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  • 1
    ISSN: 1432-1203
    Source: Springer Online Journal Archives 1860-2000
    Topics: Biology , Medicine
    Notes: Abstract Mild hyperhomocysteinemia is associated to mutations either in cystathionine ß-synthase (CBS) or in 5,10-methylenetetrahydrofolate reductase (MTHFR) genes. In 1995, Sebastio et al. characterized a 68 bp insertion in cis with the most common CBS mutation (T833C) detected in homocystinuric patients. Recently, this double mutation has been detected in Italian and North-American controls. Compared to a group of patients affected by coronary artery disease, North-American controls showed not statistically significant difference. Moreover, Italian controls displayed a microheterogeneity in the mutant allele frequency distribution depending on their geographical origin (North or South of Italy). Aim of our study was to evaluate the prevalence of the double in cis mutation in different populations. We studied 377 healthy subjects belonging to various human groups. Genomic DNA, extracted from peripheral blood samples, was amplified using specific primers; PCR fragments were digested with Bsr I restriction enzyme to detect the double mutation. Our data show a significant heterogeneity among the populations studied, therefore this mutation turned out to be a reliable anthropogenetic marker. The distribution of the double mutation will contribute, with other DNA polymorphisms, to evaluate the genetic admixture of mixed populations such as Afro-Americans
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1238
    Keywords: Adult respiratory distress syndrome ; Pulmonary hypertension ; Pulmonary and tissue gas exchange ; Aspirin ; Acute lung injury
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Objective There have been several studies that have already explored the potential beneficial role of cyclo-oxygenase (CO) inhibitors on oleic acid (OA)-induced lung injury in different species. These studies report no significant effect of CO inhibition, though thromboxane B2 (TxB2) was effectively blocked. However, recent studies indicate that pre-treatment with aspirin (ASA) preserve gas exchange in OA lung injury in dogs. Aim of our study has been to evaluate the potential beneficial effects of the pre-treatment with low doses of ASA on gas exchange, hemodynamics, respiratory mechanics, prostanoids and lung histology in OA-induced lung injury in sheep. Design 0.09 ml/kg of OA was administered into the right atrium of 14 anaesthetized sheep. Six received a bolus of ASA (10 mg/kg i. v.) 30 min before OA, the others saline as placebo. Measurements and results Pulmonary and tissue gas exchange, pulmonary and systemic hemodynamics, respiratory system mechanics, TxB2 and 6-keto-PGF1α, leukocytes and platelets concentrations were measured throughout the subsequent 3 h and lung histology was effected at end-experiment. The principal findings of our study are: 1) ASA reduces OA-induced early pulmonary vasoconstriction and bronchoconstriction, parallelled by a suppression of TxB2 generation; 2) the late increase in pulmonary artery pressure and airway resistance due to OA is not inhibited by ASA; 3) the early disturbance in pulmonary gas exchange is reduced by ASA, whereas the late severe deterioration is exaggerated by ASA; 4) the stability of tissue exchange ratio (R) at ≈1 in ASA-group compared to its fall to ≈0.7 in controls. Conclusion Our findings suggest that ASA: 1) is only effective to treat the very transient TxB2-induced pulmonary vasoconstriction resulting in hydrostatic edema, and it is ineffective, even accentuates, the subsequent major pulmonary endothelial cell injury leading to alveolar flooding that is unrelated to TxB2; 2) has a transient protective effect on the TxB2-induced early bronchospasm; 3) has a biphasic behaviour on gas exchange, with a benefit which lasts only one hour and then results in a worse gas exchange; 4) has an immediate, stabilizing, persisting effect on R, contrasting with its transient effect on pulmonary hemodynamics and PaO2.
    Type of Medium: Electronic Resource
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  • 3
    ISSN: 1432-2277
    Keywords: Key words Renal transplantation ; Cardiovascular disease ; Risk factors ; Hemostasis ; Homocysteine
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Long-term survival of renal transplant recipients appears to be influenced by the occurrence of thromboembolic complications and cardiovascular disease. In order to investigate the prevalence of new hemostasis-related risk factors for venous and arterial thrombosis, we investigated 63 renal transplant recipients and 66 age- and sex-matched control subjects. We assayed antiphospholipid antibodies [lupus anticoagulant (LA) and anticardiolipin antibodies (aCL)], lipoprotein (a) [Lp(a)], plasminogen activator inhibitor-1 (PAI-1), and total homocysteine (tHcy) levels. We found a significantly higher prevalence of positivity for LA (P 〈 0.001); no difference was detected in the prevalence of aCL between patients and controls. PAI-1 levels were significantly higher in renal transplant recipients than in controls [12.3 IU/ml (2–45.5) vs 7.9 IU/ml (4–18.0); P 〈 0.0001] with an odd ratio (OR) of 11.8 (4.9–28.5) in univariate analysis and of 5.8 (2.1–15.4) in multivariate analysis. Lp(a) levels were higher in patients then in controls [159 mg/l (1–992) vs 100.5 mg/l (10–412); P 〈 0.005] with an OR of 5.9 (1.9–18.4) in univariate analysis and of 3.5 (0.9–13.4) in multivariate analysis. Fasting levels of tHcy were significantly higher in renal transplant recipients [7.0 μmol/l (4.0–68) vs 8.1 μmol/l (2.0–24.0); P 〈 0.00001] with an OR of 40.4 (14.7–111) in univariate analysis and of 33.1 (11.1–115.5) in multivariate analysis. After methionine loading test, we documented levels of tHcy above the 90th percentile of controls in 60/63 patients (95 %). Finally, we found a significant correlation between tHcy and PAI-1 plasma levels (r = 0.76; P 〈 0.000 001). Our results show a high prevalence of hemostasis-related risk factors for arterial and venous thrombosis in renal transplant recipients, suggesting the need for the investigation of these patients for the presence of these risk factors in order to improve their long-term survival and to tailor therapy.
    Type of Medium: Electronic Resource
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  • 4
    ISSN: 1432-2218
    Keywords: Key words: Blood clotting activation — Open and videolaparoscopic cholecystectomy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Background: Tissue injury after trauma and surgery may induce alterations in blood coagulation and fibrinolysis, and the hypercoagulable state observed after surgery can be associated with the risk of postoperative thromboembolic complications. Recently, videolaparoscopic (VLPS) cholecystectomy has been introduced, and its advantages over the open procedure seem related to the reduced surgical trauma. The aim of this study was to investigate hemostatic system alterations in patients who undergo open and VLPS cholecystectomy. Methods: Fibrinogen, prothrombin fragment F1+2, D-dimer, and plasminogen activator inhibitor type-1 (PAI-1) activity was determined in 10 patients who underwent open (group A) and 10 patients who underwent VLPS cholecystectomy (group B), respectively. Blood samples were obtained the day of surgery in the morning (B1), after anesthesia (A1), 1 hour after the start of surgery (S1), then 30 min (E.05) and 24 h (E.24) after the surgery. Results: No significant differences were observed in baseline values between groups A and B for the parameters investigated. At 24 h after surgery, fibrinogen increased significantly (p 〈 0.05) in group A and also was significantly higher than in group B (p 〈 0.05). In group A, a marked increase in F1+2 levels (p 〈 0.01) was observed in all the samples, with the maximum values on the first day after surgery (3.7 nmol/l; 1.2–6.0 nmol/l), whereas in group B, a slight but significant increase in F1+2 levels (2.1 nmol/l; 1.1–3.9 nmol/l; p 〈 0.01) was observed only 30 min after the end of surgery. In both groups A and B, D-dimer markedly increased after surgery, without statistical significant differences between the two groups at any time. The PAI-1 activity plasma levels remained in the normal range during and after surgery in both groups. Conclusions: These results indicate that VLPS surgery induces an activation of the clotting system that, although of low degree and short duration, can lead to a transient prothrombotic state.
    Type of Medium: Electronic Resource
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  • 5
    ISSN: 1619-1560
    Keywords: Autonomic nervous system disease ; Diabetic neuropathy ; Heart rate spectrum analysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Power spectrum analysis of the R—R interval was used in 20 controls and in two groups of type I (insulin dependent) diabetics (27 patients) to detect changes in total power or in its components (low frequency and high frequency) that might be considered an early evidence of impairment of cardiac autonomic nervous system control. A significant difference between controls and severe diabetics (with autonomic involvement) was found in all components. In the early stage of diabetes without evidence of autonomic involvement, an absolute reduction of the low frequency component in the standing position and a significant reduction of the percentage increase compared with the lying position, was found to discriminate diabetics from controls. The occurrence of somatic neuropathy was unrelated to changes in autonomic function. These data indicate that: (1) power spectrum analysis is sensitive enough to detect cardiac autonomic neuropathy in diabetics, where standard methods fail; (2) power spectrum analysis is the method of choice in the early stages; (3) in severe type I dependent diabetes there is a reduction of power spectrum analysis total power and a defective response to standing up; (4) cardiac autonomic neuropathy develops independently from somatic neuropathy.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1573-9686
    Keywords: Atrial arrhythmia ; Spatiotemporal organization ; Nonlinear analysis ; Intra-atrial electrograms
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Technology
    Notes: Abstract The aim of this study was to determine the presence of organization of atrial activation processes during atrial fibrillation (AF) by assessing whether the activation sequences are wholly random or are governed by deterministic mechanisms. We performed both linear and nonlinear analyses based on the cross correlation function (CCF) and recurrence plot quantification (RPQ), respectively. Recurrence plots were quantified by three variables: percent recurrence (PR), percent determinism (PD), and entropy of recurrences (ER). We recorded bipolar intra-atrial electrograms in two atrial sites during chronic AF in 19 informed subjects, following two protocols. In one, both recording sites were in the right atrium; in the other protocol, one site was in the right atrium, the other one in the left atrium. We extracted 19 episodes of type I AF (Wells' classification). RPQ detected transient recurrent patterns in all the episodes, while CCF was significant only in ten episodes. Surrogate data analysis, based on a cross-phase randomization procedure, decreased PR, PD, and ER values. The detection of spatiotemporal recurrent patterns together with the surrogate data results indicate that during AF a certain degree of local organization exists, likely caused by deterministic mechanisms of activation. © 2000 Biomedical Engineering Society. PAC00: 8719Nn, 8719Hh, 8780-y, 0705Kf
    Type of Medium: Electronic Resource
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