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Biomedical subjects

M Grassi

Publications and source records attributed to M Grassi.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Hypoglycemic therapy and hemostasis in maturity- onset diabetes mellitus: existence of an early prethrombotic state.

We studied 115 patients with uncomplicated maturity-onset diabetes mellitus, 55 males and 60 females; patients were divided into 7 groups according to the hypoglycemic therapy (diet alone, tolbutamide, glibenclamide, phenformin, combination of the last two drugs, insulin, combination of insulin and phenformin). All patients were tested for a prethrombotic state by the simultaneous determination of the following parameters: ADP-induced platelet aggregation, Factor VIII as antigen and procoagulant activity and the plasma levels of fibrinogen and antithrobin III. Our results show that these parameters were markedly altered in diabetic patients when compared to apparently normal subjects of the same age; on the contrary, differences between groups of diabetic patients were very slight and hardly ever statistically significant. These results suggest that the prethrombotic alterations of hemostatic system are very similar in all groups of diabetic patients; this is true also for patients submitted to diet alone, i.e. with slight and usually recent-onset diabetes mellitus. In conclusion, our study suggests the opportunity, at least from the theoretical point of view, of systematic antiaggregant and/or anticoagulant treatment(s) in maturity-onset diabetes mellitus, whose severe and precocious prethrombotic alterations seem to be independent of the hypoglycemic treatment applied.

Adenosine Diphosphate↗
PubMedDate not supplied

Hypoglycemic treatments and the fibrinolytic system in maturity-onset diabetes mellitus without thromboembolic manifestations.

The fibrinolytic system was investigated in 115 patients with maturity-onset diabetes mellitus in good metabolic control and without thromboembolic manifestations. The patients were divided into 7 groups according to the hypoglycemic therapy: diet alone, tolbutamide, glibenclamide, phenformin, combination of the last two drugs, insulin, combination of insulin and phenformin. Our results indicate that in maturity-onset diabetes both fibrinolytic activity and inhibitors of fibrinolysis are increased. The enhanced fibrinolytic activity was not affected by different hypoglycemic drugs, whereas the main antiplasmins showed wide variations in the different treatment groups. In particular, a significant reduction of alpha 2M was observed in patients on glibenclamide therapy. In conclusion, our study showed that the high fibrinolytic state seems to be a constant element in diabetes, and that the different behaviors of the fibrinolytic system, reported by various authors in patients taking different hypoglycemic drugs, could be explained by the wide range of plasmin inhibitor levels observed in these conditions.

Aged↗
PubMedDate not supplied

Behavioral changes induced by the thyrotropin-releasing hormone analogue, RGH 2202.

The behavioral activity of the thyrotropin-releasing hormone (TRH) analogue, L-6-ketopiperidine-2- carbonyl-leucyl-L-prolinamide (RGH 2202), has been studied in the rat. The number of errors in a radial maze test was reduced after acute intraperitoneal (IP) injection of RGH 2202 at the dose of 5 or 10 mg/kg. Grooming activity was increased with a lower dose, 1 mg/kg. Hypoxia-induced amnesia, as assessed with active and passive avoidance behavior tests, was reversed in rats treated with 5 or 10 mg/kg of the drug. The loss of learning and memory capacity shown by aged rats in the same behavioral tests was also reduced after injection of RGH 2202. In a test for sexual activity of male rats, the higher dose of the drug induced a facilitation of mounting and ejaculations, while smaller doses were ineffective. The rotorod test revealed a decreased number of falls in animals treated with 5 or 10 mg/kg of RGH 2202. In all behavioral tests, the same doses of natural thyrotropin-releasing hormone (TRH) were less effective, indicating that this analogue may be qualified as a potentially active drug in human pathologies.

Animals↗
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Protective action of phosphatidylserine on stress-induced behavioral and autonomic changes in aged rats.

Phosphatidylserine (PS) was administered in aged rats subjected to various stressor stimuli in order to evaluate its effect on grooming behavior, core temperature and gastric ulcers. Novelty-induced grooming appeared to be increased in aged rats as compared to young controls. The subchronic intraperitoneal treatment with PS (20 mg/kg/day for 20 days) decreased grooming activity in aged rats, whereas it did not affect that of young animals. Restraint stress induced hyperthermia in both aged and young rats. However, 90 min after the beginning of restraint, PS-treated old rats showed a normalization of core temperature. Furthermore, restraint-plus-cold stress induced gastric ulcers in both aged and young rats. The treatment with PS was followed by a decreased incidence of gastric lesions in aged, but not in young rats. The mechanism of PS protective action against stress-induced behavioral and autonomic changes is unknown, but it may involve the brain level as this drug exerts a noteworthy influence on behavior and autonomic functions.

Aging↗
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Effects of RGH 2202 on cognitive and motor behavior of the rat.

The behavioral activity of the thyrotropin-releasing hormone (TRH) analogue, L-6-ketopiperidine-2-carbonyl-leucyl-L-prolinamide (RGH 2202), has been studied in animal models of central neurotransmission disruption. In 24-month-old rats, repeated administration of the peptide (5 or 10 mg/kg/day, injected IP for 20 days) was followed by a facilitated acquisition of active avoidance behavior in the shuttle-box test and retention of passive avoidance reaction in a step-through passive avoidance task. Also, ambulation in an open field was increased and motor performance and co-ordination in the rotorod test was facilitated by the treatment. Scopolamine-induced amnesia was reverted by RGH 2202 in adult rats tested both in active and passive avoidance tasks. Cognitive deficits induced in rats by prenatal manipulation with methylazoxymethanol (MAM) were reduced in adulthood by repeated administration with RGH 2202. These results indicate that the TRH-analogue, RGH 2202 may improve cognitive and motor disturbances in aging or induced by central neurotransmission disruption. It is possible that the peptide is functioning, at least in part, by intervening with the central cholinergic neurotransmission.

Age Factors↗
PubMedDate not supplied

[Health status of adolescents: what relations with family image? Adolescents Work Group].

INTRODUCTION: Many studies have been carried out recently to investigate the relationship between health conditions and family and self characteristics. OBJECTIVES: To identify family characteristics (such as type of family, socio-economic status, parent immigration, affection for parents, parents' psychological and physical health) and self characteristics (age, drug use, satisfaction for several life circumstances, psychosomatic symptomatology) that are differently distributed by sex and levels of psychological and physical distress among teen-agers. METHODS: We carried out a cross-sectional study on a sample of teen-agers attending high school in Pavia (Italy), using a self-administered questionnaire. The students were divided in four groups having different levels of psychological and physical distress, based on GHQ-30 (psychological distress indicator), on the number of hospital admissions and consultations to a physician in the last year (the last two are physical distress indicator). Data were analysed applying the multivariate analysis of Canonical Variate. RESULTS: 1346 students were sampled, but only 1189 questionnaire were analysed: 36.8% regarding males and 63.2% females. The Canonical Variate analysis indicated that psychosomatic symptomatology, satisfaction for several life circumstances and affection for parents are important for describing the four distress groups. CONCLUSIONS: Only affection for parents has an important role on psychological and physical distress of adolescents, while family characteristics traditionally considered associated with psychological and physical distress in teen-agers (such as living with one or without parents, low socio-economic status) are not associated.

Adolescent↗
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Modelling of drug-release from poly-disperse microencapsulated spherical particles.

The topic of this paper is the experimental and theoretical study of drug-release from a system of polydisperse microencapsulated particles that, for the sake of simplicity, are assumed to be spherical. The theoretical analysis performed yields of a mathematical model to describe the physical phenomena involved in drug-release from such a system. In particular, the model is based on the hypothesis of a progressive dissolution of the internal solid drug core (due to solvent penetration through the coating) that gives a liquid solution in the region between the coating and the dissolving solid core. The existence of a concentration gradient between the inner solution and the outer release environment determines drug diffusion through the coating. The coacervation technique was adopted to microencapsulate the solid drug cores (theophylline, a bronchodilator for the treatment of chronic asthma and chronic obstructive lung disease) by an insoluble polymeric layer of ethylcellulose. The amount of drug released from these microencapsulated particles to the external receiver phase is monitored by means of a UV spectrophotometer. As the proposed model fits the experimental results well, it was concluded that it can be a good tool to design and to study this kind of drug-release system.

Bronchodilator Agents↗
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[Hepatocarcinoma: epidemiologic and clinical evaluation of 90 patients].

PURPOSE: The aim of the study was to improve the knowledge of epidemiology and clinic of primitive HCC. PATIENTS AND METHODS: Ninety consecutive HCC patients, attending the Medical Therapy Dpt. of Rome University "La Sapienza" were examined: diagnosis of HCC was based on histologic data in 71; in the others the diagnosis derived from ultrasonographics, RMN, TC data. RESULTS AND CONCLUSIONS: Show M/F ratio 3.7/1; in 87% HCC is associated to liver cirrhosis (HCC/CEA); the cumulative presence of HBV and HCV is 75.6%: HCV alone 33.4%, resulting the major risk factor for HCC; patients with associated alcoholism, HBV and/or HCV show evidence of earlier appearance of HCC. Significant higher presence of HBsAg is recorded in HCC without surrounding liver cirrhosis compared to HCC/CE. The cumulative survival rate of treated patients is higher compared with non treated, irrespectively to kind of therapy. The HCC/CE+ patients have significant greater presence of elevated levels of alpha-FP and portal thrombosis compared to a randomized group of patients with liver cirrhosis only. At the end we outline that over 10% of HCC has none note risk factor for hepatic diseases.

Adult↗
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Detection and clinical evaluation of GBV-C/HGV in plasma from patients with chronic hepatitis of unknown etiology.

PURPOSE: The role of GBV-C/HGV virus infection in patients with chronic hepatitis of unknown etiology has been studied. Two groups of patients have been included: a) 50 consecutive patients with chronic hepatitis (mean age 47 yrs; M/F = 35/15), negative for markers of hepatitis viruses (HBV-HCV). These patients did not show evidence of metabolic, autoimmune, alcoholic or toxic liver disease; b) 50 healthy blood donors (mean age 35 yrs; M/F = 35/15). All the subjects were HIV-seronegative. PATIENTS AND METHODS: The detection of GBV-C/HGV RNA was performed by reverse transcription-polymerase chain reaction techniques and capillary zone electrophoresis analysis (CZE). RESULTS: There was no difference between the two groups of patients (14% vs 6%; p = 0.18 NS). CONCLUSIONS: The etiopathogenetic role of GBV-C/HGV in chronic hepatitis of unknown etiology is yet to be shown.

Adult↗
PubMedDate not supplied

[Development of a physical performance scale for patients with implanted pacemakers].

The development and the validation of the Pavia Physical Performance Scale (PPPS) is here presented. PPPS is a new instrument evaluating the physical performance of pacemaker implanted patients. Data comes from a cross-over clinical trial on the efficacy of two functions of the pacemaker device. Primary end-point is the improvement of the physical performance together with the quality of life. We used data of 168 patients actually enrolled and interviewed with the Pavia Physical Performance Scale. We first selected 30 Likert-type items; then we applied a statistical methodology of Homogeneity Analysis (HOMALS). We verified the homogeneity of the scale and the internal consistency (Cronbach's alpha = 0.92). With the same methodology, we developed the final version of PPPS. The final version lists 20 items; based on the results of the psychometric analysis, we turned the Likert-type scoring into a binary scoring (1 = no limitation of physical activity, 0 = limitation or never tried). The external validity, trough an Analysis of Variance of PPPS mean scores within New York Heart Association classes (NYHA), has been performed. We found a negative linear trend of PPPS scores and NYHA classes. That means an association between high PPPS scores (good physical performance) and low NYHA classes (also good physical capacity). The Pavia Physical Performance Scale (PPPS) could be proposed as a valid and consistent scale aimed to evaluate physical performance in pacemaker implanted patients. We suggest to use it in the clinical practice in addition to more traditional techniques.

Humans↗
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ECRHS screening questionnaire scoring: a methodological suggestion for asthma assessment. European Community Health Survey.

Univocal definition and classification of Asthma have always been a matter of discussion, and that is reflected in the difficulty of constructing a measure of pathology severity. The European Community Health Survey is a multinational survey designed to compare the prevalence of asthma in subjects, aged 20 to 44 years, in several European areas. In each participating center a sample of 3000 adults filled a self-administered screening questionnaire composed by 9 dichotomous items. Aim of the present study is to investigate unidimensionality of the ECRHS screening questionnaire and to determine and validate a scoring of asthma-like symptoms seriousness. Dimensionality and scoring was determined through a Homogeneity Analysis by Alternating Least Square; while scoring validation was assessed by a cross validation technique. This study found the existence of a sole dimension underlying the screening questionnaire; furthermore a scoring of asthma-like symptoms seriousness was determined with the indication of a cut-off in order to distinguish between asthma symptomatic and non symptomatic subjects.

Adult↗
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[Late post-traumatic diaphragmatic hernia: unusual cause of colonic occlusion].

Traumatic diaphragmatic rupture is not an uncommon problem, particularly in the last few years because of the increasing number of road accidents, improved diagnostic techniques and resuscitation techniques after serious traumas. In a certain number of cases, post-traumatic diaphragmatic hernias may become clinically manifest only months or years after thoracic or abdominal trauma and are still a challenge to surgeons because of the vague clinical symptoms and the diagnostic difficulties involved. The Authors report a case of acute colon occlusion due to diaphragmatic hernia 24 months after thoraco-abdominal trauma. None of the radiological or endoscopic examinations demonstrated the presence of diaphragmatic hernia. Laparoscopy showed a diaphragmatic rupture with incarceration of the left colonic segment. The laparoscopic procedure was converted for technical reasons and the diaphragmatic defect was closed with a primary suture.

Adult↗
PubMedDate not supplied

[Possibilities of thermal medicine in gastrointestinal functional disorders].

The aim of this review is that of offer an update on the real therapeutic possibility of the thermal medicine in the functional gastrointestinal disorders. The functional dyspepsia, the irritable bowel syndrome, the functional constipation and the functional disorders of the biliary tract (in accordance with Roma II criteria), are the illness for which the drinking mineral waters could give a valid therapeutic support.

Balneology↗
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[Fangotherapy in chronic degenerative rheumatic diseases].

The authors remind the historical role of the mud-therapy in the care of chronic degenerative rheumoartrhopaties, namely osteoarthritis. The main researches belong activity of muds on plasmatic hormones, cytokines, endorphins; a great deal of care is devoted to evaluation of efficacy of mud therapy and relating end points. The clinic outcomes of mud therapy, namely in osteoarthritis patients, were referred. Altogether the studies stress the employ of mud therapy in the treatment of osteoarthritis, the consequences of traumas, some dismetabolic chronic arthropaties, and fibromyalgic syndromes.

Arthritis, Rheumatoid↗
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[Meta-analytical study of gastrointestinal stromal tumors (GIST)].

Gastrointestinal stromal tumors (GIST) are the most common mesenchymal neoplasms of the gut wall. GIST have still today controversial aspects of their histogenesis that are reflected on the classification, clinical behaviour and prognosis. The authors analyzed 14 studies observed between 2000 and 2001; also the tumors early classified as leiomyomas, leiomyosarcomas and schwannomas were included in these studies because, on the basis of immunohistochemical analysis, their cells were c-Kit positive. The GIST occurred in 728 patients with the age range of 12 days-96 years with a male predominance (59.3%). The most common symptoms were abdominal pain (25.4%) and gastrointestinal bleeding (23.4%). CT scan was the most important diagnostic technique. Surgery was the only useful treatment; in this study completeness of resection predicted for longer survival. Overall survival was between 21.4% and 88.8%; the percentage of deaths was between 11.1% and 78.5%. Distant metastases, localised in liver and lungs, and locoregional recurrences developed in a percentage between 9% and 68%.

Adolescent↗
PubMedDate not supplied

[Recent trends in the therapy of hepatitis C].

The treatment of HCV correlated hepatitis is an important argument, because of the great incidence and prevalence of this disease. At the end of the Eighties, the IFN was the first substance used for HCV correlated hepatitis therapy. The IFN monotherapy with a dose of 3-6 MU for 6-12 months eradicates the infection in the 15% of cases, and cause an histological temporary improvement in a variable number of patients that keep the infection. In the following years, the research on evaluation of the efficacy of the recombinant interferons or interferons made with genetics engineering (IFN alpha 2a, IFN alpha 2b and IFN Consensus) has given results comparable with the results obtained with IFN alpha. Later, it started the experimentations with IFN associated to other substances, for example IFN-ribavirin combination therapy. The treatment IFN-Ribavirin eradicates the infection in 30% of the patients with the genotype 1b and in 60% with the genotype 2 or 3, while this treatment is less efficacious in the patients with the genotype 4. Recently, it started to use the PEG IFN. The pegylation is the combination of a polietylen-glicole molecule with the IFN molecule, so as to prolong its half-life and reduce the dose only one a week, with reduction of the collateral effects. Some studies has shown that the use of PEG-IFN in monotherapy could help the patients with advanced liver complaint. Successive studies are directed to show the efficacy of the PEG-IFN and ribavirin combination therapy. Recent researches put in evidence new substances, that could represent the future for HCV correlated hepatitis therapy. Between these substances we have to highlight the interleukin, the inhibitors of the viral multiplication and the inhibitors of IMPDH (Inosine monophosphate dehydrogenase). At the beginning of 2002 has made the improvement of HCV vaccine known. Actually, in the USA there are in progress human experimentations, and the production of gamma-globuline, that could be effective to prevent the infection.

Adult↗