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Biomedical subjects

M Traina

Publications and source records attributed to M Traina.

At least 37 records · Page 2Linked to original sources
PubMed1990

Natural history of congestive gastropathy in cirrhosis. The Liver Study Group of V. Cervello Hospital.

In a prospective study of the natural history of congestive gastropathy, 212 consecutive cirrhotic patients (75 treated with sclerotherapy) were included. Mean follow-up was 46 months. Mild gastropathy (mosaiclike pattern) was found in 110 patients and severe gastropathy (granular mucosa with cherry spots) was found in 20. Prevalence of Helicobacter pylori, formerly Campylobacter pylori, was 50% in patients without, 43% in those with mild, and 28% in those with severe gastropathy. Congestive gastropathy was significantly more frequent in patients treated with sclerotherapy (83% vs. 50%, P less than 10(-5)). Sixty-month actuarial proportions of patients free of anemia (in the absence of hematemesis or melena), were 17% with severe, 62% with mild, and 93% without gastropathy (P less than 10(-8]. Corresponding figures for overt bleeding were 25%, 73%, and 87% (P less than 10(-7], whereas those for survival were 46%, 72%, and 85% (P = 0.0005), respectively. A multivariate regression analysis supported the following conclusions: (a) sclerotherapy and the presence of large esophageal varices significantly increase the risk of congestive gastropathy, which (b) is a significant risk indicator of both chronic and overt bleeding but does not independently affect survival.

Adult↗
PubMed1990

[Electrocardiographic indices of reperfusion and limitation of the necrotic area in acute myocardial infarct].

The aim of this study was to assess the evolution of ST segment displacement and the formation of new Q waves in relation to the late angiographic demonstration of recanalization of the infarct-related vessel in 36 patients with acute myocardial infarction admitted in our Institution within 8 hours from the onset of symptoms. Eighteen patients were treated with intravenous urokinase (200,000 + 1,200,000 UI) followed by sodium-heparin 1,000 U/ev/hour for 48 hours and calcium-heparin 3,000 UI/10 Kg/12 hours from the third day to discharge. Eighteen patients were treated from admission only with calcium-heparin as seen before. All the patients have been followed with serial electrocardiograms; we evaluated the sum of ST displacements (ST12) and Q waves score (Q12) in the 12 standard leads on admission, and on the twelfth, twenty-fourth, forty-eighth hour, and on discharge. On the basis of the late angiographic findings and apart from the treatment, we divided the patients into 2 groups: patients with recanalization of infarct-related vessel (20 patients, 55.5%) and patients with occlusion of the infarct-related vessel (16 patients, 44.6%). We did not observe statistically significant differences between the 2 groups for decrease of ST segment displacement of formation of new Q waves, even if reperfused patients showed a more rapid and complete decrease of ST segment displacement and a more rapid formation of new Q waves with respect to occluded patients. Our data indicate that from a clinical point of view electrocardiographic indices are not a sensitive marker of recanalization of infarct-related vessel.(ABSTRACT TRUNCATED AT 250 WORDS)

Angiography↗
PubMed1990

[Short- and long-term effects of enalapril on the left ventricular function in patients with congestive heart insufficiency].

Several studies have demonstrated that enalapril causes a clinical and hemodynamic improvement in patients with congestive heart failure. Nevertheless, the drug capability of influencing left ventricular systolic and diastolic indexes has not been evaluated. In 12 patients with severe congestive heart failure (NYHA class III-IV), treated with digitalis and diuretics, we performed a baseline evaluation through a right heart catheterization, echocardiography and radionuclide ventriculography. The effects on left ventricular systolic and diastolic function indexes after the administration of enalapril 5 mg by oral route have been evaluated. After 3 months of chronic therapy with enalapril 5 mg twice daily, we performed a further evaluation through echocardiography and radionuclide ventriculography. At the acute test we observed a significant improvement of left ventricular ejection fraction (EF), left ventricular stroke index (LVSI), and peak of filling rate (PFR), with a significant reduction of pulmonary wedge pressure (PWP) and peripheral vascular resistance (PVR). After 3 months of chronic therapy EF was significantly increased with respect to baseline values (37 +/- 6.9% vs 28.7 +/- 7.9%, p less than 0.05) and showed a further increase after the drug administration (from 37 +/- 6.9% to 48 +/- 5.4%, p less than 0.001). PFR showed a similar behaviour and reached at the follow-up evaluation normal values (from 1.97 +/- 0.7 edv/s to 2.57 +/- 0.6 efv/s, p less than 0.001). Furthermore, the echocardiographic dimensions of the left ventricle decreased significantly with a significant increase of shortening fraction. In conclusion, our study demonstrates that in patients with severe congestive heart failure enalapril improves the left ventricular systolic and diastolic function indexes and this improvement is persistent.

Aged↗
PubMed1986

[Controlled study of the effect of long-term administration of canrenoate potassium in cirrhotic ascites].

Two groups of patients with water retention due to ascites in cirrhosis of the liver were treated with antialdosterone diuretics (42 cases with K-canrenoate and 48 cases with spironolactone) for prolonged periods of time (an average of more than 5 months). Both substances were seen to be active, re-equilibrating sodium and water balance, bearing in mind a few methodologic limitations described in the text. Investigation of possible side effects showed that the incidence of gynecomastia, which is fairly common with spironolactone, was considerably reduced or practically absent with K-canrenoate.

Adult↗
PubMed1986

Predictive value of ultrasonography in the screening of non-ascitic cirrhotic patients with large varices.

To evaluate the accuracy of ultrasonography in the screening of cirrhotic patients with large varices, the receiver operator characteristic (ROC) curves of the portal, mesenteric, and splenic veins of 215 consecutive non-ascitic patients were plotted in order to select the most indicative optimal threshold. The contribution of respiratory variations of splenic and mesenteric veins was also evaluated. Taking 13 mm as the limit for the normal diameter of the portal vein, 10 and 9 mm for the upper limits of the mesenteric and splenic veins, respectively, and respiratory variations being absent, the positive rates were 91, 88, and 92 per cent and the false-positive rates were 44, 38, and 42 per cent, respectively. The predictive values of a positive test were 0.34, 0.33, and 0.34, respectively, and the predictive values of a negative test were 0.96 for the portal and mesenteric veins and 0.97 for the splenic vein. Because the portal vein is always visible, the portal diameter may be employed in the screening through the presence of large varices in association with the assessment of respiratory variation in the splenic or mesenteric diameter. A cut-off point of 13 mm and the absence of respiratory variations precludes the need for endoscopy in 47 per cent of patients.

Endoscopy↗
PubMed1984

Circulating immune complexes containing IgG, IgA and IgM in patients with myocardial infarction: detection with C1qSP and anti C3SP.

Immunological reactions have been recognized in cardiac disease and immune complexes (ICs) have been suggested to be of pathogenetic significance in the occurrence of post-myocardial infarction syndromes. ICs of IgA, IgG, IgM class have been detected in myocardial infarction utilizing a C1qSP and an anti C3 assay. A poor concordance was found between the two methods. Early pericarditis was found to be associated with the presence of ICs, suggesting that ICs may play a role in developing pericarditis or that they may be considered a marker of pericarditis by an immunological mechanism.

Aged↗
PubMed1984

[Training effect and hemodynamic parameters in myocardial infarct patients undergoing rehabilitation].

Thirty-five patients with previous myocardial infarction underwent a programme of supervised physical rehabilitation. Twenty-two patients achieved a training effect (TE), after rehabilitation, i.e. a decrease of the double product (DP) for corresponding work loads and an increase of their physical work capacity (PWC). Thirteen patients, despite the absence of any clinical signs of decreased performance, did not obtain the above mentioned haemodynamic effects. In all of the patients the ejection fraction (EF) both at rest and during exercise was measured using a nuclear stethoscope. In patients with TE, the EF was 57 +/- 5% at rest, and 64 +/- 9% during exercise; in patients without TE the EF was 52 +/- 8% at rest and 46 +/- 10% during exercise. The correlation between TE (delta% PWC) and EF at rest and during exercise respectively, is positive and statistically significant, but there is a higher (r = 0,73) and more significant (p less than 001) correlation between delta% PWC and EF during exercise.

Adult↗
PubMed1981

[MDA formation by platelets and plasmatic BTG levels in patients suffering from acute myocardial infarction (author's transl)].

Platelets are thought to be involved in the initiation and propagation of arterial and venous thrombi. A new formation of platelet thrombus in a coronary artery has been implicated in the genesis and extension of myocardial infarction. Experimental evidence suggests that platelet aggregates may be responsible for occlusion of small coronary arteries and subsequent ischemia. Whether the thrombotic component of myocardial infarction is primary or secondary in a given patient, platelet function alterations can influence many mechanisms - operating at the microenvironment level from which depends if the thrombotic lesion grows or sends platelet emboli to the smaller myocardial vessels. Although myocardial infarction is usually associated with arteriographic evidence of atherosclerotic coronary obstruction, examples of infarction in the absence of coronary artery disease have been reported. ARterial thrombosis, small vessel coronary disease and arterial spasm are several possibilities that have been described. Recently in some cases of myocardial infarction, coronary artery spasm has been demonstrated angiographically; thromboxanes, vasoconstrictive and platelet aggregating substances, are released by platelets; thromboxanes, vasoconstrictive and platelet aggregating substances, are released by platelets during myocardial ischemia as an increase of prostaglandin synthesis, like prostacyclin, is stimulated by ischemia and hypoxia. The local release of these substance may modify the myocardial cell viability and regional blood flow. The aim of the present study was to investigate some changes in platelet function in relation to the time stimulated with thrombin. The tests showed, in the first three days, an augmented release of BTG levels with a platelet "exhaustion", demonstrated by a reduced formation of MDA by platelets changing to a state of hyperactivity, with a maximal production of MDA in 10th-15th day.

Adult↗