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Biomedical subjects

T Poli

Publications and source records attributed to T Poli.

At least 19 recordsLinked to original sources
PubMed2003

Oromandibular reconstruction with simultaneous free flaps: experience on 10 cases.

Composite defects resulting from surgery for advanced oral cancer represent a difficult reconstructive problem and, in some cases, tissutal defects are extensive requiring multiple free flaps. Personal experience is reported with double free-flap technique in the reconstruction of large complex defects in 10 patients treated for T4 oral squamous-cell carcinoma. Fibula osteo-cutaneous free flap was used in association with forearm free flap in 5 cases, fibula osseous-forearm in 3 cases, fibula osseous-rectus abdominis in 1 case, iliac crest-forearm in 1 case. Forearm free flap was used for intra-oral reconstruction in all cases. Total flap survival is 100% and all patients regained adequate oral diet. At the time of evaluation (February 2001), 40% of patients are alive and mean survival rate is 36 months. In conclusion, simultaneous free flap reconstruction, in massive oro-mandibular defects, represents in some selected patients, a good choice to achieve satisfactory aesthetic and functional results.

Adult↗
PubMed2003

Role of intra-operative sentinel lymph node biopsy in oral cavity and oropharynx squamous cell carcinoma: preliminary data.

In patients with squamous cell carcinoma of the oral cavity and oropharynx, the presence of latero-cervical lymph node metastases was found to be the most important of the better known prognostic factors. Still, today, the most reliable technique by which to detect the presence of lymph node metastases is surgery aimed at the dissection of the latero-cervical space; albeit, this surgical procedure has been shown to be an over-treatment in a large percentage of patients presenting squamous cell carcinoma, clinically, radiologically and histologically negative, at neck level. The technique of intra-operative biopsy of sentinel lymph node, routinely used in the staging and treatment of tumours with elective lymphatic involvement such as carcinoma of the breast and malignant cutaneous melanoma, has progressively caught the attention of head and neck surgeons in the most important referral centres in the world, and, indeed, its role has been hypothesised in the treatment of patients with squamous cell carcinoma of the oral cavity and oropharynx with clinically N0 neck. Preliminary results are reported, concerning the use of this intraoperative sentinel lymph node biopsy technique with double tracer in patients presenting squamous cell carcinoma originating in the mucosa of the upper air-digestive tract, clinically and radiologically free from disease at latero-cervical level.

Adult↗
PubMed2001

[Primary reconstruction of lateral oro-mandibular defects using titanium plates (Thorp) and revascularized non-osseous flaps: a personal experience].

Reconstruction of a particular defect is an highly complex problem, that is reflected in the number and variety of techniques proposed. This is particularly true for reconstruction of mandibular segment defects usually together with the need to repair oro-pharnygeal soft tissues defects of various size. The high rate of successes that can be obtained today using microvascular reconstruction techniques explains the reason why bone free flaps have progressively become the "gold standard" used as benchmark for all other forms of primary mandibular reconstruction. However, for selected patients (elderly patients or individuals in poor general health; the presence of lateral oro-mandibular defects or soft tissue defects significantly exceeding the bone defect) the association of non-osseous microvascular free flaps (such as forearm skin flaps or miocutaneous free flaps of the abdominal rectus muscle) with a titanium mandibular reconstruction plate (THORP) can prove a valid alternative. Indeed, in these cases reconstruction of choice would be the association of two free flaps, one osseous and the other non osseous. The use of THORP-type mandibular reconstruction plates in repairing lateral defects increases the overall risk of complications related to the reconstruction technique which is already hindered by the risks associated with the use of microvascular free flaps. The present work starts with a retrospective evaluation of 5 years series of primary mandibular reconstruction for lateral oro-mandibular defects following oncological surgery. The role of THORP-type titanium mandibular plates, used in combination with non-osseous free flaps in the treatment of selected patients, is then described and discussed.

Aged↗
PubMed1995

An acquired hemorrhagic disorder of fibrin crosslinking due to IgG antibodies to FXIII, successfully treated with FXIII replacement and cyclophosphamide.

We report a new case of severe bleeding diathesis due to an acquired inhibitor of fibrin crosslinking. The patient, an 80-year-old woman, was admitted to the hospital for a massive subcutaneous hematoma, with severe anemia requiring red cell transfusion; a subsequent retroperitoneal hematoma developed 2 weeks later. Coagulation studies were normal except for a thromboelastographic pattern suggestive of FXIII deficiency. Clot solubility test was abnormal even after 1:1 mix with normal plasma. Immunochemical studies confirmed the presence of a monoclonal IgG lambda inhibitor directed against FXIII activity (type II FXIII inhibitor). The patient IgG fraction selectively inhibited FXIII transamidating activity but did not inhibit the thrombin-mediated activation of FXIII. The patient was treated with high doses of FXIII concentrate to overcome the inhibitor and immunosuppressive therapy with cyclophosphamide and discharged in good conditions. High doses of commercially available FXIII appear to be a safe and effective method of controlling acute episodes of bleeding in patients with acquired FXIII deficiency.

Aged↗
PubMed1994

Low molecular weight heparin versus warfarin in the prevention of recurrences after deep vein thrombosis.

To evaluate the role of low-molecular weight heparin (LMWH) as an alternative to oral anticoagulants in the prevention of recurrent venous thromboembolism, we compared in a randomized trial conventional warfarin treatment with a three-month course of enoxaparin 4000 anti-Xa units once a day subcutaneously. 187 patients with symptomatic deep-vein thrombosis (DVT), diagnosed by strain-gauge plethysmography plus D-dimer latex assay and confirmed by venography in most cases, were treated with full-dose subcutaneous heparin for ten days and then randomized to secondary prophylaxis. During the 3-month treatment period, 6 of the 93 patients who received LMWH (6%) and 4 of the 94 patients on warfarin (4%) had symptomatic recurrence of venous thromboembolism confirmed by objective testing (p = 0.5; 95% confidence interval [CI] for the difference, -3% to 7%). Four patients in the LMWH group had bleeding complications as compared with 12 in the warfarin group (p = 0.04; 95% CI for the difference, 4% to 14%). In the 9-month follow-up period, during which 34 patients on warfarin prolonged treatment for other 3 months and 14 up to one year, 10 patients in the enoxaparin group and 4 patients in the warfarin group suffered a documented recurrence of venous thromboembolism. Of these 14 late recurrences, just one occurred in patients with postoperative DVT. After one year there were 16 recurrences (17%) in the LMWH group and 8 (9%) in the warfarin group (p = 0.07; 95% CI for the difference, 1% to 16%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

Subcutaneous vs intravenous heparin in the treatment of deep venous thrombosis--a randomized clinical trial.

271 patients with acute symptomatic deep venous thrombosis of lower limbs, confirmed by strain-gauge plethysmography and/or venography, were randomly assigned to receive intermittent subcutaneous heparin calcium or heparin sodium by continuous intravenous infusion for 6-10 days. Heparin dosage was adjusted to maintain activated partial thromboplastin time values (Thrombofax reagent) at 1.3-1.9 times the basal ones. Strain-gauge plethysmography was repeated at the end of heparin treatment, and evaluation of therapy was performed by comparing the indexes of venous hemodynamics and by assessing the incidence of pulmonary embolism and of bleeding complications. In the intravenous group, Maximal Venous Outflow (MVO) increased from 20.8 +/- 12.8 to 28.4 +/- 17.5 ml/min per 100 ml of tissue and Venous Capacitance (VC) from 1.39 +/- 0.92 to 1.94 +/- 1.0 ml/100 ml of tissue (mean +/- SD). In the subcutaneous group, MVO increased from 21.0 +/- 12.7 to 27.5 +/- 18.1 and VC from 1.60 +/- 0.86 to 2.06 +/- 1.0. The median improvement of MVO and VC were 22% and 36% respectively in the IV group and 20% and 24% in the SC group. Clinical pulmonary embolism occurred in 2 patients in the intravenous group (1 fatal) and in 4 in the subcutaneous group (1 fatal). 9 major bleeding complications occurred in the intravenous group (1 fatal) and 5 in the subcutaneous group (1 fatal). The differences were not significant at the statistical analysis. The results suggest that subcutaneous intermittent heparin has a comparable efficacy to continuous intravenous heparin in the treatment of deep venous thrombosis. To the same conclusion points an overview of the seven randomized trials which compared these treatment modalities.

Adolescent↗
PubMed1988

Fructosamine assay: an index of medium-term metabolic control parameters in diabetic disease.

The fructosamine levels and some metabolic control parameters were evaluated in 120 diabetics and in 60 controls. Higher levels of fructosamine were found in diabetics compared to normals (3.22 +/- 0.06 vs. 1.82 +/- 0.05 mmol/l; P less than 0.001). Positive correlations were found between fructosamine and metabolic control parameters in diabetic subjects. Moreover, non-insulin-dependent diabetic subjects had better correlations. The study of fructosamine variation in relation to plasma glucose change showed that fructosamine levels were modified after at least 2 weeks of good metabolic control. In conclusion, the fructosamine assay could be a useful method for medium-term metabolic control evaluation.

Adolescent↗
PubMed1988

Collisional spectroscopy as a screening procedure for the determination of 2-(2-furoyl)-4(5)-(2-furanyl)-1H-imidazole from acid hydrolysis of B-poly(L-lysine) and B-albumin.

The direct determination of 2-(2-furoyl)-4(5)-(2-furanyl)-1H-imidazole (FFI), present in the acid hydrolysis products of B-poly(L-lysine) and B-albumin and which appears to be a key intermediate in the physicochemical changes occurring during the incubation of protein with glucose, has been carried out by collisional spectroscopy, using a commercial double-focusing, reverse-geometry mass spectrometer and without any sample derivatization and chromatographic separation procedures.

Albumins↗
PubMed1988

Reduced in vivo biological activity of in vitro glycosylated insulin.

We evaluated the in vivo biological activity of in vitro extensively glycosylated insulin (GI) with the euglycemic-hyperinsulinemic glucose-clamp technique in postabsorptive nondiabetic subjects. Insulin-mediated glucose disposal was approximately 30% lower (P less than .03) with GI (9.2 +/- 1.2 mg.kg-1.min-1, mean +/- SE) than with the nonglycosylated hormone (12.6 +/- 0.7 mg.kg-1.min-1) at comparable plasma insulin concentrations (approximately 90 microU/ml). Binding of GI to a specific receptor on circulating cells (erythrocytes and monocytes) was normal. We conclude that in vitro extensive glycosylation of insulin reduces its biological activity in vivo, as reflected by insulin-mediated glucose disposal, probably at a postreceptor level.

Adult↗
PubMed1988

Amidinosemicarbazido derivatives of pyrazole: synthesis and inhibitory effect on blood coagulation and platelet aggregation.

Amidinosemicarbazido derivatives of pyrazole having various substituents on pyrazole ring were prepared and their effect on platelet function and blood coagulation was determined in vitro. Platelet aggregation and serotonin release induced by ADP, collagen, arachidonic acid and thrombin were markedly inhibited by pyrazole derivatives at mM concentrations. Compounds with a hydrophobic nucleus at position 1 of the pyrazole ring showed the most potent antiplatelet activity. On the contrary, their effect on blood coagulation was faintly inhibitory.

Anticoagulants↗
PubMed1987

Synthesis and antifungal activity of 4-thiazol-2-yl-5-aminopyrazoles and 4-aminopyrazolo [3,4-c] isothiazoles.

Starting from 4-thiocarbamoyl-5-aminopyrazoles (I), the AA could prepare two series of products: 4-thiazol-2-yl-5-aminopyrazoles (II) and 4-aminopyrazolo [3,4-c] isothiazoles (III). The screening for in vitro antifungal activity evidenced that compounds (III) are effective in controlling most examined fungi; in particular 1-phenyl-3-methyl-4-aminopyrazolo [3,4-c] isothiazole (III a) at the concentration of 20 p.p.m. completely inhibited the growth of Pythium ultimum and Corticium solani, responsible for the collar rot of the beet.

Antifungal Agents↗
PubMed1986

Effects of a new pyrazolo [3, 4-d]pyrimidine on growth and morphology of Candida albicans.

A new pyrazolo [3, 4-d]pyrimidine derivative was synthesized and its antifungal activity evaluated in vitro against mycelial and yeast cells of Candida albicans. The most striking ultrastructural changes following treatment with 10-30 micrograms/ml (mycelia) and 25-75 micrograms/ml (yeasts) consisted in the deterioration of the organelle membranes and in aberrant thickenings of the cell wall. The complete disorganization of the cytoplasmic structures seemed to be the final event.

Antifungal Agents↗
PubMed1985

Glycosylated serum proteins in diabetic patients and their relation to metabolic parameters.

Glycosylated plasma proteins (GSP) and some metabolic parameters (plasma glucose profile, urine glucose excretion, glycosylated hemoglobin, cholesterol, triglycerides) were evaluated in 70 diabetic and 70 normal subjects. Of the late diabetic complications, retinopathy, nephropathy and somatic neuropathy were evaluated. Proliferative retinopathy was observed in 41 of the 70 diabetics studied. No retinopathy or background retinopathy was observed in 29 diabetics. Nephropathy was diagnosed in 39 patients and somatic neuropathy in 44 patients; 26 diabetic subjects had no complications. GSP levels were 0.82 +/- 0.03 nmolHMF/mg prot in diabetics and 0.43 +/- 0.02 nmolHMF/mg prot in controls. GSP levels were positively correlated with metabolic parameters evaluated the same day and 14 days before. A positive correlation between GSP and triglycerides was seen for the first time. The patients with retinopathy showed levels of GSP significantly higher (p less than 0.001) in respect to patients with background retinopathy or absence of it (0.91 +/- 0.03 vs 0.74 +/- 0.04 nmolHMF/mg prot). GSP were significantly higher in the patients with somatic neuropathy (0.93 +/- 0.02 nmolHMF/mg prot) (p less than 0.001) than in the subjects without neuropathy (0.72 +/- 0.04 nmolHMF/mg prot). GSP levels were 0.92 +/- 0.03 nmolHMF/mg prot in diabetics with proteinuria and 0.75 +/- 0.04 nmolHMF/mg prot in diabetics without proteinuria (p less than 0.001). These results confirm the importance of GSP determination as another parameter of glycemic control and particularly as an index of the overall protein glycosylation processes.

Adult↗
PubMed1985

Is red cell sorbitol content a good marker of glycemic control in diabetic patients?

Red cell sorbitol (RCS) concentration and some metabolic parameters were evaluated in 62 diabetic patients. 42 normal subjects were studied as controls. RCS levels were 66.1 +/- 2.0 nmol/gHb in diabetic patients and 41.8 +/- 2.0 nmol/gHb in controls (p less than 0.001). RCS levels were positively correlated with all metabolic parameters evaluated in diabetic patients and in controls. To evaluate RCS distribution, diabetic subjects were subdivided in 3 groups according to fasting plasma glucose (FPG) (less than or equal to 150; 151-200; greater than 200 mg/dl) and glycosylated hemoglobin (GHb) levels (less than or equal to 8; 8.1-10; greater than 10%). 31 patients with FPG less than or equal to 150 mg/dl, all except 7, had RCS levels in the normal range. These 7 patients however had GHb levels greater than 10%. 18 patients with FPG between 151-200 mg/dl had RCS levels in the normal range. Of 13 patients with FPG greater than 200 mg/dl all, except 3, had RCS levels above the normal range. These 3 patients had GHb levels greater than 10%. 45 patients with GHb less than or equal to 10% had RCS values in the normal range. 17 patients with GHb levels greater than 10%, had RCS levels over the normal range. Our data show that RCS levels seem to be related more strictly with GHb. RCS levels increase significantly only in patients with bad metabolic control. Even if RCS levels seem to be a medium-term index of metabolic "equilibrium" they cannot be useful in the routine monitoring of metabolic control in diabetic patients.

Adult↗
PubMed1984

Accuracy of strain-gauge plethysmography as a diagnostic test in clinically suspected deep venous thrombosis.

Strain-gauge plethysmography (SGP) is currently employed in the diagnosis of deep venous thrombosis (DVT), but its accuracy has not been adequately tested. In this study we evaluated SGP against venography in 209 consecutive patients referred to us because of clinically suspected DVT of lower limbs. Venography was performed bilaterally if symptoms or signs suggesting DVT were present in both limbs. It was always performed after SGP and independently assessed. A total of 269 limbs could be evaluated with both SGP and venography, which disclosed DVT in 128 limbs of 110 patients. There were 109 proximal and 19 distal DVT. Out of the 128 limbs with DVT, SGP was positive in 114 (sensitivity = 89%) using Maximal Venous Outflow (MVO) as the diagnostic parameter, and positive in 116 (sensitivity = 91%) using an index obtained multiplying MVO for Venous Capacitance (VC). Out of the 141 venographically negative limbs, there were 6 false positive results using MVO and 9 using MVO X VC (specificity = 96% and 94% respectively). SGP sensitivity in acute proximal venous thrombosis was 97%, while it was about 60% in distal DVT. Most false positive results occurred in patients with edema of cardiac origin. SGP appears to be a useful diagnostic test in suspected DVT of lower limbs, particularly when both MVO and the index MVO X VC are used.

Adolescent↗
PubMed1984

Correlation between changes induced by venous occlusion on factor VIII-von Willebrand factor components and fibrinolytic activity.

The effects of standardized venous occlusion (VO) on factor VIII-von Willebrand factor (F VIII-VWF) components (F VIII:C, F VIIIR:AG, F VIIIR:RCof) and on fibrinolytic activity were investigated in 45 healthy subjects, in 28 women on oral contraceptives, and in 78 patients with various chronic diseases (28 with peripheral arterial disease, 19 with liver cirrhosis, 13 with rheumatoid arthritis, and 18 with diabetes). All the three F VIII-VWF components showed highly significant increases, although not of the same magnitude, with consequent variations in the ratios between them. A significant activation of fibrinolysis was also demonstrated with both euglobulin lysis time (ELT) and diluted blood clot lysis time (DBCLT). A strong linear correlation between pre- and post-stasis values was recorded for all the F VIII-VWF components and for the two fibrinolysis tests. No significant relationship was, on the contrary, found between F VIII-VWF and fibrinolytic parameters.

Blood Coagulation Factors↗