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Biomedical subjects

S Cortelazzo

Publications and source records attributed to S Cortelazzo.

At least 73 records · Page 4Linked to original sources

Danazol for the treatment of idiopathic thrombocytopenic purpura.

Fourteen patients with idiopathic thrombocytopenic purpura (ITP) refractory to steroids and/or splenectomy were treated with danazol (200 mg 3 times a day) for 2 months. The following responses were achieved: excellent (platelet count greater than 100 X 10(9)/l) in 5 patients; good (greater than 50 X 10(9)/l, but less than 100 X 10(9)/l) in 2 patients, and poor in (no increase of platelet count) 7 patients. In three cases remission lasted more than 7 months. Danazol was well tolerated and in most patients better suited than steroids for long-term intake.

Adult↗

Bleeding on patients with autoimmune thrombocytopenic purpura and normal platelet count.

80% of patients with chronic autoimmune thrombocytopenic purpura (ATP) may reach normalization of platelet count after steroids or splenectomy. In some of these cases a bleeding tendency may still persist and this has been attributed to abnormalities of platelet function resulting from the effect of platelet-bound antibodies. We have studied 49 ATP patients in order to assess the frequency and the pattern of this immune thrombopathia, and the correlation with the levels of platelet associated IgG (PAIgG). Only 3 patients (6%) had prolonged bleeding time and persistence of mucocutaneous haemorrhages, whereas 36% presented an altered platelet aggregation pattern. Platelet serotonin content, platelet and plasma beta-thromboglobulin concentration, and malondialdehyde generation after thrombin stimulus were found also altered, but the findings were not clearly correlated with the concentration of PAIgG.

Adolescent↗

Treatment of 49 unrandomized patients with advanced Hodgkin's disease.

Forty-nine patients with previously untreated advanced Hodgkin's disease were treated in our Institution between 1973 and 1981. Treatment modalities of these patients were reviewed, and they were divided into 3 groups according to the treatment employed: 13 patients received MOPP only, 22 patients received MOPP plus involved field radiotherapy, and 14 received alternating MOPP/ABVD chemotherapy. The response rates for the 3 groups were respectively 38.5%, 63.6% and 78.6%. A longer follow-up is needed to assess a significant difference in survival curves. The advantages of adjuvant radiotherapy and alternating non-cross-resistant drugs in advanced Hodgkin's disease are discussed.

Adolescent↗

Thrombohaemorrhagic complications in 101 cases of myeloproliferative disorders: relationship to platelet number and function.

A series of 101 consecutive patients with chronic myeloproliferative disorders including polycythaemia vera, chronic myelogenous leukaemia, idiopathic myelofibrosis and essential thrombocythaemia have been studied. The aim was to establish the incidence of thrombotic and haemorrhagic complications and the possible role played by platelet number and function. The total incidence of haemostatic complications was 21% and the platelet functional tests investigated (platelet aggregation, generation of malondialdehyde, endogenous serotonin, beta-thromboglobulin and platelet coagulant activity) were of little help for predicting these clinical complications.

Adolescent↗

Effect of aspirin on platelet 5-hydroxytryptamine and beta-thromboglobulin plasma levels in patients with myeloproliferative diseases.

14 patients with myeloproliferative diseases (MD) showed low 5-hydroxytryptamine (5-HT) platelet content and high beta-thromboglobulin (beta-TG) plasma levels. This pattern could support the view that MD platelets undergo "in vivo" degranulation. A single dose of aspirin was unable to induce modifications of platelet 5-HT and plasma beta-TG, whereas 6 out of 14 patients treated over 7 days period with the drug showed a decrease but not normalization in their beta-TG levels. No modification of platelet 5-HT was obtained suggesting that the cause of dense bodies deficiency may lie in the production of abnormal platelets and not be related to "in vivo" degranulation.

Adult↗

Platelet activation in myeloproliferative disorders.

Beta-thromboglobulin (beta-TG) and platelet factor four (PF4) are specific platelet proteins released when a process of platelet activation occurs. The present study was undertaken in order to measure beta-TG and PF4 both as absolute plasma value and ratio to platelet number in 69 patients with myeloproliferative disorders (MD). The aim was to establish whether the increase of the two proteins could depend on platelet number or indicated an "in vivo" platelet activation. In 74% of patients beta-TG was found elevated and PF4 was high in 68% of cases. However in 34.7% and in 31.9% of cases respectively, the elevation of the two platelet markers was correlated to platelet number and the ratio was normal. Only in about one third of cases an "in vivo" platelet activation could be admitted and this finding provides a more rational use of antiaggregating agents.

Adolescent↗

Abnormal aggregation and increased size of platelets in myeloproliferative disorders.

Platelet aggregation is frequently impaired in myeloproliferative disorders (MPD). The presence of spontaneous platelet aggregation (SPA) or alterations of the aggregation pattern after ADP, epinephrine and collagen have been a frequent feature in the series of 52 patients here presented. The occurrence of SPA was not related to the findings obtained with the aggregating agents or to the number of circulating platelets. The aggregation results did not correlate with the number of megathrombocytes. The presence of platelet abnormalities, not completely corrected after busulfan therapy, and the increased size of platelets should aid in diagnosis of myeloproliferative disorders.

Adult↗

An evaluation of bilirubin kinetics with respect to the diagnosis of Gilbert's syndrome.

1. The kinetics of the plasma disappearance of bilirubin (2 mg/kg intravenously) were studied in 106 patients with Gilbert's syndrome and in 13 normal subjects. 2. All patients had significant decreases in hepatic bilirubin clearance and transfer rates from plasma to liver, resulting in increased values for plasma retention at 4 h. The calculated value for unconugated bilirubin production was normal in 40% of patients and increased in the remainder. 3. In 29 of the Gilbert's patients their bromosulphthalein kinetics were studied 1 week before the bilirubin test. These results were essentially normal and it was concluded that the hepatic clearance mechanisms for bilirubin and bromosulphthalein are different. 4. In 10 patients the bilirubin transport maximum (Tm) was found to be low whereas the relative storage capacity (S) was normal. Phenobarbitone treatment in four patients resulted in an increase in Tm, and S decreased in two patients and remained unchanged in the other two. 5. These results support the hypothesis that there are several variants of Gilbert's syndrome and that the bilirubin tolerance test is a useful diagnostic test.

Adult↗

Treatment of acute lymphoblastic leukemia in adults.

Thirty-seven adult patients with acute lymphoblastic leukemia were treated with a protocol called HEAV'D including Adriamycin, Vincristine, L-Asparaginase, Cyclophosphamide and Dexamethasone. The complete remission rate was 70 per cent. The median duration of remission was more than 30 months. Patients with initial leukocyte count below 20 000/mmc experienced a longer remission (median not reached) than patients with a leukocyte count above 20 000/mmc (median 10 months).

Adolescent↗

Spectrum of platelet aggregation abnormalities in myeloproliferative diseases.

Several platelet abnormalities have been described in myeloproliferative diseases. The present study deals with 81 patients with polycythaemia vera, chronic myelogenous leukemia, essential thrombocythaemia and idiopathic myelofibrosis, and reports the analysis of the findings in platelet-induced aggregation. Platelet abnormalities induced by ADP, adrenaline and collagen were found in 41.9% of the patients. A defect of primary aggregation was documented in 13 cases and one of them showed an aggregation pattern similar to that of Glanzmann's disease. Fifteen patients had an impairment of secondary aggregation, and in one case of this group the platelet malondialdehyde and serotonin findings were consistent with a defect resembling that of typical congenital storage pool deficiency. A disturbance of the arachidonic acid pathways associated with a storage pool deficiency was found in a third patient belonging to a group with abnormalities of primary and secondary aggregation. In conclusion, platelets in myeloproliferative diseases have several defects and in a few cases their combination is similar to those of congenital diseases.

Adenosine Diphosphate↗

Diagnostic and prognostic significance of platelet-bound IgG measurement in immune thrombocytopenic purpura.

The test proposed by Dixon et al. is an important contribution to the technique for detection of platelet-associated antibody. This test measures platelet-associated IgG by a complement-mediated red blood cell lysis-inhibition technique. We have used the direct Dixon test to study 44 cases of immune thrombocytopenic purpura and 90 controls, including subjects with nonimmune thrombocytopenic purpura and healthy subjects. Increased PAIgG was noted in 86.3% of ITP patients. However, the pretreatment values of PAIgG were not helpful for predicting the therapeutic response to either prednisone or splenectomy. Six patients in long-term clinical remission had normal platelet counts and distinctly abnormal PAIgG values. This condition was associated with qualitative platelet functional defects. This latter finding seems to be of diagnostic interest and deserves further investigations.

Adolescent↗