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Biomedical subjects

V Cupelli

Publications and source records attributed to V Cupelli.

At least 19 recordsLinked to original sources
PubMed2005

Survival of malignant pleural mesothelioma cases in the Tuscan Mesothelioma Register, 1988-2000: a population-based study.

This study analyses survival of Tuscan residents (Italy, 3.5 million population) diagnosed by histological examination with malignant pleural mesothelioma (MPM) during the period 1988-2000, and recorded in the Tuscan Malignant Mesothelioma Register. The aim was to establish the prognostic role of demographic, diagnostic and asbestos exposure variables. During 1988-2000, 381 MPM cases were recorded (318 men; 63 women). Vital status was ascertained up to 31 December 2002. No cases were lost to follow-up. Median survival of certain MPM was 324 days (11 months; 95% CI 297-366); 45.7% (95% CI 40.6-50.6%) survived more than 1 year; 24.2% (95% CI 20.0-28.5%) more than 2 years. In univariate and multivariate analyses survival was associated with histological subtype (epithelioid subtype had the longest survival). Gender, age, period of diagnosis, hospital of diagnosis and asbestos exposure did not show significant effects. Therapeutic information was available for patients of the period 1997-2000. There was no significant difference in survival between treated versus untreated patients. In conclusion, no advance in prognosis at the population level in the most recent period can be suggested on the basis of the data available to the Tuscan Malignant Mesothelioma Register.

Aged↗
PubMed2001

Effects of silica on human lung fibroblast in culture.

Silica has been reported to directly stimulate cellular proliferation of human lung fibroblasts, and silica-treated macrophage supernatants induce fibroblast proliferation and some of their biosynthetic activities. Alveolar macrophages produce increased amount of tumour necrosis factor alpha (TNF-alpha) and transforming growth factor beta (TGF-beta). Lung fibroblasts are producers of interleukin-6 (IL-6). We investigated the capacity of lung fibroblasts obtained from normal and silicosis subjects to elaborate IL-6 in response to TNF-alpha and to TGF-beta. Our data show that TNF-alpha and TGF-beta are able to stimulate the proliferation of human lung fibroblasts in culture, to increase the collagen production of the cells and are both able to increase IL-6 production by lung fibroblasts of patients with silicosis. We hypothesise that silica is able to stimulate lung fibroblast both directly, increasing the cell proliferation, and indirectly stimulating the release of factors (as TNF-alpha and TGF-beta) from activated alveolar macrophages, that are able to increase proliferative and biosynthetic activities of fibroblast.

Cell Division↗
PubMed1993

[The sports fitness of patients operated on for aortic coarctation: assessment by exercise Doppler echocardiography].

BACKGROUND: The aim of this study was to assess the utility of Doppler echocardiography both at rest and during isotonic exercise in evaluating competition eligibility of patients with repaired coarctation of the aorta (CoAo). METHODS: Seventeen young patients (11 male, 6 female; mean age 17.1 +/- 7.9 years) with previous surgical repair of CoAo were examined. Mean follow-up after repair was 10.3 +/- 3.5 years. All patients underwent complete Echocardiographic examination (M-mode, 2D and Doppler) and an exercise test on an ergometric bicycle, with continuous wave Doppler monitoring of flow velocity in descending aorta, with a transducer positioned in the suprasternal notch. Peak and mean Doppler gradients in descending aorta were measured both at rest and during exercise, using the simplified Bernoulli equation. According to peak Doppler gradient at rest, patients were divided into two subgroups: Group IA = patients with peak gradient lower than 25 mmHg; Group IB = patients with peak gradient greater than 25 mmHg. Finally, 17 healthy subjects (Control Group), matched for age and body surface area, were examined. RESULTS: Systolic and diastolic blood pressure both at rest and during exercise were not significantly different in the 3 groups. Patients of Group IB showed a significant increase of left ventricular mass (124.0 +/- 24.4 vs 85.8 +/- 24.1 g/m2, p < 0.01), and during exercise, a significant increase of peak gradient (68.3 +/- 27.2 vs 23.5 +/- 9.0 mmHg, p < 0.0001) and mean gradient (34.8 +/- 11.5 vs 11.9 +/- 5.0 mmHg, p < 0.0001) at the level of the descending aorta. In patients of Group IA, echocardiographic parameters were not different in comparison with the Control Group, whereas Doppler gradients during exercise were only slightly greater than those observed in the Control Group (peak gradient 36.9 +/- 13.0 vs 23.5 +/- 9.0 mmHg, p < 0.05; mean gradient 19.6 +/- 6.0 vs 11.9 +/- 5.0 mmHg, p < 0.05). However, 4 patients of Group IA showed a peak gradient during exercise greater than 40 mmHg (this value was equivalent to the mean value plus 2 Standard Deviations, observed in the Control Group) with the presence of diastolic flow, whereas exercise systolic blood pressure was lower than 200 mmHg. CONCLUSIONS: Thus, as a result of this study aimed at evaluating competition eligibility in patients with repaired CoAo, two subgroups of patients have to be distinguished according to Doppler echocardiography results: a) patients with peak Doppler gradient at rest greater than 25 mmHg, for whom competition is forbidden; b) Patients with peak gradient lower than 25 mmHg who must be investigated with exercise Doppler echocardiography to exclude an abnormal increase of Doppler gradients, even if exercise blood pressure is within normal limits.

Adolescent↗
PubMed1990

Effects of training on the electrophysiologic properties of atrium and accessory pathway in athletes with Wolff-Parkinson-White syndrome.

Twenty-two subjects with Wolff-Parkinson-White (WPW) electrocardiographic pattern performing agonistic physical activity were referred to our laboratory to assess arrhythmogenic risk (group 1). This allowed us to evaluate a less known aspect, namely that of effects of training on the electrophysiologic properties of the atrium and accessory pathway. This was done utilizing a control group of 10 WPW patients who did not perform agonistic physical activity (group 2). All subjects were symptom free, and without signs of associated cardiopathy if we exclude 1 patient of group 1, who presented moderate mitral valve prolapse. Group 1 patients showed significantly higher mean values for basic cycle length (p less than 0.001), atrial effective (p less than 0.04) and functional (p less than 0.02) refractory period, and anterograde effective refractory period of the accessory pathway (p less than 0.02). The different behavior observed in group 1 patients could be explained considering the known influence of training on the equilibrium of the autonomic nervous system. Moreover, it is noteworthy that the two groups did not differ for inducibility of atrial fibrillation (AF). This should be taken into account considering the importance of AF in WPW. In conclusion, our study does not demonstrate any negative electrophysiologic effects of training in patients with WPW.

Adolescent↗
PubMed1990

[Effects of hypertrophy on cardiac systolic and diastolic performance in athletes with mild hypertension].

Aims of the study has been the evaluation of morphological and functional aspects of left ventricle in subjects undergoing mild hypertension and sport adaptation effects. These evaluations have been carried out by Echo-Doppler both at rest and during sharp increase in after load induced by isometric stress. Together with the morphological parameters represented by mass index and by radius to thickness ratio, we have studied stroke volume and transmitral flow pattern assessing the maximum flow velocity during rapid filling phase (E), during atrial contraction phase (A) and their ratio (E/A). We have studied 31 male subjects from 39 to 60 (average 47) exercising twice or three times a week (in the main, aerobic sports such as road cycling). They were subdivided into two groups, the first included 16 subjects with mild hypertension (AP = 155 +/- 9/97 +/- 5 mmHg) the second included 15 normotensive subjects without known pathologies, comparable for age and body surface (AP = 125 +/- 15/77 +/- 10 mmHg). Hypertensive subjects exercising regularly, showed a mass index (164 +/- 42 g/m2) significantly higher than the controls (139 +/- 35 g/m2, P less than 0.01) but they ke a normal filling pattern at rest and similar stroke volume values. During isometric exercise instead, the velocities of E and A waves showed a different trend in the two groups with a higher reduction in E/A ratio in hypertensive subjects. The per cent decrease in this ratio turned out to be 15% in the control group and 33% in hypertensive subjects (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Relationship between age and anterograde refractoriness of the accessory pathway in Wolff-Parkinson-White patients.

In 22 patients (age range 13-40 years) with Wolff-Parkinson-White ECG pattern without evidence of associated cardiomyopathy we measured the anterograde effective refractory period of the accessory pathway (ERP-AP) by extrastimulus method (at twice diastolic threshold) during atrial pacing (100/min). The ERP-AP range was 220-480 ms. There was a significant direct correlation between age and ERP-AP (r = 0.50, p less than 0.01). An ERP-AP less than or equal to 250 ms was found in 4 patients (age less than or equal to 23 years). This is noteworthy in the light of reports that, over the years: (1) typical Wolff-Parkinson-White ECG signs can disappear and (2) the frequency of tachycardic episodes decreases. Our data suggest a lower risk of high ventricular rates during atrial fibrillation with increasing age.

Adolescent↗
PubMed1989

Anaerobic threshold in runners and cyclists.

Two different noninvasive procedures have been used to determine the anaerobic threshold (AT) in 15 long distance runners and in 6 cyclists. The AT values obtained by ventilatory methods (on treadmill for runners and on cycloergometer for cyclists) and the AT values obtained by a field test were significantly correlated.

Adult↗
PubMed1988

Atrial electrophysiologic properties of patients with asymptomatic Wolff-Parkinson-White syndrome.

To evaluate the existence of a peculiar atrial electrophysiologic substrate, we studied 18 patients with asymptomatic Wolff-Parkinson-White (WPW) syndrome. These patients were compared with 10 age-matched normal subjects (N). Effective and functional refractory periods were determined at two right atrial sites (high and low in the lateral wall), during atrial pacing (100 min-1) and at twice diastolic threshold. Disperson (D) of effective (ERP) and functional (FRP) refractoriness was evaluated as the difference between refractory periods at the two atrial sites. WPW patients showed significantly lower mean values of effective and functional refractoriness at both atrial sites and significantly higher mean values of D-ERP and D-FRP. Moreover, in calculating the highest normal values of D-ERP and D-FRP (as mean values of N plus 2SD) it was observed that WPW with abnormal values of D showed a statistically (chi 2 test) higher incidence (100%) of induced atrial fibrillation (AF). These findings indicate the existence of both an abnormal atrial electrophysiologic substrate and of a higher vulnerability in WPW. Finally, AF was induced generally at the site with the lower refractoriness (i.e. low lateral site). This should be taken into account when considering how atrial fibrillation can be induced more easily.

Adolescent↗
PubMed1987

Long-term follow-up in children without heart disease with ventricular premature beats.

In order to evaluate the significance of premature ventricular beats (PVBs) in childhood, 9 children (mean age 12.8 +/- 2.3 years) without clinical or in noninvasive investigational signs of heart disease, with occasional PVBs detected during early medical control, have been studied over periods ranging from 12 to 68 months. At the beginning and end of the follow-up period all children performed a step test, a maximal cycloergometric exercise test, 24-hour electrocardiographic monitoring, echocardiogram and routine laboratory examinations. While at first control complex PVBs were found in 4 children, at final control only 2 showed complex PVBs, 1 simple PVBs and 1 no PVB. Among the 5 children having simple PVBs at first control, only one showed complex PVBs at the end of the follow-up, with 3 simple PVBs and 1 no PVB. The disappearance of more dangerous PVBs (run of three or more) and also the large variability of arrhythmia (both for its presence and complexity) during the numerous tests, seem to demonstrate that in children with normal hearts the occurrence of PVBs can be considered as benign and free of adverse implications.

Adolescent↗
PubMed1987

Ergometric evaluation of physical fitness of athletes affected by mitral valve prolapse: study of 80 cases.

Physical fitness of athletes affected by mitral valve prolapse (MVP) was examined, in order to evaluate the influence of sport activity on the natural history of the disease. Maximal workload, total workload, percentage efficiency (according to Hollmann's formula), double product of maximal cycloergometric stress test performed by 80 athletes (53 male, 27 female, mean age 23.8 yrs) with MVP were considered and compared with the same parameters obtained by 160 (120 male, 40 female) normal athletes (N) matched for age and weight. Moreover, the same ergometric data of two maximal exercise tests, performed by 30 subjects of the MVP group, a mean follow-up period of 2.5 years (range 1-6 years) were compared. No significant difference was found between MVP and N group ergometric data, except for double product, that was significantly lower in MVP group with respect to N group (P less than 0.001). Moreover, no difference was found between MVP with or without mitral regurgitation, and N. No difference was found between the first and the last ergometric test in the follow-up group. In conclusion, our results suggest that athletes with MVP have no reduction of physical fitness. Ergometric follow-up, almost in our cases, does not indicate a negative influence of physical activity on the natural history of the disease.

Adult↗
PubMed1986

Effects of one year of physical training on borderline hypertension: an evaluation by bicycle ergometer exercise testing.

Previous observations have suggested the possibility of separating the borderline hypertensive population into two groups on the basis of blood pressure responses to maximal exercise testing. In order to evaluate the effects of 1 year of physical training on hypertensive subjects, 14 men with resting borderline hypertension and with a normal pressure response to exercise (group I) and 12 with resting borderline hypertension but with an abnormal pressure response to exercise (group II) underwent a maximal bicycle ergometer stress test in a sitting position before and after the training period. In group I, systolic and diastolic blood pressure levels both at rest and during submaximal exercise were significantly reduced after the training period. In group II, resting systolic blood pressure was unchanged, whereas resting diastolic pressure was significantly increased. During submaximal exercise, systolic and diastolic blood pressure showed only mild, nonsignificant differences when compared before and after training. No differences were found during maximal exercise. Blood pressure response to stress testing is useful to identify early stages of the disease and to plan preventive measures consisting of regular physical training either alone or associated with dietary and/or pharmacological treatment.

Adult↗
PubMed1976

[Hemodynamic research and physiopathologic remarks on "vibration angiopathy" with Raynaud's phenomenon (author's transl)].

A hemodynamic research was carried out by the authors in ten patients affected with upper limb "vibration angiopathy", as well as in ten healthy control subjects. Digital artery flow and systolic, diastolic and mean pressures were measured, and vascular resistances and the so-called "systolic index" calculated, both in basal condition and following hand warming. In patients with "vibration angiopathy" fingers were examined, which on a previous arteriographic study showed the most and the least severe arterial lesions, respectively. No statistically significant differences were detected between the mean values of the hemodynamic indices obtained from the most and the least involved fingers, respectively, as well as between such values and the control subject ones. These results would suggest--even with due reservation on account of the relatively small number of cases and of their different features--that digital artery lesions, as shown by arteriography, have no definite hemodynamic significance. The lack of a statistically significant decrease of the digital artery mean pressure, compared to control subjects, supports the hypothesis that Raynaud's phenomenon in "vibration angiopathy" is not due to a transmural pressure fall. Finally, the lack of correlation between the severity of arterial lesions and Raynaud's phenomenon site suggests that the vasomotion impairment which causes the phenomenon is not related to such lesions.

Arteries↗
PubMedDate not supplied

Determination of S-phenylmercapturic acid by GC-MS and ELISA: a comparison of the two methods.

S-phenylmercapturic acid (PMA) is a specific urinary biomarker of benzene at exposure levels lower than 1 ppm. However, measuring PMA in urine is an expensive task by either GC or HPLC due to the necessity of extensive sample pretreatment. In the present study, a commercial chemiluminescence enzyme-linked immunosorbent assay (ELISA) test for PMA and GC-MS were used for screening urine samples of 60 workers employed in petrochemical settings. The ELISA results were evaluated by comparison with the GC-MS. Overall, the ELISA test proved sensitive (limit of detection=0.1 microg l(-1)), rapid, robust and reliable, affording results in good agreement with the GC-MS (54% of measurements) and no false-negatives. On the other hand, 46% of the ELISA assays were assigned as false-positives (arbitrarily established when ELISA >5 microg l(-1), GC-MS <5 microg l(-1) and a correlation coefficient of 0.687 was calculated between the two methods. It appears that urinary PMA routine biomonitoring on large numbers of samples is carried out in a cost-effective and rapid approach by preliminary screening with the ELISA assay followed by GC-MS confirmation of concentrations exceeding the biological exposure index for PMA.

Acetylcysteine↗
PubMedDate not supplied

Respiratory risks in tunnel construction workers.

Respiratory diseases are frequent in tunnel construction workers. A group of 144 subjects randomly selected from the population of 2516 workers engaged in the construction of the railway tunnel under the Appennine Mountains, from Bologna to Firenze was investigated. A group of 69 males comparable for age, living area and habits was studied as a control group. Assessment of air pollutants (NO, NO2, SO2, total dust, silica %) was carried out by means of fixed monitoring stations as well as personal monitors. All the subjects included in the study were examined with a standardised protocol which included physical examination, lung function tests (before and after shift work) and a questionnaire to college respiratory symptoms. Low concentrations of environmental pollutants were evidenced. Significantly lower values of FEV1 and PEF were determined in the worker group pared to controls. A significant decrease in respiratory parameters was shown after shift work. Variables capable of influencing the decrease in parameters include smoking habits, work activity, presence of cough and expectoration, period of the year (spirometries resulted worse in the winter time). Significantly lower values of FEV1 and PEF were evidenced in the workers compared to controls. In spite of the present low work environmental exposure conditions, some physiologic parameters appear altered in tunnel construction workers. This may depend on a variety of noxious agents present in the working environment.

Adult↗
PubMedDate not supplied

[General criteria of working ability in subjects with color vision defects].

A correct evaluation of the colour vision is important to make decisions concerning the recruitment in numerous occupations that require colour discrimination. In order to identify valid pre-employment colour vision testing methods, tests actually used and in particular the Ishihara test are considered. After a careful examination we conclude that candidates who pass the Ishihara test have sufficient colour perception to meet ordinary needs and further trade test are not necessary. Nevertheless we do not consider sufficient to rely on the Ishihara test alone to reject a candidate. The diagnostic algorihm proposed is recommended in pre-employment medical examinations for distinguishing people with normal colour vision, slight or sever colour deficiency.

Algorithms↗