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S Testa

Publications and source records attributed to S Testa.

At least 37 records · Page 2Linked to original sources
PubMed1996

Increased plasma level of vascular endothelial glycoprotein thrombomodulin as an early indicator of endothelial damage in bone marrow transplantation.

We investigated the nature of hemostatic alterations occurring after bone marrow transplantation. In 45 patients, we evaluated the coagulation parameters, naturally occurring anticoagulants and thrombomodulin at days +15 and +22 after conditioning therapy. It was observed that endothelial cell damage is a central pathogenetic mechanism in some BMT complications. The increased plasma level of thrombomodulin after conditioning therapy is therefore discussed as a marker of endothelial cell injury. At day +15 a significant increase of fibrinogen from 276.1 mg/dI to 389.1 mg/dI was observed, while the natural anticoagulants all decreased significantly. Eleven patients with clinical complications related to endothelial damage had a significant thrombomodulin increase which, in uncomplicated patients, remained unchanged or resulted in lower than baseline values. Analysis of the data shows a strong correlation between clinical findings, reflecting endothelial cell injury and thrombomodulin increase when the increment is > or = 30%. We found a significant elevation in thrombomodulin in 70% of clinical complications related to endothelial cell damage namely: septicemia, GVHD, VOD. There were four cases (or 9%) of false positive data, and only two (or 4.5%) of false negative results. We therefore propose thrombomodulin assessment as a valid parameter to monitor chemotherapy toxicity-related complications.

Adolescent↗
PubMed1995

[Colonic angiodysplasia: an important cause of digestive hemorrhage].

Angiodysplasia of the colon is one of the most common causes of lower gastrointestinal bleeding in elderly patients. The diagnosis can be made by colonscopy or angiography. The best treatment, endoscopic coagulation or surgical resection, is still being debated. Over a period of nearly seven years, 5 patients with angiodysplasia of the colon were treated in our Department. The treatment was right hemicolectomy for all patients with localization at the caecum or ascending colon; in the only patients with segmoid localization a segmentary resection was performed. During a mean follow-up of 22.8 months no patient had any further bleeding. In our opinion surgery is a satisfactory treatment, even if for localization on the left colon a conservative treatment should be preferred.

Adult↗
PubMed1994

Postoperative extradural analgesia in children: comparison of morphine with fentanyl.

We have compared the efficacy and side effects of extradural morphine with extradural fentanyl for postoperative pain relief. Thirty children (ages 1-16 yr) were allocated randomly to receive, after extradural administration of 0.5% bupivacaine 0.75 ml kg-1 and before surgical incision, extradural morphine 0.75 microgram kg-1 (group M), with an additional dose administered 24 h later or extradural fentanyl 2 micrograms kg-1 (group F) followed by a continuous extradural infusion (during 48 h). There was no major complication (respiratory depression). Pain scores were satisfactory in both groups for 48 h. Ventilatory frequency was greater in group M 20, 21, 22, 23 and 25 h after the beginning of analgesia (P < 0.05). Pruritus, nausea and vomiting were less common with extradural fentanyl (20% vs 53%, P < 0.05 and 0% vs 33%, P < 0.05) than with morphine. Urinary retention occurred with equal frequency (25%) in the two groups. After a bolus of 2 micrograms kg-1, continuous extradural infusion of fentanyl 5 micrograms kg-1 day-1 provided analgesia comparable to that from a daily bolus of extradural morphine 0.75 mg kg-1 and produced fewer side effects.

Adolescent↗
PubMed1993

Plasma concentrations of midazolam after i.v., nasal or rectal administration in children.

Midazolam is used frequently for premedication in children, preferably by non-parenteral administration. We have compared plasma concentrations of midazolam after nasal, rectal and i.v. administration in 45 children (aged 2-9 yr; weight 10-30 kg) undergoing minor urological surgery. General anaesthesia consisted of spontaneous respiration of halothane and nitrous oxide in oxygen via a face mask. After administration of atropine and fentanyl i.v., children were allocated randomly to receive midazolam 0.2 mg kg-1 by the nasal, rectal or i.v. route. In the nasal group, children received 50% of the dose of midazolam in each nostril. In the rectal group, midazolam was given rectally via a cannula. Venous blood samples were obtained before and up to 360 min after administration of the drug. Plasma concentrations of midazolam were measured by gas chromatography and electron capture detection. After nasal and rectal administration, midazolam Cmax was 182 (SD 57) ng ml-1 within 12.6 (5.9) min, and 48 (16) ng ml-1 within 12.1 (6.4) min, respectively. Rectal administration resulted in smaller plasma concentrations. In the nasal group, a plasma concentration of midazolam 100 ng ml-1 occurred at about 6 min. After 45 min, the concentration curves after i.v. and nasal midazolam were similar.

Administration, Intranasal↗
PubMed1993

[Hypocobaltemia in chronic obstructive arteriopathy. Physiopathologic and therapeutic importance].

The role of some so-called primary and secondary (or oligo-elements) elements in the physiopathology of the cardiocirculatory system has been well known from a number of years and they have been regularly included in the treatment protocols. Some, including K, Ca, Mg and Zn, are extremely well known and widely used in clinical practice. Recently, however, a growing number of studies have focused on the biological importance of other oligo-elements in the pathogenetic mechanisms of atherogenesis and its clinical manifestations. This study aimed to verify the exact role of free cobalt in the physiopathology of the chronic obstructive arterial diseases (COAD). A total of 80 patients affected by 2nd stage COAD were examined and the levels of some oligo-elements, including Co, were assayed. Constantly low levels were found (85% of cases) in relation to other oligo-elements studied (Cu, Zn, Mg, Ca). This findings is particularly interesting since it confirms the biochemical hypothesis of atherosclerosis according to which parietal damage plays a central role in the pathogenetic mechanism. Some enzymatic deficiencies, which lead to changes in membrane stability at the level of the endothelial cells, are closely related to the presence of tissutal and humoral peroxidation products. These peroxides (lipid peroxides), which are formed following the interaction of fatty acids with oxygen free radicals, have been identified by a number of studies as being responsible for endothelial damage. Several authors have shown that lipid peroxidation is involved in the atherogenic process through several mechanisms entailing monocytic activity and reduced prostacyclin (PG2) synthesis.(ABSTRACT TRUNCATED AT 250 WORDS)

Arterial Occlusive Diseases↗
PubMed1992

Effects of palmitoyl CoA and palmitoyl carnitine on the membrane potential and Mg2+ content of rat heart mitochondria.

Palmitoyl CoA and palmitoyl carnitine added to rat heart mitochondria in amounts above 20 and 50 nmoles/mg protein, respectively, induced a fall in transmembrane potential and loss of endogenous Mg2+. The dissipation of membrane potential by low concentrations of palmitoyl CoA in the presence of Ca2+, but not that of high concentrations of palmitoyl CoA alone, was prevented by either ruthenium red, Cyclosporin A or Mg2+, but reversed only by Mg2+. The fall of membrane potential induced by palmitoyl carnitine was not prevented by any of these factors. It is suggested that the action of both palmitoyl CoA and palmitoyl carnitine at high concentrations is due to a non specific disruption of membrane architecture, while that of low concentrations of palmitoyl CoA in the presence of Ca2+ is associated specifically with energy dissipation due to Ca2+ cycling.

Animals↗
PubMed1992

Normal tissue plasminogen activator and plasminogen activator inhibitor activity in plasma from patients with type 1 diabetes mellitus.

The fibrinolytic system was investigated in 38 patients (21 males and 17 females) affected by type 1 diabetes mellitus (18 free from complications, 10 with retinopathy, and 10 with autonomic neuropathy) and in 8 healthy controls. Two separate fibrinolysis-stimulating tests were done: standardized venous occlusion and 1-desamino-8-D-arginine vasopressin infusion. Plasma tissue plasminogen activator antigen and activity and plasma plasminogen activator inhibitor activity were measured. All the patients were in good metabolic control (mean HbA1c 7.4%, range 6.1-8.0%). No significant differences were observed either between the diabetic patients and the control subjects, nor among the subgroups of diabetic patients. The fibrinolytic system is probably not involved in type 1 diabetes mellitus.

Deamino Arginine Vasopressin↗
PubMed1992

[Intrathecal morphine therapy in children with cancer].

Five children with cancer pain were given continuous intrathecal morphine or fentanyl infusion associated with bupivacaine 0.25% without epinephrine. The morphine daily dose varied from 0.1 mg.kg-1 to 1 mg.kg-1, the maximum daily dose of fentanyl was 0.1 mg.kg-1 associated with the same dose of intravenous fentanyl, and the maximum daily dose of bupivacaine was 1 mg.kg-1. Intrathecal treatment was started after oral and epidural morphine treatment had failed. The children were at home, under the care of several nurses and physicians. A satisfactory analgesia was achieved until demise occurred. In all children, urinary retention was the only side effect of the therapy. Therefore, intrathecal opioid and bupivacaine may be indicated after oral morphine therapy has failed in children with advanced cancer refractory pain.

Bupivacaine↗
PubMed1991

Fibrinopeptide A excretion in urine: a marker of the cumulative thrombin activity in stable versus unstable angina patients.

Plasma levels and 24-hour urine excretion of fibrinopeptide A were measured in a consecutive series of 179 patients with angina pectoris. Sixty-four patients had stable angina and 115 patients had unstable angina. Urine was collected over 24 hours the day before coronary arteriography, and blood samples were taken at the end of urine collection. When the values of fibrinopeptide A in plasma and in the 24-hour urine specimens were compared, no significant correlation was found in patients with either stable (rs = 0.16, difference not significant) and unstable (rs = 0.07, difference not significant) angina. The concentrations of fibrinopeptide A in the plasma did not differ significantly when patients with stable angina (range 0.1 to 82.6, median 7.4 ng/mL) were compared with patients with unstable angina (range 0.2 to 61.7, median 14 ng/mL, p = 0.055), whereas fibrinopeptide A 24-hour urinary excretion was significantly higher in patients with unstable angina (range 0.3 to 38.1, median 11.8 micrograms/24 hr) than in patients with stable angina (range 0.4 to 38.1, median 3.8 micrograms/24 hr, p less than 0.001). Twenty-four-hour urine excretion of fibrinopeptide A in patients with unstable angina and angiographically documented intracoronary thrombi were higher than the corresponding values in patients with unstable angina without such angiographic characteristic (p less than 0.001). The largest increase in plasma and urine concentration of fibrinopeptide A was observed in patients whose first episode of angina at rest occurred within the previous 48 hours. We conclude that the cumulative thrombin activity, assessed by 24-hour urinary excretion of fibrinopeptide A, is a more useful index, compared with single fibrinopeptide A measurement in plasma, for discriminating between patients with stable and with unstable angina pectoris.

Angina Pectoris↗
PubMed1991

[Primary and secondary hyperparathyroidism. Analysis of our results].

The Authors introduce their experience of primary and secondary surgical treatment of hyperparathyroidism, pointing out at first the good confidence of echography, scintigraphy and TAC, in the pre-operating diagnostic of the parathyroid glands localization and then the satisfactory clinical results with a follow-up which, up to date, has not shown any relapse.

Adenoma↗
PubMed1990

Psychophysiological outcome of cognitive, behavioral and psychophysiologically-based treatments of agoraphobia.

Psychophysiological process and outcome phenomena were analyzed to examine differential temporal patterns within and across cognitive, behavioral and physiologically-based treatments of agoraphobia. Eighty-eight severe and chronic agoraphobics with panic attacks (DSM-III) were randomly assigned to one of three treatments: Paradoxical Intention, Graduated Exposure or Progressive Deep Muscle Relaxation Training. Protocol therapists, whose treatment integrity was objectively monitored, conducted 12 two-hour weekly sessions. All subjects received programmed practice instructions concurrent with their primary treatment. Analyses revealed numerous significant reductions on in vivo psychophysiological measures for the relaxation condition, a few improvements for the exposure treatment and no effects for the paradoxical intention modality. The mediating role of pretreatment physiological reactivity in treatment outcome and follow-up status was examined and revealed no significant associations. Synchrony-desynchrony patterns were found to vary widely according to both treatment phase and the time interval between assessments. No between-group differences were observed on the proportion of synchronizers. However, synchronizers exhibited superior outcome and follow-up compared to desynchronizers on all domains except the physiological measures. Conceptual, methodological and clinical implications of these findings are discussed with recommendations for future research.

Adult↗
PubMed1990

Panic disorder: cognitive-behavioral treatment.

The effectiveness of an integrated treatment program utilizing cognitive-behavioral therapies for Panic Disorder was examined. Treatment was comprised of Cognitive Model of Panic-derived procedures, Cognitive Therapy and Applied Relaxation Training. Subjects meeting DSM-III-R criteria for Panic Disorder received thirteen 2.5-hr sessions of outpatient therapy in small groups, over a 12-week period. Subjects were given an extensive rationale of the etiology, development and maintenance of Panic Disorder, within the framework of the Cognitive Model of Panic, and controlled behavioral experiments in panic evocation to internal panicogenic cues, cognitive reappraisal of somatic and ideational cues, breathing retraining, Applied Relaxation Training and Cognitive Therapy to identify and remediate maladaptive beliefs and dysfunctional cognitive schemas. A comprehensive assessment battery was given at pre-mid-post-treatment which included measures of tripartite functioning, global severity, panic, fear, anxiety, depression and psychiatric symptomatology. Analyses indicated statistically significant improvements across all outcome domains. All subjects were free of spontaneous (uncued) panic attacks at post-treatment, and all met operationalized criteria for high endstate functioning. These findings are discussed, with recommendations for future research.

Adult↗
PubMed1990

Transport and action of spermine in rat heart mitochondria.

At concentrations of 0.5-1.0 mM, spermine fully prevents the fall of membrane potential induced in rat heart mitochondria either by aging at room temperature or by the addition of palmitoyl CoA. Spermine also prevents the inhibitory action of palmitoyl CoA on adenylate translocase activity. When added to heart mitochondria de-energized by the same damaging conditions (aging or addition of palmitoyl CoA) spermine restores both membrane potential (provided that ATP is also added) and the activity of adenylate translocase. A part of added spermine is immediately bound to anionic sites on mitochondrial membranes, another part is slowly transported into heart mitochondria. Whereas binding is an energy independent process, transport is driven by the transmembrane potential. Spermine penetrates the mitochondrial matrix at significant rates only at high membrane potential, such as that produced either by phosphate transport or addition of nigericin.

Adenosine Triphosphate↗
PubMed1989

Impaired grating discrimination following right hemisphere damage.

We investigated the effect of unilateral brain lesions on visual discrimination of low-, middle- and high-frequency gratings. The performance of patients with right hemisphere lesions was significantly impaired compared with that of both controls and patients with left hemisphere lesions. This impairment was largely limited to patients with right posterior hemispheric lesions and was present with all spatial frequencies. These findings run counter to the hypothesis that high and low spatial frequencies are preferentially processed by different hemispheres.

Adult↗