PubMed HealthSearch

Biomedical subjects

M Masotti

Publications and source records attributed to M Masotti.

At least 19 recordsLinked to original sources

Comparison of serum total sialic acid, C-reactive protein, alpha 1-acid glycoprotein and beta 2-microglobulin in patients with non-malignant bowel diseases.

Total sialic acid (TSA), C-reactive protein (CRP); alpha 1 acid glycoprotein (alpha 1-AG), and beta 2-microglobulin were determined in 84 patients affected by non-malignant intestinal diseases, Crohn's disease (CD) and ulcerative colitis (UC), active and in remission; non-ulcerative proctosigmoiditis; diverticulosis; diverticulitis (ie, inflammatory complication of diverticulosis). Only in patients with acute phase CD, TSA was statistically higher than those in remission, as well as in controls. In patients with acute CD and in those with diverticulitis, CRP was significantly higher than in the controls. alpha 1-AG was found significantly increased in acute UC and CD patients versus the respective groups in remission, as well as versus controls. Moreover, alpha 1-AG was higher in patients with diverticulitis. beta 2-microglobulin did not differ in any group of patients. In five patients with CD in acute phase, investigated before and during the pharmacological treatment (5-aminosalycilic acid and steroids), CRP values fell into the normal range after the second week of therapy, whereas TSA values reached the higher limit of the normal range after the third week, except for two CD patients with a larger location (ileocolonic) of the disease. The results are briefly discussed.

Adolescent

Effects of adrenaline on ventricular function and coronary haemodynamics in relation to catecholamine handling in transplanted human hearts.

We investigated cardiovascular and coronary responses to intravenous infusions of adrenaline, which raised arterial concentrations in a stepwise fashion from basal to about 5-6 nmol.l-1, in 11 non-rejecting heart transplanted patients, and in eight intact innervated subjects. Cardiac adrenaline extraction and noradrenaline release rate were also measured. The transplanted patients showed larger increases in heart rate (36 +/- 11% vs 16 +/- 6%, P < 0.0001) and cardiac index (80 +/- 30% vs 56 +/- 19%, P < 0.05), while stroke volume increments were similar in the two groups (32 +/- 17% vs 35 +/- 13%). The study groups did not differ with respect to changes in arterial pressure, cardiac work or peripheral resistances. Coronary sinus blood flow increased to a greater extent in the transplanted group (75 +/- 35% vs 48 +/- 31%, P < 0.05) and myocardial oxygen consumption also tended to increase more in these patients (78 +/- 42% vs 48 +/- 34%, NS). Myocardial adrenaline extraction was greatly reduced in the transplant patients (-6 +/- 25% vs 64 +/- 18%, P < 0.001), while forearm adrenaline extraction was similar in the two groups (41 +/- 22% vs 40 +/- 23%, NS). Cardiac noradrenaline overflow tended to be lower in the transplanted group (12 +/- 62 vs 48 +/- 43 pmol.min-1, NS). There was a wide range of noradrenaline overflow values (-64 to 147 pmol.min-1) and definite high values in three patients. Cardiac noradrenaline overflow was not correlated to heart rate responsiveness to adrenaline. We conclude that patients with cardiac transplantation respond to adrenaline with exaggerated increases in heart rate and thus in cardiac output. High values of cardiac noradrenaline overflow are seen in some transplant recipients and may suggest reinnervation. Signs of reinnervation are not associated with consistently lower heart rate responses to beta-adrenergic stimulation.

Adult

Two-year follow-up after laser thermal balloon angioplasty (LTBA) in lower extremities: initial experience.

We describe the results obtained with the use of laser thermal balloon angioplasty (LTBA) in the treatment of atherosclerosis obliterans of the lower limbs in 37 patients (34 males, 3 females, mean age 58 +/- 9 years) with occlusive arterial disease (Fontaine stages II-IV) presenting 39 significant lesions. Immediate results and two years of clinical follow-up are analyzed. Initial ankle/brachial Doppler index was 0.51 +/- 0.17. Eighteen lesions were located in the iliac area (13 stenoses 2.3 +/- 1 cm and 5 occlusions 4.2 +/- 3 cm) and 21 lesions in the femoropopliteal area (5 stenoses 2.6 +/- 2 cm and 16 occlusions 5.7 +/- 3 cm). A percutaneous procedure was used in 38 cases. In only one case was femoral dissection needed. The laser source was argon in 26 cases and Nd-YAG in 13. Initial success was 85% (89% in iliac lesions and 81% in femoropopliteal lesions; 100% in stenoses and 70% in occlusions). The presence of occlusion (p less than 0.01) and/or calcium (p less than 0.05) negatively influenced the immediate results. No major complications were observed; seven (17%) minor complications occurred. Ankle/brachial Doppler index after treatment was 0.82 +/- 0.21. Cumulative clinical patency for successfully treated patients after two-year follow-up was 91%. LTBA thus represents an effective and less aggressive way of treating peripheral atherosclerosis obliterans. In spite of some limitations, it is useful in selected patients. The results of this study are very much like those in the literature for similar series and early experience.

Adult

Effects of the recombinant human erythropoietin (rHuEPO) administration on hematologic parameters, red cell creatine and 2,3-diphosphoglycerate contents, in patients affected by end-stage renal disease.

Twenty patients with renal failure and severe anemia (hemoglobin range 6.6-8.7 g/dl) on thrice-weekly maintenance hemodialysis were treated with recombinant human erythropoietin (rHuEPO). After three months of intravenous (iv) therapy the hemoglobin increase averaged 2 g/dl, and was steadily maintained even after two months of subcutaneous (sc) therapy. The significant increase of macrocyte counts, determined by an automated red blood cell counter after both steps of therapy, suggested the release of young red cells (large cells) into blood circulation. This assumption may be supported by the significant increase of the red cell creatine contents. 2,3-diphosphoglycerate (2,3-DPG) levels of the erythrocytes did not significantly change after rHuEPO administration.

Adult

Early and late hyperferremia during cisplatin chemotherapy.

Changes in plasma iron levels were evaluated in 48 neoplastic patients receiving a total of 56 courses of polychemotherapy in which high doses of cisplatin were administered on day 1. Serum iron showed a three-fold mean increase 24 hours after cisplatin infusion, rising from a basal mean value of 78.25 +/- 45.74 micrograms/dl to 242.12 +/- 72.67 micrograms/dl (P less than 0.001). Hyperferremia began to lower after the 3rd day and pretreatment levels were again observed the 10th day. Ferritin increased progressively from a basal mean value of 565.81 +/- 435.18 micrograms/l to 928.73 +/- 665.41 micrograms/l the 7th day (P less than 0.001). Hemolysis and tissutal necrosis were excluded, since red cells, hemoglobin, muscular and hepatic enzymes and indirect bilirubin remained unmodified. Reticulocytes began to lower on the 3rd day and reached the nadir the 7th day: therefore the cisplatin-induced blockage of erythropoiesis, with consequent reduced iron use was maximum the 3rd day--as observed in animals by other Authors--and could not explain the early hyperferremia developing within 24 hours. Consequently hyperferremia seems to consist of two overlapping stages: an early stage by unknown interference of cisplatin on iron-loaded reticulo-endothelial cells, with consequent acute iron emissions into the blood stream; and a later stage by toxic effect of the drug on erythroid precursors with reduced iron uptake by bone marrow.

Aged

Left ventricular dynamics and plasma catecholamines during isometric exercise in patients following cardiac transplantation.

Haemodynamics and plasma catecholamine responses to isometric exercise were evaluated invasively in 11 orthotopic heart transplant recipients and seven control subjects. Differences in haemodynamic responses between the two groups were already apparent after one min of handgrip at 30% of maximal voluntary contraction, and very pronounced at the end of the fourth minute. At this point transplanted patients showed smaller increments in heart rate (4.8 +/- 3.2 vs 20.4 +/- 14.1 beats.min-1, P less than 0.001), mean arterial pressure (13.7 +/- 7.2 vs 31.5 +/- 12.2 mmHg, P less than 0.001) and cardiac index (0.51 +/- 0.22 vs 1.02 +/- 0.53 L.min-1.m-2, P less than 0.01), whereas left ventricular end-diastolic pressure increased to a greater extent (8.8 +/- 4.9 vs 2.2 +/- 1.8 mmHg, P less than 0.01). Stroke volume index increased similarly (3.8 +/- 1.8 vs 2.0 +/- 3.5 ml beat-1.m-2, NS) and systemic vascular resistance remained unchanged in both groups. The slopes of the left ventricular function curves (ratio of change in left ventricular work to change in left ventricular end-diastolic pressure) indicated depressed left ventricular function in the transplanted patients. The two groups showed similar increments in mixed venous plasma norepinephrine and epinephrine indicating normal sympathoadrenal activation in the transplanted patients. In conclusion, transplanted hearts respond to handgrip with attenuated increases in heart rate, cardiac output and arterial pressure and by increasing left ventricular filling pressure, suggesting a poor contractile reserve probably due to denervation. Circulating catecholamines, especially epinephrine, probably contribute to the cardiac responses to isometric exercise.

Adult

Five years of angiographic and clinical follow-up after successful percutaneous transluminal coronary angioplasty.

The first 67 consecutive patients (77 lesions) who underwent successful coronary angioplasty (PTCA) at our hospital were clinically followed with serial exercise testing over a 5-year (4 to 7) observation period. Two sequential angiographic controls were performed 6.9 +/- 4.6 (64 patients) and 49.5 +/- 21.6 (42 patients) months after PTCA. The 5-year risk of cardiac death was 8%, of myocardial infarction 2%, or coronary artery bypass grafting 16% and of repeat PTCA 8%. At 5 years, 67% of the patients remain asymptomatic. Restenosis greater than or equal to 70% diameter was observed within the first year after PTCA in 30% of the patients. Progression of coronary artery disease (CAD) was observed in 13 patients (20%). In the first angiographic control, CAD progression was 4% (3/77) in dilated and 3% (3/115) in non-dilated arteries (ns). In the second angiographic control, it was 7% (3/45) and 10% (8/81), respectively (ns). Thus good clinical and angiographic results are still observed after 5 years. Restenosis is an early, self-limited, time-restricted phenomenon that occurs in 30% of patients. Angioplasty does not appear to accelerate CAD progression.

Angina Pectoris

Prevention of aortocoronary vein-graft attrition with low-dose aspirin and triflusal, both associated with dipyridamole: a randomized, double-blind, placebo-controlled trial.

A randomized, double-blind, placebo-controlled trial was performed in 209 patients to evaluate the efficacy of a low dose of aspirin plus dipyridamole or that of a new antiplatelet agent (triflusal) plus dipyridamole in the prevention of aortocoronary vein-graft occlusion. An angiographic control performed in 161 patients 9 days after surgery showed no significant differences between groups, but a new control on 138 of those patients 6 months later did show significant linear trends towards fewer distal anastomosis occlusions (P = 0.027) from the placebo (24%, 22/91) to the aspirin (16%, 17/106) and to the trifusal groups (12%, 10/86), and towards fewer new occlusions (P = 0.056) from 12% (9/78) to 10% (10/99) and to 2.6% (2/78), respectively, in the same groups. A multivariate logistic regression model, used to determine the effect of 33 variables on distal anastomosis occlusion at 6 months control, demonstrated that diameter of distal bed (P = 0.006), moderately to severely atherosclerotic distal bed (P = 0.003) and the interactions between poor distal bed and triflusal (P = 0.005) were independent predictors of occlusion. Thus, triflusal plus dipyridamole appeared superior to low-dose aspirin plus dipyridamole in the prevention of vein-graft occlusion, independently of coronary and vein-graft determinants of occlusion.

Adult

Does intravenous streptokinase therapy facilitate the formation of anti-heart antibodies in acute myocardial infarction?

Streptokinase (SK), a nonenzymatic protein produced by group C beta haemolytic streptococci, is a potent antigen. It is used worldwide as a thrombolytic agent in the treatment of acute myocardial infarction (AMI). Specific antiheart antibodies (AHA) have been found with a significantly high incidence in patients with AMI, and after streptococcal infection as a result of stimulation by constituents of the group A streptococci antigenically cross-reactive with sarcolemmal portion of the muscle fiber of the heart. Since there may be partial antigenic identity of group C streptococcal membranes with membranes isolated from group A streptococci, we have designed a prospective study to evaluate the incidence of serum AHA (and of other organ-specific and non-organ-specific antibodies) in 36 patients with AMI, 14 of whom treated with SK. AHA, of IgG class, were of the sarcolemmal-subsarcolemmal type, and did not fix complement. They were found in 4/36 patients already on admission; of the 32 patients negative, none developed AHA later, on days 7, 15 and 21 of hospitalization, also after treatment with SK (in 14 cases). There was no significant difference either within or between the two SK-treated and non-SK-treated groups also with regard to the incidence of organ-specific and non-organ-specific autoantibodies. These findings do suggest that the intravenous SK therapy does not facilitate the formation of AHA in AMI.

Antibody Formation

[Findings in relation to serum and urinary iron in heterozygotic beta-thalassemia].

Iron status (expressed as serum ferritin and iron levels) has been compared in normal and in heterozygous beta-thalassemic subjects. A higher serum ferritin concentration has been found in beta-thalassemic males, showing, therefore, a shift towards super-normal values of the balance between tissue iron and serum ferritin levels. In beta-thalassemic subjects the serum ferritin levels have been found in the normal range and this seems to be correlated with an adequate and ready iron supply by protein transferrin to hyperplastic bone marrow. The higher urinary iron values in normal male subjects can be explained in this way: a large iron supply from the transferrin to the thalassemic erythroid cells limits the contribution from this protein to the urinary iron.

Adolescent