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Biomedical subjects

P Di Micco

Publications and source records attributed to P Di Micco.

10 recordsLinked to original sources
PubMed2006

Molecular and clinical conditions associated with venous thromboembolism in oncological patients.

The association between cancer and thrombophilia has been known since 1865 since Trousseau described it. However in the last three decades an increased interest has been raised on this issue related to several molecular and condition that are involved in the daily management of oncological patients. This brief review has been focused on molecular conditions underlying cancer acquired thrombophilia then to further clinical aspects inducing thrombophilia in oncological patients such as surgery, chemotherapy, concomitant medical illness and inherited thrombophilia.

Blood Coagulation Tests↗
PubMed2006

Upper extremity DVT in oncological patients: analysis of risk factors. Data from the RIETE registry.

AIM: The aim of the study is to up date informations on the clinical characteristics and outcome of patients with upper-extremity deep vein thrombosis (DVT) from the Informatised Registry on Venous Thromboembolism (RIETE). METHODS: RIETE is an ongoing registry of consecutive patients with symptomatic, objectively confirmed, acute venous thromboembolism. In this analysis the clinical characteristics and 3-month outcome of all cancer patients with upper-extremity DVT were evaluated. RESULTS: Up to February 2006, a total of 14,391 patients with symptomatic, objectively confirmed acute venous thromboembolism had been enrolled in RIETE. Of the 2,945 patients with active cancer 196 (6.7%) had arm DVT: 104 had catheter-associated DVT. Most cancer patients with arm DVT were males, younger than 65, and had a low incidence of additional risk factors or underlying diseases. Twenty of them (10%) had symptomatic pulmonary embolism (PE). Most patients were treated with low-molecular-weigh heparin, both initially (94%) and after discharge (75%). During the 3-month follow-up period 12 patients (6.1%) developed VTE recurrences (PE 6, DVT 6), 8 (4.1%) had major bleeding (fatal in 3), 43 (22%) died. CONCLUSIONS: Our data from the RIETE registry show that upper limb DVT is a serious complication in patients with cancer, with a high incidence of recurrences and bleeding complications.

Adult↗
PubMed2005

Acquired factor XII deficiency in a woman with recurrent pregnancy loss: working on a differential diagnosis in a single case.

BACKGROUND: Antiphospholipid syndrome (APS) has been often associated to RPL since 1980 and some reports in the Literature rarely described antibodies to factor XII in patients with APS. CASE HISTORY: We report the case history of 34-year-old caucasian women with recurrent fetal loss and persistent prolonged activated partial thromboplastin time. Haemostatic tests revealed persistent light decrease of clotting factor XII with normal values of IgG and IgM anticardiolipin antibodies and transient positivity for lupus anticoagulant (LA). Few reports in the Literature described antibodies to factor XII in patient with antiphospholipid syndrome (APS) and transient LA. So, once other causes of RPL were excluded, the patient was diagnosed an unusual form of APS associated to antibodies to factor XII, reduced factor XII plasma levels, transient LA and prolonged activated partial thromboplastin time. DISCUSSION: We suggest to consider also antibodies directed to clotting factors (e.g. factor XII in our case) as second step of thrombophilia screening in RPL, in particular if a persistent prolonged aPTT is present without an apparent cause.

Journal Article↗
PubMed2005

Up-date on solitary plasmacytoma and its main differences with multiple myeloma.

Solitary plasmacytoma is plasma cell neoplasm. It is a localized bone disease and for this reason it is different from multiple myeloma (systemic plasma cell neoplasm). Sometimes, solitary plasmacytoma precedes a following multiple myeloma. Clinical findings of solitary plasmacytoma are related to the univocal localization on damaged bone, while laboratory findings could be similar to multiple myeloma (i.e. M component, kidney dysfunction, blood calcium alterations, increased beta-2-microglobulin). However, during a solitary plasmacytoma, laboratory findings could not be present contemporaneously such clinical complications (i.e. kidney failure, immunological disorders with a trend toward infectious disease and/or autoimmunity, neurological disorders, haematological disorders, amyloidosis, POEMS syndrome). These raise the reason because solitary plasmacytoma has better prognosis compared to multiple myeloma.

Aged↗
PubMed2001

Alteration of haemostasis in non-metastatic gastric cancer.

BACKGROUND: Cancer is one of the most common acquired causes of venous thromboembolism. AIM: To evaluate haemostasis disorders in patients with non-metastatic gastric cancer. PATIENTS AND METHODS: We studied 11 patients with non-metastatic gastric cancer (9 males and 2 females, median age 54 years) and 20 healthy subjects (15 males and 5 females, median age 48 years) control. We measured prothrombin time, activated partial thromboplastin time, coagulation time, clot lysis time, fibrinogen, clotting factors (II, VII, VIII, IX, X), C protein, S protein, AT III, activated protein C resistance, prothrombin 1+2 fragment, tissue plasminogen activator and D-Dimer in all subjects. RESULTS: Fibrinogen plasma levels were significantly higher in patients with non-metastatic gastric cancer than in control group (505+/-24 mg/dl vs 336+/-30 mg/dl, p<0.001). We also found a significant increase in prothrombin 1+2 fragment plasma concentration compared with controls (3.8+/-0.6 nM vs 0.83+/-0.09 nM, p<0.001). Plasma D-dimer levels were 20-fold higher in patients with non-metastatic gastric cancer compared with controls (9.57+/-0.4 ng/dl vs 0.4+/-0.05 ng/dl, p<0.001). Also tissue plasminogen activator was significantly higher in gastric cancer patients than in controls (20.8+/-2.32 ng/ml vs 9.1+/-1.37 ng/ml, p<0.01). Finally clot lysis time was significantly accelerated in gastric cancer patients compared with control subjects (81+/-37 min vs 233+/-74 min, p<0.01). CONCLUSIONS: Patients with non-metastatic gastric cancer are at risk for thrombotic events due to the combined increase in fibrinogen plasma levels and thrombin formation.

Activated Protein C Resistance↗
PubMed2001

Porins from Salmonella typhimurium accelerate human blood coagulation in vitro by selective stimulation of thrombin activity: implications in septic shock DIC pathogenesis.

The effect of porins, major hydrophobic outer membrane proteins purified from Salmonella typhimurium, on human blood coagulation was investigated. It was found that micromolar concentrations of porins accelerated markedly human blood coagulation in vitro. Using appropriate experiments, data were obtained showing that the main target of the porin-induced procoagulant effect was thrombin. A possible binding of porins with thrombin has been suggested to be the basis of this effect. The implications of this finding in the pathogenesis of the disseminated intravascular coagulation syndrome (DIC) occurring during the Gram-negative septic shock is discussed.

Antithrombin III↗
PubMed2000

Inhibition of antithrombin by protein SV-IV normalizes the coagulation of hemophilic blood.

The aim of the study was to evaluate the effect of the protein Seminal Vesicle Protein No. 4 (SV-IV), a potent inhibitor of antithrombin III (antithrombin), on the coagulation of blood obtained from patients affected by hemophilia A. In the coagulating blood of these patients, the antithrombin/thrombin ratio was found to be markedly higher (about 44) than in normal individuals (about 4. 4). This high ratio was related to the low efficiency of thrombin-generating reactions induced by the factor VIII deficiency and to the high levels of free (not bound to serine proteases) antithrombin present in the hemophilic serum (antithrombin concentration was the same in normal and hemophilic plasma). The elevated concentration of free antithrombin in hemophiliacs was primarily a consequence of a reduced consumption caused by the scarce availability in the hemophilic serum of factors Xa and IIa, which are serine proteases possessing strong binding affinity for antithrombin. Addition of SV-IV to coagulating hemophilic blood reduced markedly the serum antithrombin and thrombin-antithrombin complexes, normalizing, as a consequence, the clotting time and other coagulation parameters. Similar results were obtained by using appropriate concentration of factor VIII.

Antithrombin III↗
PubMedDate not supplied

[Atherosclerosis and rheumatoid arthritis: relationships between intima-media thickness of the common carotid arteries and disease activity and disability].

OBJECTIVES: To investigate the intima-media thickness of the common carotid arteries (IMT-CCA) in patients with Rheumatoid Arthritis (RA), and its relationships with classical atherosclerosis risk factors and disease features i.e. duration, activity and disability. METHODS: 48 RA patients (35 F, 13 M; age ed 26-69 years median 55; disease duration 1-18 years, median 8), and 22 controls (16 F, 6 M; age 28-66, median 50) matched for classical atherosclerosis risk factors, i.e. age, sex, smoking, blood pressure, body mass index, diabetes, familiarity, and for postmenopausal status, were studied. IMT and plaques were measured in the left and right common carotid arteries. Serum total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, apoliporotein AI, apolipoprotein B, and rheumatoid factor were determined in patients and controls. The DAS28, the HAQ-DI and disease duration were considered as clinical parameters reflecting disease status. RESULTS: The IMT-CCA (mean +/- SD) was significantly greater in the 48 RA patients than in the 22 controls subjects (1.00+/-0.25 vs. 0.78+/-0.21; p=0.0007). In the 70 subjects investigated CCA-IMT resulted to be significantly correlated with diastolic blood pressure, body mass index, triglyceride and RA status. In the 48 RA patients no correlation was detected with either disease duration or activity or disability. CONCLUSION: our study confirms an increased IMT in RA patients without any clinically evident manifestation of cardiovascular disease. It supports the existence of subclinical atherosclerosis in RA.

Adult↗