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Biomedical subjects

R De Maria

Publications and source records attributed to R De Maria.

At least 91 records · Page 5Linked to original sources
PubMed1989

Experience with itraconazole in cryptococcosis and aspergillosis.

Cryptococcosis and aspergillosis in immunocompromised patients are extremely difficult clinical conditions to manage and treatment with available antifungal drugs often fails. Itraconazole, R-51211, Janssen Pharmaceutica, a new orally absorbed triazole, is a possible alternative drug which is potentially effective and nontoxic. Preliminary experience with 28 patients, eight with cryptococcosis and 20 with aspergillosis, is reported. Of these patients, 16 were immunocompromised (seven with the acquired immune-deficiency syndrome (AIDS), five heart transplant recipients and four with leukaemia or lymphoma). Overall, results of treatment were good (18 in remission, four markedly improved, four moderately improved and two failed). Prevention of relapses of cryptococcosis was obtained in all patients with AIDS on long-term itraconazole monotherapy (3 mg/kg). Treatment of invasive aspergillosis required a higher dosage (about 5 mg/kg) and prolonged administration. Besides its efficacy this antifungal agent allowed outpatient management.

Acquired Immunodeficiency Syndrome↗
PubMed1989

Echocardiographic assessment of cardiac allograft rejection.

Twenty-one patients surviving orthotopic cardiac transplantation were studied by serial M-Mode and cross-sectional echocardiography on the same day as endomyocardial biopsy (EBS) (n = 205) during a mean follow-up period of 7.7 +/- 6 months. Results of EBS and the corresponding echocardiograms were divided into three groups: (1) no rejection (62 patients); (2) onset of mild rejection (11 patients); (3) onset of moderate rejection (17 patients). Groups 1 and 3 differed significantly in interventricular septum plus posterior wall thickness (IVS + PWth) (P less than 0.001), LV mass (P less than 0.001), LV ejection fraction (LVEF) (P less than 0.001), increased myocardial echogenicity (ME) (P less than 0.01), impaired RV wall motion (P less than 0.001). Groups 1 and 2 differed significantly only in increased ME (P less than 0.01). Groups 2 and 3 differed significantly in IVS + PWth (P less than 0.05), LV mass (P less than 0.01), LVEF (P less than 0.01), and impaired RV wall motion (P less than 0.01). With acute rejection we observed (1) increase of greater than 4 mm in IVS + PWth (55%), (2) increase of greater than 30% in LV mass (34%), (3) reduction of greater than 10 points in LVEF (27%), (4) RV dilatation and wall motion impairment (31%), (5) appearance or marked increase of pericardial effusion (34%), (6) increased ME (58%). Specificity of the individual criteria ranged from 95.6% to 100%.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗
PubMed1989

Serum interleukin-2 receptor levels measured by enzyme immunoassay in heart and kidney transplanted patients.

IL-2R serum concentrations were assayed by a sandwich enzyme immunoassay method in order to ascertain if the measurement of the soluble form of IL-2R can be considered a useful marker of allograft rejection in heart and kidney transplanted patients. Serum IL-2R levels increased significantly compared to pre-operated values (1129 +/- 215 U/ml vs. 592 +/- 209 U/ml, p less than 0.01) in six heart-transplanted patients during acute rejection crises documented by clinical findings and endomyocardial biopsy, and returned to baseline levels after successful treatment (544 +/- 395 U/ml vs. 1129 +/- 215 U/ml, p less than 0.01). Moreover, we observed that severe bacterial (n = 5) or viral (n = 2) infections were also accompanied by a significant increase of IL-2R serum levels in heart-transplanted patients (1076 +/- 263 U/ml vs. 486 +/- 146 U/ml, p less than 0.01 in bacterial, and 1290 +/- 368 U/ml vs. 370 +/- 85 U/ml in viral infections). In the six patients with renal transplant, the mean pre-operative IL-2R level was also elevated (1507 +/- 203 U/ml). A 1.5-4 fold increase of IL-2R levels has been observed at the beginning of both acute rejection and clinically evident infection. Our data show that the serum concentration of IL-2R is increased in heart and kidney transplanted patients during allograft rejection crisis. However, the information gained with this assay must be cautiously interpreted because an increase of IL-2R concentrations can also indicate bacterial or viral infections.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1987

Relationship between changes in R wave voltage and cardiac volumes. A vectorcardiographic study during hemodialysis.

The effects of acute changes in cardiac volumes determined by hemodialysis on cardiac voltages were assessed in 18 chronically uremic patients by means of a vectorcardiographic and scalar Frank leads recording, immediately before, at the 90th and 180th minute, and immediately after hemodialysis. The following parameters were simultaneously monitored: body weight, systolic and diastolic blood pressure, heart rate, hematocrit and, in eight patients, echocardiographic systolic and diastolic diameters of the left ventricle. During hemodialysis all voltages considered except R wave in X lead increased significantly. They were inversely correlated with body weight, blood pressure, and systolic and diastolic diameters and directly with hematocrit (volemia-dependent parameters). The maximal vector on the left sagittal plane and the R wave amplitude in Z lead, representing left ventricular posterolateral wall activation, showed the greatest increase. When, at the end of hemodialysis, an amount of fluids ranging from 300 to 800 ml was restored, these cardiac voltages decreased paralleling the increase of left ventricular diameters. In conclusion, these results demonstrate that cardiac voltage and volumes are inversely related.

Adult↗
PubMed1987

[Echocardiographic study of left ventricular function in the mitral valve prolapse syndrome].

In the aim to clarify the magnitude and features of alterations in left ventricular function observed in patients with mitral valve prolapse syndrome (MVPS), we studied 41 patients with MVPS with M-mode echocardiography and computerized reading of recordings (with particular regard to the diastolic phase), and compared them with a control group of 15 healthy subjects matched for age and sex. Routine morphological and functional echocardiographic parameters were evaluated and, in addition, peak rates of movement of left ventricular endocardia, of wall thicknesses change and of cavity dimensions variations were obtained. Finally, a detailed analysis of various diastolic phases have been performed, according to the method proposed by Hanrath et al. There were no significant statistical differences in the morphological echocardiographic parameters (ventricular diameters, wall thicknesses) between the two groups. Patients with MVPS showed (compared to the control group) a significant increase in the peak rate of posterior wall endocardium movement during systole (1.64 +/- 0.42 vs 1.29 +/- 0.30, p less than 0.01) and a reduction of peak rate of interventricular septum thickening (1.21 +/- 0.36 vs 1.45 +/- 0.46, p less than 0.05). The comparison of all other systolic function parameters did not show statistical differences. As far as diastolic phase is concerned, no significant differences were found in the analysis of the peak velocities. However, evaluation of the diastolic phases demonstrated, in MVPS group, a significantly shorter slow filling period, both in absolute value (185.88 +/- 78.91 vs 303.15 +/- 117.58, p less than 0.001) and in percent of the whole diastole (37.42 +/- 11.88 vs 52.50 +/- 10.61, p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Echocardiographic evaluation of changes in cardiac performance induced by hemodialysis.

For the purpose of assessing the cardiovascular effects of hemodialysis (HD), M-mode echocardiography was performed 24 hours before and 2 hours after this procedure in 15 patients with chronic renal failure. The results, which include computer analysis of digitized interventricular septum (IVS) and left ventricular posterior wall (LVPW), show the following statistically significant changes after HD: reduction of end-diastolic and end-systolic internal diameters of the left ventricle (LVID), increase of mean velocity of circumferential fiber shortening, of peak rate of systolic and diastolic LVID variation, of systolic and diastolic LVPW movement, and of IVS movement in systole. These results demonstrate that after HD the left ventricle not only decreases in size but also its performance improves in both contraction and relaxation. These changes did not correlate with the reduction in body weight and arterial pressure following HD; hence HD seems to act on left ventricular function by reducing mainly afterload and, possibly, by modifying some humoral parameters. In conclusion, M-mode echocardiography, especially when utilized in conjunction with the computerized analysis of the recordings, is useful and reliable in monitoring hemodynamic changes occurring during the dialytic session.

Adult↗
PubMed1981

Friedreich's ataxia. A light- and electron microscopic study of peripheral nerve biopsies.

Sural or superficial peroneal nerve biopsies of patients with clinical diagnosis of Friedreich's ataxia were studied. Patients were divided in two groups, typical and abortive forms: loss of fibers accompanied by axonal atrophy and segmental demyelination are the basic changes in both groups, although the decrease in number of myelinated fibers was most severe in typical FA. In the cases with slower progression there is a tendency to form onion bulb complexes.

Atrophy↗
PubMed1975

A new series of benzodiazepines. 1-Hydroxyalkyl derivatives of 1,3-dihydro-2H-1,4-benzodiazepin-2-ones.

A series of new 1-hydroxyalkyl derivatives of 1,3-dihydro-2H-1,4-benzodiazepin-2-ones bearing a 3-hydroxyl or a 4-N-oxide function together with some related compounds have been synthesized. Compound (22) [1-(2-hydroxyethyl)-3-hydroxy-7-chloro-1,3-dihydro-5-(o-fluorophenyl)-2H-1,4-benzodiazepin-2-one] has been selected for further studies both in animals and in humans as an antianxiety-sedative agent.

Alcohols↗
PubMedDate not supplied

Assessment of left ventricular function with M-mode echocardiography in a selected group of diabetic patients.

Sixty patients with non-insulin-dependent diabetes underwent M-mode echocardiographic examination. They were all in good metabolic control under treatment with oral antidiabetic drugs and/or diet; none had clinical evidence of micro- or macroangiopathy, cardiovascular disease, arterial hypertension, or other associated risk factors. The control group consisted of 30 normal subjects. No significant differences were shown either with routine or computer-assisted evaluation of the echocardiograms; if there was a significant difference, there was a wide overlap with normal values. However, alterations of the systolic function of the left ventricle were shown by the reduction of the percentage fractional shortening during the first third of systole (9.14 +/- 5.85 vs 12.27 +/- 7.04, p less than 0.05); alterations of the diastolic function were shown by the marked mitral opening delay (54.15 +/- 20.64 msec vs 10.57 +/- 5.18, p less than 0.00001) and the presence of a B notch (50% of the diabetics). In particular, the B notch seemed to be associated with more severe impairment of left ventricular performance. Therefore, these data appear particularly useful in detecting even slight abnormalities in cardiac function in diabetic patients.

Adult↗
PubMedDate not supplied

Ki-67 index as indicator of the post-surgical prognosis in feline mammary carcinomas.

Forty-eight feline mammary carcinomas (FMC) were resected surgically from 48 cats to determine whether the Ki-67 index (Ki-67I) would provide an indication of the post-surgical survival time (PST). Twenty-four cats (50 per cent) were still alive (group A) one year after surgery, whilst 24 (50 per cent) (group B) had died. Formalin-fixed, paraffin wax-embedded histological sections were immunostained with a monoclonal antibody to Ki-67 (MIB-1) and at least 1000 nuclei in eight to 10 representative fields were counted. The Ki-67I was expressed as the percentage of positive nuclei. In FMC, the Ki-67I ranged from 7.5 to 49.7 (24.8+/-9.5). A statistically significant difference (P = 0.000006) in the Ki-67I was found between group A and group B cats. No other statistically significant differences were found between these groups. The Ki-67I did not correlate with age or different histological type, according to the WHO classification. A Ki-67I cut-off of 25.2 represents a useful tool for identifying FMC with a more aggressive course.

Age Factors↗