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Biomedical subjects

M Grassi

Publications and source records attributed to M Grassi.

196 records · Page 11Linked to original sources
PubMedDate not supplied

[MDR (multidrug resistance) in hepatocarcinoma clinical-therapeutic implications].

Our purpose was to summarize current knowledge on "multidrug resistance", or MDR, an intrinsic or acquired cross resistance to a variety of structurally and functionally unrelated drugs, still representing one of the major problems in the therapy of cancer and other diseases. MDR depends on various mechanisms, the best known being the activity of ABC transport proteins, mainly Pgp, MDR1 gene product,and MRPs; but also other transporters can cause resistance, for example TAP, a peptide transporter, CFTR, cystic fibrosis transmembrane regulator, ABCG2, or breast cancer resistance protein (BCRP) and LRP, lung resistance protein. MDR has been detected in nearly all types of cancer, because it affects many organs and can occur against a wide number of drugs; it is frequent even in other diseases, such as epilepsy and HIV. We focused on MDR phenomenon in HCC, one of the commonest tumors in the world, and one of the most resistant to pharmacological treatment. This characteristic might be partly determined by a link between MDR and angiogenic phenotypes. The relationship between MDR in hepatocellular carcinoma and the effectiveness of therapeutic treatments has been particularly examined. Finally, the importance to overcome the strong chemoresistance of hepatocellular carcinoma with methods alternative to drugs, namely gene therapy, which makes use of antisense oligonucleotides and anti-MDR1 ribozymes, has been pointed out.

Animals↗
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Evaluation of the efficacy of the Italian guidelines on COPD: a cluster randomized trial.

BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is a profoundly disabling disease managed predominantly by General Practitioners (GPs). We planned this prospective trial to evaluate the applicability of Italian GP-directed guidelines in routine practice and whether adherence to them improves treatment efficacy, with respect to decreased exacerbations, hospital admissions, drug use, and out-patient appointments and improved quality of life (QoL). METHODS: In a cluster randomised trial, 22 GPs were randomly put into two groups: one group was asked to follow the guidelines (YES-GL), the other to continue normal clinical practice (NO-GL). These GPs enrolled 123 patients with COPD and followed them for one year. RESULTS: Patients managed by the YES-GL GPs had more outpatient appointments and specialist consultations and a higher probability of being classified as having severe COPD. The QoL was fairly low in both groups, and all other clinical outcomes taken into consideration, were not affected by application of the guidelines. CONCLUSION: The guidelines did not substantially alter the clinical evolution of COPD patients, even though some facets of management improved.

Aged↗
PubMedDate not supplied

The prevalence of gallstones in patients suffering from liver cirrhosis: a clinico-statistical study of 350 patients.

The overall prevalence according to sex and to age group of biliary calculosis was assessed in 350 patients with liver cirrhosis: data were compared with homogeneous findings in the general population of the GREPCO study. Cholelithiasis was found to be significantly more frequent in cirrhotics, and the pattern was confirmed when data were analyzed according to sex; a significantly higher percentage was found in cirrhotics of the 40-49 and 60-69 age groups. Among cirrhotics with gallstones, alcoholics represented a smaller percentage compared to non-lithiasic cirrhotics. The incidence of complications such as digestive hemorrhage, coma, and hepato-renal syndrome, was equal in cirrhotics with and without biliary calculosis, or, as far as coma was concerned, even lower among the former. A fatal outcome was less frequent in cirrhotic patients with than in those without cholelithiasis. Our results go to show that biliary calculosis does not aggravate the course of liver cirrhosis.

Adult↗
PubMedDate not supplied

Leptospirosis survey in wild rodents living in urban areas of Rome.

The aim of the study was to survey the current extension of the infected brown rats (Rattus norvegicus) living on the site Ripa Grande-San Michele port located in the center of the sity along the accessible right bank of the Tiber river by using a specific molecular technology. The detection of Leptospira, in 11 trapped brown rats, by tube-based Polymerase Chain Reaction (PCR) was performed. The amplified samples were analysed by capillary zone electrophoresis (CZE). Sequence analysis of the amplified DNAs confirmed the specificity of the detection of leptospires. Five out of 11 brown rats exhibited positivity for Leptospira. The survey points out the high rate of leptospiral infection in the brown rats living in the most ancient urban area of Rome.

Animals↗
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[Spa and climate therapy in chronic obstructive pulmonary diseases].

The authors remind the main epidemiological and clinical findings of Chronic Obstructive Pulmonary Disease (COPD); the prevalence and incidence of COPD is increasing and COPD is now the IV cause of death in the world. Moreover, it is cause of increasing pharmaceutic and hospital charges. COPD has multifactorial etiology, linked to genetic and exogenous factors, as tobacco smoke, air pollution, microbial infections and cold. The GOLD guide lines of the medical therapy of the COPD are showed. The spa therapy of COPD is based on the inhalation use of mineral water, mainly sulphurous and salsojodic. Sulphurous mineral waters have vasodilating activity on vessels of bronchial mucose, improving its trophic state, and increase the production of secretory IgA and muco-ciliary clearance; they have fluidificant activity on bronchial secretion. Clinical trials showed improvement of cough, sputum and functional indexes as FEV1 and CV. Salsojodic mineral waters increase the fluidity of the bronchial mucus, muco-ciliary clearance and the trophism of the bronchial mucose. The authors remind the properties of sulphate and bicarbonate mineral waters in the spa therapy of COPD. Finally authors refer about some effects of spa therapy and climatic-environmental situations on COPD morbidity.

Aerosols↗
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[Morphological aspects of atherosclerosis lesion: past and present].

Atherosclerosis is an inflammatory process disease that involves the artery wall and that is characterized by the progressive accumulation of lipids. The term arteriosclerosis has been created by Lobstein in 1833. Subsequently, during the 19th century, the contribution of Rokitansky and Virchow was important to elucidate the pathogenesis of arteriosclerosis and the morphologic aspects of the plaque. In the beginning of the 20th century, Aschoff was a leading proponent who regarded the morphologically different intimal lipid deposits of children and adults as early and late stages of one disease and he called them atherosis and atherosclerosis, respectively. The first classification of atherosclerosis was made by the World Health Organization (WHO) in 1958 and it consisted of the following sequence: fatty streak, atheroma, fibrous plaque and complicated lesions. In 1990s, thanks to much more sensitive techniques, the American Heart Association (AHA) proposed a new morphological classification based on eight lesion types designated by Roman numerals which indicate the usual sequence of lesion progression. Finally, Virmani et al. (2000) described a classification with the add of a specific plaque type, not recognized by the AHA classification, called "thin fibrous cap atheroma" which is more likely to rupture. The atherosclerotic process is characterized by typical ultrastructural changes that mainly involve the endothelial and smooth muscle cells. The morphological alterations of the endothelium are associated with dysfunctions leading to a proinflammatory and prothrombotic phenotype. This process seems to be due to turbulent blood flow and low fluid shear stress that normally occurs in particular regions of the vascular tree. Inflammation has a key role in the pathogenesis of atherosclerosis and it is supported by numerous factors such as modified LDL, hypertension, diabetes mellitus, free radicals and, in particular, by infectious agents such as Chlamydia pneumoniae.

Adult↗
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The effects of acetyl-l-carnitine on experimental models of learning and memory deficits in the old rat.

Experimental models of learning and memory deficits in aged rats can be studied by means of behavioural tests that provide an important tool for evaluating the effect of drugs on these parameters. Active and passive avoidance tests showed a clear impairment of learning and memory capacity of old rats. These tests were also used to study the behavioural effect of acetyl-l-carnitine in aged rats. The subchronic treatment with this drug was followed by a significant improvement of acquisition and retention of avoidance responses, indicating a facilitation of learning and memory capacity of aged rats.

Acetylcarnitine↗
PubMedDate not supplied

[Non-Q infarct. Clinical and prognostic aspects].

Prognosis of on-Q wave myocardial infarction (nQMI) has been the subject of considerable controversy over the last few years and a systematically aggressive approach with PTCA or coronary by-pass surgery (CBS) has been advocated as a means to reduce subsequent coronary events rate. To investigate clinical outcome and possibly identify high-risk subgroups 131 consecutive patients (pts) meeting diagnostic criteria for nQMI, admitted to our CCU for their first myocardial infarction between January 1980 and June 1985, were followed-up for a mean period of 34 months (range 6-72). Mean age of pts was 59 +/- 7 yrs; 101 (76%) were males, 30 (24%) females. No pt was lost to follow-up. During the same period 684 pts were admitted for Q wave myocardial infarction. Major coronary events such as angina, reinfarction, CBS, cardiac death as well as overall early and late mortality were considered for statistical evaluation with uni-multivariate analysis taking into account multiple data from pts history and acute clinical presentation. Angina appeared or recurred in 71 pts (54%), reinfarction occurred in 14 (10.7%); 25 pts underwent CBC (19%). Early cardiac deaths were 7 (5.3%), late cardiac deaths 12 (9.2%); overall mortality rate 18.1%. Uni- and multivariate statistical analysis did not disclose significant criteria predicting major coronary events and no high-risk subgroup could be identified, confirming uncertainties and doubts from literature.

Aged↗
PubMedDate not supplied

Heparin-induced thrombocytopenia with arterial thrombosis: an unusual case.

A case of heparin-induced thrombocytopenia with thrombosis (HITT) is described. The patient, treated for several days with porcine Ca-heparin at a dosage of 10,000 IU/day, presented severe thrombocytopenia (Plt 36 x 10(9)/L), intermittent right leg ischemia, and a positive heparin-induced platelet aggregation assay. We promptly discontinued heparin and started picotamide, an antiplatelet drug. Rapid clinical improvement was observed in a few days. We stress the unusual features of the reported case (HITT during prophylactic therapy with low doses of porcine heparin; intermittent thrombosis), and we suggest picotamide represents a rational therapy for HITT on the basis of clinical and pathogenetic considerations.

Drug Therapy, Combination↗
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[Current therapeutic methods in primary sclerosing cholangitis].

The authors synthesize the main etiopathogenetic, physiopathologic and clinic findings of CSP and describe the pharmacs employed in the treatment of disease: corticosteroids, cyclosporin, penicillamine, colchicine, tacrolimus, metotrexate, hydrophylic bile salts. They outline the poor or none therapeutic activity of the majority of these and stress the improvement of some clinical parameters after prolonged use of hydrophilic bile salts. However none of the used pharmacs can stop the pathologic course of the disease. At the end authors remember the usefulness of liposoluble vitamins to prevent carential syndromes.

Bacterial Infections↗
PubMedDate not supplied

[Hepatic steatosis: clinical-statistical study of patients diagnosed by histological or ultrasonographic methods].

PURPOSE: This study wants to document eziopathogenetic factors and clinical, instrumental and hystological characters that associate to the various types of hepatic steatosis. PATIENTS AND METHODS: In this retrospective study have been examined two different groups of randomized patients. The "Group 1" comprehended 70 patients with hystologic diagnosis of hepatic steatosis (steatohepatitis--SH--60%; steatosis--SE--40%). The "Group 2" comprehended 70 patients with ultrasonographic pattern of fatty liver (slight degree: 70%; severe degree: 30%). RESULTS: Analysis of results relative to the "Group 1" showed the role of HCV-infection in etiopathogenesis of the SH, significantly greater than in SE (76.2% vs 25%; p < 0.0001). SE is often associated with exogenous noxae (alcoholism: 28.6%; use of long-term medications: 14.3%) or metabolic disorders (hyperglycemia 28.6%, hyperlipidemia 42.8%, obesity 25%). Haven't seen differences of clinical data or serum liver tests between SE and SH. Histological features that predicted the development of cirrhosis and/or fibrosis are more frequent in SH (SH: 40.4% vs SE: 10.7%; p < 0.01). The analysis of "Group 2" hasn't shown differences of clinical data or serum liver tests between slight and severe degree. CONCLUSIONS: Analysis of results relative to the two groups of patients ones has shown that SE and SH are thick asymptomatics and associated at hepatomegaly and at increase of ALT, AST, gamma GT. The increase of ALT and/or AST leads to search for the markers of HBV and HCV; when they are positive, hepatobiopsy is necessary for the diagnosis of possible SH or evolutive state to liver cirrhosis.

Acquired Immunodeficiency Syndrome↗