = .28 p less than .05 and r = .34 p less than .05). IT was significantly higher in insulin treated patients compared with those on oral hypoglycemic treatment (154 +/- 41 msec; 122 +/- 25 msec; p less than .05) (M +/- SD). No significant effect on IT was induced by body weight, diastolic BP, serum triglycerides. A positive correlation was found between the number of RF (FSC greater than or equal to 220 mg/dl; systolic BP greater than or equal to 160 mmHg; insulin treatment) in each patient and IT (r = .55 p less than .001). In the absence of RF, IT was similar to that in non diabetic, normocholesterolemic, normotensive men of the same age (119 +/- 27; 116 +/- 15). FSC, systolic BP and insulin treatment are major RF for PA in male NIDDM patients. The condition is worsened by the simultaneous presence of two or more RF together.

Adult↗
PubMedDate not supplied

Implementing preventive health measures: a pilot study.

OBJECTIVE: Implementation of preventive services guidelines is performed inconsistently. In an attempt to reduce variation in guideline implementation, we developed a patient questionnaire based on the US Preventive Services Task Force Guide and the Health Plan Employer Data and Information Set 3.0 performance measures of the National Committee on Quality Assurance. SUBJECTS: 100 hospitalized patients of five primary-care physicians. METHODS: In a pilot study, 100 hospitalized patients of five primary-care physicians were questioned about their compliance with evidence-based, preventive healthcare recommendations. Information was requested on blood pressure measurement, cholesterol screening, fecal occult blood testing, smoking-cessation counseling, Pap testing, mammography, postmenopausal hormonal replacement therapy counseling, prostate examination and prostate-specific antigen (PSA) testing, use of aspirin and beta-blockers following an acute myocardial infarction, testing of diabetics for hemoglobin A1c and retinal eye examinations, questioning of the elderly for auditory and visual problems, and receipt of influenza and pneumococcal vaccines. Information on variations from the recommended preventive service was fed back to their physicians. Six months after the initial survey, the patients were requestioned to determine if compliance had improved with the recommendations. RESULTS: We found significant improvement in fecal occult blood testing, smoking cessation, Pap smear testing, mammography use, prostate examinations and PSA testing, hemoglobin A1c testing, seeing or hearing loss follow-up, and the administration of influenza and pneumococcal vaccines. CONCLUSIONS: Improving implementation of preventive services recommendations is a challenge. This pilot study suggests that involving the patient more in the process and informing the physician of the results may improve the process.

Adult↗
PubMedDate not supplied

[Warm ischemia in kidney from non-heart beating donor . Instrumental evaluation].

A dramatic shortage of kidneys available for transplantation, due do the widespread reduction in consent, has urged us to explore alternative sources of kidney harvesting, in the attempt to reduce the current gap between the small number of donations and the large number of patients on waiting-list. We set our attention on non-heart-beating donors (NHBD). In the "first step" of our research, we tested an experimental technique, by using commercial pigs' kidneys, that has been useful to determinate the maximum warm ischemic time that a kidney of NHBD could tolerate. Parameters of this research were the resistance of the kidney in perfusion machine and the renal scintigraphy. Our results permitted to establish that the maximum warm ischemic time that a kidney of NHBD could tolerate, is 50 minutes (p > 0.001). This experimental technique could be employed to remove every doubt about the effective condition of NHBD kidney before the transplant, in the outlook, by using those kidneys, to reduce the organ shortage.

Animals↗