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Abratenko P, Aduszkiewicz A, Akbar F, Pons MA, Asaadi J, Aslin M, Babicz M, Badgett WF, Bagby LF, Baibussinov B, Behera B, Bellini V, Beltramello O, Benocci R, Berger J, Berkman S, Bertolucci S, Bertoni R, Betancourt M, Bettini M, Biagi S, Biery K, Bitter O, Bonesini M, Boone T, Bottino B, Braggiotti A, Brailsford D, Bremer J, Brice SJ, Brio V, Brizzolari C, Brown J, Budd HS, Calaon F, Campani A, Carber D, Carneiro M, Terrazas IC, Carranza H, Casazza D, Castellani L, Castro A, Centro S, Cerati G, Chalifour M, Chambouvet P, Chatterjee A, Cherdack D, Cherubini S, Chithirasreemadam N, Cicerchia M, Cicero V, Coan T, Cocco AG, Convery MR, Copello S, Cristaldo E, Dange AA, de Icaza Astiz I, De Roeck A, Di Domizio S, Di Noto L, Di Stefano C, Di Ferdinando D, Diwan M, Dolan S, Domine L, Donati S, Doubnik R, Drielsma F, Dyer J, Dytman S, Fabre C, Fabris F, Falcone A, Farnese C, Fava A, Ferguson H, Ferrari A, Ferraro F, Gallice N, Garcia FG, Geynisman M, Giarin M, Gibin D, Gigli SG, Gioiosa A, Gu W, Guerzoni M, Guglielmi A, Gurung G, Hahn S, Hardin K, Hausner H, Heggestuen A, Hilgenberg C, Hogan M, Howard B, Howell R, Hrivnak J, Iliescu M, Ingratta G, James C, Jang W, Jung M, Jwa YJ, Kashur L, Ketchum W, Kim JS, Koh DH, Kose U, Larkin J, Laurenti G, Lukhanin G, Marchini S, Marshall CM, Martynenko S, Mauri N, Mazzacane A, McFarland KS, Méndez DP, Menegolli A, Meng G, Miranda OG, Mladenov D, Mogan A, Moggi N, Montagna E, Montanari C, Montanari A, Mooney M, Moreno-Granados G, Mueller J, Naples D, Nebot-Guinot M, Nessi M, Nichols T, Nicoletto M, Norris B, Palestini S, Pallavicini M, Paolone V, Papaleo R, Pasqualini L, Patrizii L, Peghin R, Petrillo G, Petta C, Pia V, Pietropaolo F, Poirot J, Poppi F, Pozzato M, Prata MC, Prosser A, Putnam G, Qian X, Rampazzo G, Rappoldi A, Raselli GL, Rechenmacher R, Resnati F, Ricci AM, Riccobene G, Rice L, Richards E, Rigamonti A, Rosenberg M, Rossella M, Rubbia C, Sala P, Sapienza P, Savage G, Scaramelli A, Scarpelli A, Schmitz D, Schukraft A, Sergiampietri F, Sirri G, Smedley JS, Soha AK, Spanu M, Stanco L, Stewart J, Suarez NB, Sutera C, Tanaka HA, Tenti M, Terao K, Terranova F, Togo V, Torretta D, Torti M, Tortorici F, Tosi N, Tsai YT, Tufanli S, Turcato M, Usher T, Varanini F, Ventura S, Vercellati F, Vicenzi M, Vignoli C, Viren B, Warner D, Williams Z, Wilson RJ, Wilson P, Wolfs J, Wongjirad T, Wood A, Worcester E, Worcester M, Wospakrik M, Yu H, Yu J, Zani A, Zatti PG, Zennamo J, Zettlemoyer JC, Zhang C, Zucchelli S, Zuckerbrot M. ICARUS at the Fermilab Short-Baseline Neutrino program: initial operation. Eur Phys J C Part Fields 2023; 83:467. [PMID: 37303462 PMCID: PMC10239613 DOI: 10.1140/epjc/s10052-023-11610-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/12/2023] [Indexed: 06/13/2023]
Abstract
The ICARUS collaboration employed the 760-ton T600 detector in a successful 3-year physics run at the underground LNGS laboratory, performing a sensitive search for LSND-like anomalous ν e appearance in the CERN Neutrino to Gran Sasso beam, which contributed to the constraints on the allowed neutrino oscillation parameters to a narrow region around 1 eV2 . After a significant overhaul at CERN, the T600 detector has been installed at Fermilab. In 2020 the cryogenic commissioning began with detector cool down, liquid argon filling and recirculation. ICARUS then started its operations collecting the first neutrino events from the booster neutrino beam (BNB) and the Neutrinos at the Main Injector (NuMI) beam off-axis, which were used to test the ICARUS event selection, reconstruction and analysis algorithms. ICARUS successfully completed its commissioning phase in June 2022. The first goal of the ICARUS data taking will be a study to either confirm or refute the claim by Neutrino-4 short-baseline reactor experiment. ICARUS will also perform measurement of neutrino cross sections with the NuMI beam and several Beyond Standard Model searches. After the first year of operations, ICARUS will search for evidence of sterile neutrinos jointly with the Short-Baseline Near Detector, within the Short-Baseline Neutrino program. In this paper, the main activities carried out during the overhauling and installation phases are highlighted. Preliminary technical results from the ICARUS commissioning data with the BNB and NuMI beams are presented both in terms of performance of all ICARUS subsystems and of capability to select and reconstruct neutrino events.
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Affiliation(s)
| | | | - F. Akbar
- University of Rochester, Rochester, NY 14627 USA
| | - M. Artero Pons
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - J. Asaadi
- University of Texas at Arlington, Arlington, TX 76019 USA
| | - M. Aslin
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
- Present Address: University of Wisconsin, Madison, USA
| | - M. Babicz
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
- INP-Polish Acad. Sci, Kraków, Poland
- Present Address: University of Zurich, Zurich, Switzerland
| | - W. F. Badgett
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - L. F. Bagby
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - B. Baibussinov
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - B. Behera
- Colorado State University, Fort Collins, CO 80523 USA
| | - V. Bellini
- INFN Sezione di Catania and University of Catania, Catania, Italy
| | - O. Beltramello
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - R. Benocci
- INFN Sezione di Milano Bicocca and University of Milano Bicocca, Milan, Italy
| | - J. Berger
- Colorado State University, Fort Collins, CO 80523 USA
| | - S. Berkman
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - S. Bertolucci
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - R. Bertoni
- INFN Sezione di Milano Bicocca and University of Milano Bicocca, Milan, Italy
| | - M. Betancourt
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - M. Bettini
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | | | - K. Biery
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - O. Bitter
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
- Present Address: Northwestern University, Evanston, USA
| | - M. Bonesini
- INFN Sezione di Milano Bicocca and University of Milano Bicocca, Milan, Italy
| | - T. Boone
- Colorado State University, Fort Collins, CO 80523 USA
| | - B. Bottino
- INFN Sezione di Genova and University of Genova, Genoa, Italy
| | - A. Braggiotti
- INFN Sezione di Padova and University of Padova, Padua, Italy
- Istituto di Neuroscienze, CNR, Padua, Italy
| | - D. Brailsford
- SBND Collaboration, Lancaster University, Lancaster, UK
| | - J. Bremer
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - S. J. Brice
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - V. Brio
- INFN Sezione di Catania and University of Catania, Catania, Italy
| | - C. Brizzolari
- INFN Sezione di Milano Bicocca and University of Milano Bicocca, Milan, Italy
| | - J. Brown
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - H. S. Budd
- University of Rochester, Rochester, NY 14627 USA
| | - F. Calaon
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - A. Campani
- INFN Sezione di Genova and University of Genova, Genoa, Italy
| | - D. Carber
- Colorado State University, Fort Collins, CO 80523 USA
| | - M. Carneiro
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | | | - H. Carranza
- University of Texas at Arlington, Arlington, TX 76019 USA
| | - D. Casazza
- INFN Sezione di Genova and University of Genova, Genoa, Italy
| | - L. Castellani
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - A. Castro
- Centro de Investigacion y de Estudios Avanzados del IPN (Cinvestav), Mexico City, Mexico
| | - S. Centro
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - G. Cerati
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - M. Chalifour
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - P. Chambouvet
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | | | - D. Cherdack
- University of Houston, Houston, TX 77204 USA
| | | | | | - M. Cicerchia
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - V. Cicero
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - T. Coan
- Southern Methodist University, Dallas, TX 75275 USA
| | | | - M. R. Convery
- SLAC National Acceleratory Laboratory, Menlo Park, CA 94025 USA
| | - S. Copello
- INFN Sezione di Pavia and University of Pavia, Pavia, Italy
| | - E. Cristaldo
- SBND Collaboration, Universidad Nacional de Asuncion, San Lorenzo, Paraguay
| | - A. A. Dange
- University of Texas at Arlington, Arlington, TX 76019 USA
| | | | - A. De Roeck
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - S. Di Domizio
- INFN Sezione di Genova and University of Genova, Genoa, Italy
| | - L. Di Noto
- INFN Sezione di Genova and University of Genova, Genoa, Italy
| | | | - D. Di Ferdinando
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - M. Diwan
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | - S. Dolan
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - L. Domine
- SLAC National Acceleratory Laboratory, Menlo Park, CA 94025 USA
| | | | - R. Doubnik
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - F. Drielsma
- SLAC National Acceleratory Laboratory, Menlo Park, CA 94025 USA
| | - J. Dyer
- Colorado State University, Fort Collins, CO 80523 USA
| | - S. Dytman
- University of Pittsburgh, Pittsburgh, PA 15260 USA
| | - C. Fabre
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - F. Fabris
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - A. Falcone
- INFN Sezione di Milano Bicocca and University of Milano Bicocca, Milan, Italy
| | - C. Farnese
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - A. Fava
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - H. Ferguson
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | | | - F. Ferraro
- INFN Sezione di Genova and University of Genova, Genoa, Italy
| | | | - F. G. Garcia
- SLAC National Acceleratory Laboratory, Menlo Park, CA 94025 USA
| | - M. Geynisman
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - M. Giarin
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - D. Gibin
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - S. G. Gigli
- INFN Sezione di Pavia and University of Pavia, Pavia, Italy
| | | | - W. Gu
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | - M. Guerzoni
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - A. Guglielmi
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - G. Gurung
- University of Texas at Arlington, Arlington, TX 76019 USA
| | - S. Hahn
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - K. Hardin
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - H. Hausner
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - A. Heggestuen
- Colorado State University, Fort Collins, CO 80523 USA
| | - C. Hilgenberg
- Colorado State University, Fort Collins, CO 80523 USA
- Present Address: University of Minnesota, Minneapolis, USA
| | - M. Hogan
- Colorado State University, Fort Collins, CO 80523 USA
| | - B. Howard
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - R. Howell
- University of Rochester, Rochester, NY 14627 USA
| | - J. Hrivnak
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - M. Iliescu
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
- Present Address: INFN-LNF, Frascati, Italy
| | - G. Ingratta
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - C. James
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - W. Jang
- University of Texas at Arlington, Arlington, TX 76019 USA
| | - M. Jung
- University of Chicago, Chicago, IL 60637 USA
- SBND Collaboration, Batavia, USA
| | - Y.-J. Jwa
- SLAC National Acceleratory Laboratory, Menlo Park, CA 94025 USA
| | - L. Kashur
- Colorado State University, Fort Collins, CO 80523 USA
| | - W. Ketchum
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - J. S. Kim
- University of Rochester, Rochester, NY 14627 USA
| | - D.-H. Koh
- SLAC National Acceleratory Laboratory, Menlo Park, CA 94025 USA
| | - U. Kose
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
- Present Address: ETH Zurich, Zurich, Switzerland
| | - J. Larkin
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | - G. Laurenti
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - G. Lukhanin
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - S. Marchini
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | | | | | - N. Mauri
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - A. Mazzacane
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | | | - D. P. Méndez
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | - A. Menegolli
- INFN Sezione di Pavia and University of Pavia, Pavia, Italy
| | - G. Meng
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - O. G. Miranda
- Centro de Investigacion y de Estudios Avanzados del IPN (Cinvestav), Mexico City, Mexico
| | - D. Mladenov
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - A. Mogan
- Colorado State University, Fort Collins, CO 80523 USA
| | - N. Moggi
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - E. Montagna
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - C. Montanari
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
- On leave of absence from INFN Pavia, Pavia, Italy
| | - A. Montanari
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - M. Mooney
- Colorado State University, Fort Collins, CO 80523 USA
| | - G. Moreno-Granados
- Centro de Investigacion y de Estudios Avanzados del IPN (Cinvestav), Mexico City, Mexico
| | - J. Mueller
- Colorado State University, Fort Collins, CO 80523 USA
| | - D. Naples
- University of Pittsburgh, Pittsburgh, PA 15260 USA
| | | | - M. Nessi
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - T. Nichols
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - M. Nicoletto
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - B. Norris
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - S. Palestini
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - M. Pallavicini
- INFN Sezione di Genova and University of Genova, Genoa, Italy
| | - V. Paolone
- University of Pittsburgh, Pittsburgh, PA 15260 USA
| | | | - L. Pasqualini
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - L. Patrizii
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - R. Peghin
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - G. Petrillo
- SLAC National Acceleratory Laboratory, Menlo Park, CA 94025 USA
| | - C. Petta
- INFN Sezione di Catania and University of Catania, Catania, Italy
| | - V. Pia
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - F. Pietropaolo
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
- On leave of absence from INFN Padova, Padua, Italy
| | - J. Poirot
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - F. Poppi
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - M. Pozzato
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - M. C. Prata
- INFN Sezione di Pavia and University of Pavia, Pavia, Italy
| | - A. Prosser
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - G. Putnam
- University of Chicago, Chicago, IL 60637 USA
| | - X. Qian
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | - G. Rampazzo
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - A. Rappoldi
- INFN Sezione di Pavia and University of Pavia, Pavia, Italy
| | - G. L. Raselli
- INFN Sezione di Pavia and University of Pavia, Pavia, Italy
| | - R. Rechenmacher
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - F. Resnati
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | | | | | - L. Rice
- University of Pittsburgh, Pittsburgh, PA 15260 USA
| | - E. Richards
- University of Pittsburgh, Pittsburgh, PA 15260 USA
| | - A. Rigamonti
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | | | - M. Rossella
- INFN Sezione di Pavia and University of Pavia, Pavia, Italy
| | | | - P. Sala
- INFN Sezione di Milano, Milan, Italy
| | | | - G. Savage
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - A. Scaramelli
- INFN Sezione di Pavia and University of Pavia, Pavia, Italy
| | - A. Scarpelli
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | - D. Schmitz
- University of Chicago, Chicago, IL 60637 USA
| | - A. Schukraft
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - F. Sergiampietri
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
- Present Address: IPSI-INAF Torino, Turin, Italy
| | - G. Sirri
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | | | - A. K. Soha
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - M. Spanu
- INFN Sezione di Milano Bicocca and University of Milano Bicocca, Milan, Italy
| | - L. Stanco
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - J. Stewart
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | - N. B. Suarez
- University of Pittsburgh, Pittsburgh, PA 15260 USA
| | - C. Sutera
- INFN Sezione di Catania and University of Catania, Catania, Italy
| | - H. A. Tanaka
- SLAC National Acceleratory Laboratory, Menlo Park, CA 94025 USA
| | - M. Tenti
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - K. Terao
- SLAC National Acceleratory Laboratory, Menlo Park, CA 94025 USA
| | - F. Terranova
- INFN Sezione di Milano Bicocca and University of Milano Bicocca, Milan, Italy
| | - V. Togo
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - D. Torretta
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - M. Torti
- INFN Sezione di Milano Bicocca and University of Milano Bicocca, Milan, Italy
| | - F. Tortorici
- INFN Sezione di Catania and University of Catania, Catania, Italy
| | - N. Tosi
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - Y.-T. Tsai
- SLAC National Acceleratory Laboratory, Menlo Park, CA 94025 USA
| | - S. Tufanli
- CERN, European Organization for Nuclear Research, 1211 Geneva 23, Switzerland
| | - M. Turcato
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - T. Usher
- SLAC National Acceleratory Laboratory, Menlo Park, CA 94025 USA
| | - F. Varanini
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - S. Ventura
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - F. Vercellati
- INFN Sezione di Pavia and University of Pavia, Pavia, Italy
| | - M. Vicenzi
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | | | - B. Viren
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | - D. Warner
- Colorado State University, Fort Collins, CO 80523 USA
| | - Z. Williams
- University of Texas at Arlington, Arlington, TX 76019 USA
| | - R. J. Wilson
- Colorado State University, Fort Collins, CO 80523 USA
| | - P. Wilson
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - J. Wolfs
- University of Rochester, Rochester, NY 14627 USA
| | | | - A. Wood
- University of Houston, Houston, TX 77204 USA
| | - E. Worcester
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | - M. Worcester
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | - M. Wospakrik
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | - H. Yu
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | - J. Yu
- University of Texas at Arlington, Arlington, TX 76019 USA
| | - A. Zani
- INFN Sezione di Milano, Milan, Italy
| | - P. G. Zatti
- INFN Sezione di Padova and University of Padova, Padua, Italy
| | - J. Zennamo
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
| | | | - C. Zhang
- Brookhaven National Laboratory, Upton, NY 11973 USA
| | - S. Zucchelli
- INFN Sezione di Bologna and University of Bologna, Bologna, Italy
| | - M. Zuckerbrot
- Fermi National Accelerator Laboratory, Batavia, IL 60510 USA
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Borrello A, Agnes A, Panunzi S, Piergentili I, Rossetto O, Fabris F, Magalini S, Gui D. Botulinum toxin infusion into the mesenteric artery has selective action on peristalsis in a rat model: experimental research. Eur Rev Med Pharmacol Sci 2023; 27:3171-3180. [PMID: 37070920 DOI: 10.26355/eurrev_202304_31951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
Abstract
OBJECTIVE Botulinum toxin type A (BoNT/A) reversibly blocks neurotransmission at voluntary and autonomic cholinergic nerve terminals, inducing paralysis. The aim of this study was to block panenteric peristalsis in rats through BoNT/A administration into the superior mesenteric artery (SMA) and to understand whether the toxin's action is selectively restricted to the perfused territory. MATERIALS AND METHODS Rats were infused through a 0.25-mm surgically inserted SMA catheter with different doses of BoNT/A (10 U, 20 U, 40 U BOTOX®, Allergan Inc.) or with saline for 24 h. Animals were free to move on an unrestricted diet. As a sign of bowel peristalsis impairment, body weight and oral/water intake were collected for 15 days. Statistical analysis was conducted with nonlinear mixed effects models to study the variation over time of the response variables. In three 40 U-treated rats, the selectivity of the intra-arterial delivered toxin action was studied by examining bowel and voluntary muscle samples and checking the presence of BoNT/A-cleaved SNAP-25 (the smoking gun of the toxin action) using the Immunofluorescence (IF) method through a specific antibody recognition. RESULTS While control rats exhibited an increasing body weight, treated rats showed an initial dose-dependent weight reduction (p<0.001 control vs. treated) with recovery after Day 11 for 10 and 20 U-treated rats. Food and water intake over time showed significantly different half-saturation constants with rats treated with higher doses who reached half of the maximum achievable in a greater number of days (p<0.0001 control vs. treated rats). BoNT/A-cleaved SNAP-25 was identified in bowel wall NMJs and not in voluntary muscles, demonstrating the remarkable selectivity of arterially infused BoNT/A. CONCLUSIONS Blockade of intestinal peristalsis, can be induced in rats by slow infusion of BoNT/A into the SMA. The effect is long-lasting, dose-dependent and selective. BoNT/A delivery into the SMA through a percutaneous catheter could prove clinically useful in the treatment of entero-atmospheric fistula by temporarily reducing fistula output.
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Affiliation(s)
- A Borrello
- Department of Emergency Surgery, Catholic University of the Sacred Heart, Policlinico Gemelli, Rome, Italy.
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3
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Casula M, Fortuni F, Frassica R, Coccia M, Magrini G, Fabris F, Gnecchi M, Leonardi S, Savastano S, Rordorf R. D-dimer for the prediction of left atrial appendage thrombosis: daydream or reality? A meta-analysis. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Left atrial appendage thrombosis (LAAT) is a dangerous condition that mainly affects patients with atrial fibrillation (AF) or those with mitral stenosis (MS), increasing their risk of stroke. Transesophageal echocardiography (TEE) is the gold standard for the diagnosis of LAAT but some technical issues and the suboptimal sensitivity in identifying small thrombi, especially within a side lobe, can limit its clinical usefulness. Reliable non-invasive diagnostic methods could be useful in clinical practice. D-dimer, a fibrin degradation product already commonly used in the diagnostic work-up of conditions such as venous thromboembolism, may have a role as a non-invasive marker of LAAT.
Purpose
To evaluate the diagnostic performance of D-dimer for the detection of LAAT in patients with AF and/or MS, using TEE as the reference standard.
Methods
We searched the literature for studies that evaluated the ability of D-dimer to predict LAAT. For each study a 2x2 table of D-dimer positivity and LAAT presence was constructed. Sensitivity, specificity, positive predictive value and negative predictive value were calculated. Considering the different diagnostic thresholds used in the included studies, the overall sensitivity and specificity were calculated using a hierarchal summary receiver operating characteristic (HSROC) model and a SROC curve was generated.
Results
6 studies, evaluating 1380 patients of whom 154 had LAAT, were included in the analysis. The prevalence of LAAT in the studies ranged from 9% to 26%, with a median of 12%. The mean age was 60±13 years, 63% were male. The mean left atrial diameter was 43±3 mm. The D-dimer diagnostic threshold ranged from 200 mcg/l to 1150 mcg/l. The overall sensitivity calculated with the HSROC model was 85%±28% and the overall specificity was 82%±29%. The negative predictive value was 98%. Figure 1 shows the summary ROC curve: individual studies are depicted by a clear circle; the red circle marks the pooled sensitivity and specificity across the 6 studies. The red dot-dashed-curve marks the boundary of the 95% credible region for the pooled estimates of sensitivity and specificity.
Conclusions
Our analysis shows that D-dimer has a good diagnostic performance with a very high negative predictive value for LAAT and therefore it might be of clinical aid for ruling out the presence of LAAT in patients with AF and/or MS. Further studies are needed to determine the best diagnostic threshold.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- M Casula
- Coronary Care Unit and LCEC, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Section of Cardiology, Pavia, Italy
| | - F Fortuni
- Coronary Care Unit and LCEC, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Section of Cardiology, Pavia, Italy
| | - R Frassica
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - M.G Coccia
- Coronary Care Unit and LCEC, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Section of Cardiology, Pavia, Italy
| | - G Magrini
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - F Fabris
- Coronary Care Unit and LCEC, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Section of Cardiology, Pavia, Italy
| | - M Gnecchi
- Coronary Care Unit and LCEC, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Section of Cardiology, Pavia, Italy
| | - S Leonardi
- Coronary Care Unit and LCEC, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Department of Molecular Medicine, Section of Cardiology, Pavia, Italy
| | - S Savastano
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlin, Pavia, Italy
| | - R Rordorf
- Coronary Care Unit and Laboratory of Clinical and Experimental Cardiology, Fondazione IRCCS Policlin, Pavia, Italy
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4
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Casula M, Fortuni F, Fabris F, Leonardi S, Gnecchi M, Greco A, Sanzo A, Rordorf R. P569Efficacy and safety of direct Xa oral inhibitors versus warfarin in patients with atrial fibrillation and cancer: a meta-analysis of randomized controlled trials. Europace 2020. [DOI: 10.1093/europace/euaa162.244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Patients with cancer are at higher risk of atrial fibrillation (AF) compared with the general population. Furthermore, cancer per se and anti-cancer treatments have been associated with thromboembolic complications and increased bleeding risk. Considering that only 12% of cancer patients can achieve a stable International Normalized Ratio target and the frequent need for invasive procedures, warfarin is not an ideal option. Direct oral anticoagulants may theoretically represent a valid alternative although their use in this population has been scarcely investigated.
Purpose
To compare efficacy and safety of direct oral Xa inhibitors (DOXaI) versus warfarin in patients with atrial fibrillation and cancer.
Methods
We searched electronic databases for randomized controlled trials (RCTs) that analyzed the use of DOXaI versus warfarin in patients with AF and cancer. The primary efficacy outcome was stroke or systemic embolism (SE). The secondary efficacy outcomes were ischemic stroke, myocardial infarction and all-cause death. The primary safety outcome was major bleeding; secondary safety outcomes were major or clinically relevant non-major bleeding, intracranial bleeding and any bleeding. The net clinical benefit was estimated as the composite of the two primary outcomes. A sensitivity analysis was performed to better define the incidence of these outcomes in patients with active cancer. The statistical software ProMeta 3 was used to estimate the risk ratio with a random-effect model.
Results
3 RCTs counting a total of 3029 cancer patients (1682 on DOXaI and 1347 on warfarin), 1354 of whom with active cancer (856 on DOXaI and 502 on warfarin), were included in the analysis. Mean age was 75.6 ± 1.2 years, and 32% were female. Mean follow-up period was 2.2 ± 0.6 years. The most common cancer sites were prostate (23%), gastrointestinal tract (22.2%), breast (12.1%) and genitourinary tract (10.6%). The mean CHADS2 score was 2.9 ± 0.6 and the mean HAS-BLED score was 2.6 ± 0.4.
There were no significant differences in the risk of stroke or SE (RR 0.76; 95% CI 0.52-1.10) as well as for all the other secondary efficacy outcomes. DOXaI significantly reduced the incidence of major bleeding in the overall cancer population (RR 0.79; 95% CI 0.63-0.99; p = 0.039); this finding was consistent also in patients with active cancer (RR 0.79; 95% CI 0.59-1.05) although the effect was not statistically significant. DOXaI also significantly reduced intracranial bleeding in overall cancer population (RR 0.12; 95% CI 0.02-0.63; p = 0.013) and any bleeding in active cancer patients (RR 0.87; 95% CI 0.77-0.98; p = 0.026). Furthermore, DOXaI significantly reduced the composite endpoints of major bleeding and stroke or SE in overall cancer population (RR 0.78; 95% CI 0.64-0.94; p = 0.008).
Conclusions
Our metanalysis shows that, in patients with atrial fibrillation and cancer, DOXaI are safer and have a similar efficacy compared with warfarin.
Abstract Figure. Primary efficacy and safety outcomes
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Affiliation(s)
- M Casula
- Department of Molecular Medicine, Section of Cardiology, University of Pavia and Cardiac Intensive C, Pavia, Italy
| | - F Fortuni
- Department of Molecular Medicine, Section of Cardiology, University of Pavia and Cardiac Intensive C, Pavia, Italy
| | - F Fabris
- Department of Molecular Medicine, Section of Cardiology, University of Pavia and Cardiac Intensive C, Pavia, Italy
| | - S Leonardi
- Department of Molecular Medicine, Section of Cardiology, University of Pavia and Cardiac Intensive C, Pavia, Italy
| | - M Gnecchi
- Department of Molecular Medicine, Section of Cardiology, University of Pavia and Cardiac Intensive C, Pavia, Italy
| | - A Greco
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - A Sanzo
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
| | - R Rordorf
- Policlinic Foundation San Matteo IRCCS, Division of Cardiology, Pavia, Italy
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5
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Camporese G, Bernardi D, Bernardi E, Avruscio GP, Marchini F, Bonfante L, Furian L, Neri F, Villalta S, Fabris F, Simioni P, Sartori MT. Absence of interaction between rivaroxaban, tacrolimus and everolimus in renal transplant recipients with deep vein thrombosis or atrial fibrillation. Vascul Pharmacol 2020; 130:106682. [PMID: 32438078 DOI: 10.1016/j.vph.2020.106682] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 02/24/2020] [Accepted: 05/08/2020] [Indexed: 01/03/2023]
Abstract
No data are available on rivaroxaban use in renal transplant recipients and on its surmised interaction with immunosuppressants. The aim was to investigate potential interactions between rivaroxaban and immunosuppressants in this setting. Renal transplant recipients with a stable renal function treated with rivaroxaban and tacrolimus with or without everolimus were investigated. All drugs and creatinine concentrations were determined daily for 2 weeks after the start of anticoagulation. Blood samples were drawn at 8.00 am and 3-4 h later for trough and peak concentrations, respectively. Bleeding and thrombotic events were recorded during a minimum follow-up of 6 months. In 8 renal transplant patients, rivaroxaban levels showed a predictable pharmacokinetic trend, both at Ctrough (30-61 μg/L) and at Cpeak (143-449 μg/L), with limited variability in the 25th-75th percentile range. Tacrolimus (Ctrough 3-13 μg/L; Cpeak 3-16 μg/L), everolimus (Ctrough 3-11 μg/L; Cpeak 5-17 μg/L) and creatinine concentrations were stable as well. Immunosuppressors variability before and after rivaroxaban were 30% and 30% for tacrolimus, 27% and 29% for everolimus, respectively, as well as 14% and 3% for creatinine. For rivaroxaban monitoring, the reference change value better performed in identifying significant variations of its concentration. No patient had bleeding or thrombotic events, worsening of renal graft function, and signs of immunosuppressants toxicity during a mean follow-up of 23 (9-28) months. In conclusion, rivaroxaban does not seem to interact with tacrolimus and everolimus in renal transplant recipients. Both anticoagulant and immunosuppressive effects seem warranted, without major bleeding complications and effect on the graft function.
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Affiliation(s)
- G Camporese
- Angiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padova University Hospital, Italy.
| | - D Bernardi
- Department of Laboratory Medicine, Padova University Hospital, Italy
| | - E Bernardi
- Department of Emergency and Accident Medicine, Conegliano Hospital, Italy
| | - G P Avruscio
- Angiology Unit, Department of Cardiac, Thoracic and Vascular Sciences, Padova University Hospital, Italy
| | - F Marchini
- Division of Nephrology and Renal Transplantation, Padova University Hospital, Italy
| | - L Bonfante
- Division of Nephrology and Renal Transplantation, Padova University Hospital, Italy
| | - L Furian
- Department of Surgery, Oncology and Gastroenterology, Padova University Hospital, Italy
| | - F Neri
- Department of Surgery, Oncology and Gastroenterology, Padova University Hospital, Italy
| | - S Villalta
- Department of Internal Medicine, Internal Medicine AULSS2 Marca Trevigiana, Treviso Hospital, Italy
| | - F Fabris
- Department of Internal Medicine, Clinical Medicine 1, Padova University Hospital, Italy
| | - P Simioni
- Department of Internal Medicine, General Medicine Unit, Thrombotic and Haemorrhagic Disorders Unit, Padova University Hospital, Italy
| | - M T Sartori
- Department of Internal Medicine, Clinical Medicine 1, Padova University Hospital, Italy
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6
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Abstract
Botulinum neurotoxins (BoNTs) are a growing family of bacterial protein toxins that cause botulism, a rare but often fatal animal and human disease. They are the most potent toxins known owing to their molecular architecture, which underlies their mechanism of action. BoNTs target peripheral nerve terminals by a unique mode of binding and enter into their cytosol where they cleave SNARE proteins, thus inhibiting the neurotransmitter release. The specificity and rapidity of binding, which limits the anatomical area of its neuroparalytic action, and its reversible action make BoNT a valuable pharmaceutical to treat neurological and non-neurological diseases determined by hyperactivity of cholinergic nerve terminals. This review reports the progress on our understanding of how BoNTs cause nerve paralysis highlighting the different steps of their molecular mechanism of action as key aspects to explain their extreme toxicity but also their unique pharmacological properties.
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Affiliation(s)
- O Rossetto
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - M Pirazzini
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - F Fabris
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - C Montecucco
- Department of Biomedical Sciences, University of Padova, Padova, Italy. .,Institute of Neuroscience, National Research Council, Padova, Italy.
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7
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Mascarenhas J, Marcellino BK, Lu M, Kremyanskaya M, Fabris F, Sandy L, Mehrotra M, Houldsworth J, Najfeld V, El Jamal S, Petersen B, Moshier E, Hoffman R. A phase I study of panobinostat and ruxolitinib in patients with primary myelofibrosis (PMF) and post--polycythemia vera/essential thrombocythemia myelofibrosis (post--PV/ET MF). Leuk Res 2019; 88:106272. [PMID: 31778911 DOI: 10.1016/j.leukres.2019.106272] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 11/12/2019] [Accepted: 11/13/2019] [Indexed: 01/23/2023]
Abstract
Ruxolitinib, a selective JAK1/JAK2 inhibitor, is the current first line therapy for myelofibrosis (MF), which reduces symptomatology and splenomegaly, but does not clearly modify disease course. Panobinostat, a histone deacetylase inhibitor, was shown to be safe and tolerable in phase I and II trials and demonstrated clinical activity in approximately a third of treated patients. Combination therapy of ruxolitinib and panobinostat showed synergistic activity in a preclinical MF model, which prompted clinical evaluation of this combination in both ruxolitinib naïve and treated MF patients. Herein, we report the results of an investigator-initiated, dose escalation, phase I trial of ruxolitinib and panobinostat in 15 patients with primary MF and post-polycythemia vera/essential thrombocythemia MF. This combination treatment proved to be safe and tolerable without dose limiting thrombocytopenia and a maximum tolerated dose of both agents in combination was not determined. The majority of patients maintained stable disease with this combination treatment and 40 % attained a clinical improvement (spleen n = 5, anemia n = 1) by modified IWG-MRT at the end of 6 cycles. This is one of the first attempts of rationally designed, JAK inhibitor-based, combination therapy studies and exemplifies the feasibility of such an approach in patients with advanced MF.
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Affiliation(s)
- J Mascarenhas
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States.
| | - B K Marcellino
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - M Lu
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - M Kremyanskaya
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - F Fabris
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - L Sandy
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - M Mehrotra
- Pathology Department, The Mount Sinai Hospital, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - J Houldsworth
- Pathology Department, The Mount Sinai Hospital, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - V Najfeld
- Pathology Department, The Mount Sinai Hospital, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - S El Jamal
- Pathology Department, The Mount Sinai Hospital, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - B Petersen
- Pathology Department, The Mount Sinai Hospital, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - E Moshier
- Department of Biostatistics, The Mount Sinai Hospital, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
| | - R Hoffman
- Tisch Cancer Institute, Division of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, One Gustave L Levy Place, Box 1079, New York, NY, 10029, United States
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8
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Scarinzi P, Bigolin P, Simoni F, Benvegnù L, Antonucci A, Biolo M, Panzavolta C, Bertocco S, Zambon S, Fabris F, Manzato E, Previato L, Zambon A. Ultrasonographic detection of xanthomas in achilles tendon of patients with heterozygous familial hypercholesterolemia. Atherosclerosis 2018. [DOI: 10.1016/j.atherosclerosis.2018.06.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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9
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Prosdocimi M, Scattolo N, Zatta A, Fabris F, Stevanato F, Girolami A, Cella G. Clearance and In Vivo Release by Heparin of Human Platelet Factor 4 (PF4) in the Rabbit. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1661162] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Summary13 male New Zealand rabbits were injected with two different doses (25 μg/Kg and 100 μg/Kg) of human platelet factor 4 antigen (PF4). The disappearance of the protein was extremely fast with an half-life for the fast component of 1.07 ± 0.16 and 1.76 ± 0.11 min respectively. The half-life for the slow component, detectable only with the highest dosage, was 18.8 min.The administration of 2500 I.U. of heparin 30 min after PF4 administration induced a partial release of the injected protein and its clearance from plasma was slow, with half-life of 23.3 ± 5.9 min and 30.9 ± 2.19 min respectively.
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Affiliation(s)
- M Prosdocimi
- The Fidia Research Laboratories, Dept, of Cytopharmacology, Abano Terme, Italy
| | - N Scattolo
- The Istituto Semeiotica Medica, 2nd Chair of Medicine, University of Padova Medical School, Padova, Italy
| | - A Zatta
- The Fidia Research Laboratories, Dept, of Cytopharmacology, Abano Terme, Italy
| | - F Fabris
- The Istituto Semeiotica Medica, 2nd Chair of Medicine, University of Padova Medical School, Padova, Italy
| | - F Stevanato
- The Istituto Semeiotica Medica, 2nd Chair of Medicine, University of Padova Medical School, Padova, Italy
| | - A Girolami
- The Istituto Semeiotica Medica, 2nd Chair of Medicine, University of Padova Medical School, Padova, Italy
| | - G Cella
- The Istituto Semeiotica Medica, 2nd Chair of Medicine, University of Padova Medical School, Padova, Italy
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10
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Fabris F, Randi M, Casonato A, Luzzato G, Mazzucato M, Girolami A. The Significance of Plasma and/or Platelet Activated Products After Apheresis Procedures. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1665268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- F Fabris
- Institute of Medical Semiotics and Second Chair of Medicine, University of Padua Medical School, Padua, Italy
| | - M Randi
- Institute of Medical Semiotics and Second Chair of Medicine, University of Padua Medical School, Padua, Italy
| | - A Casonato
- Institute of Medical Semiotics and Second Chair of Medicine, University of Padua Medical School, Padua, Italy
| | - G Luzzato
- Institute of Medical Semiotics and Second Chair of Medicine, University of Padua Medical School, Padua, Italy
| | - M Mazzucato
- Institute of Medical Semiotics and Second Chair of Medicine, University of Padua Medical School, Padua, Italy
| | - A Girolami
- Institute of Medical Semiotics and Second Chair of Medicine, University of Padua Medical School, Padua, Italy
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11
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Zanon RDB, Fornasiero L, Boscaro M, Cappellato G, Fabris F, Girolami A. Increased Factor VIII Associated Activities in Cushing's Syndrome: A Probable Hypercoagulable State. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1657142] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
SummaryThirteen women and 2 men affected by Cushing’s syndrome were investigated. The following parameters were used: plasma and urinary cortisol levels, factor VIII assay (antigen, activity and von Willebrand factor) together with other coagulative assays.Samples were taken before surgery or before medical and/or radiation therapy and every 30–50 days after treatment and continued for 11 months. Cortisol and factor VIII were increased before treatment and decreased slowly after treatment to become normal in 3–4 months. Other clotting tests did not show significant changes. It seems that high plasma cortisol levels may stimulate the production of factor VIII. Patients with Cushing’s syndrome often exhibit thromboembolic complications after surgery. It is likely that the clotting abnormalities responsible for such complications is the increased factor VIII activities level.
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Affiliation(s)
- R Dal Bo Zanon
- The University of Padua Medical School, Institute of Medical Semeiotics and Second Chair of Medicine, Padua, Italy
| | - L Fornasiero
- The University of Padua Medical School, Institute of Medical Semeiotics and Second Chair of Medicine, Padua, Italy
| | - M Boscaro
- The University of Padua Medical School, Institute of Medical Semeiotics and Second Chair of Medicine, Padua, Italy
| | - G Cappellato
- The University of Padua Medical School, Institute of Medical Semeiotics and Second Chair of Medicine, Padua, Italy
| | - F Fabris
- The University of Padua Medical School, Institute of Medical Semeiotics and Second Chair of Medicine, Padua, Italy
| | - A Girolami
- The University of Padua Medical School, Institute of Medical Semeiotics and Second Chair of Medicine, Padua, Italy
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12
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Fabris F, Randi M, Casonato A, Scattolo N, Girolami A. Platelet Serotonin and Platelet Aggregation in the Differential Diagnosis of Thrombocytosis. Thromb Haemost 2018. [DOI: 10.1055/s-0038-1657298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- F Fabris
- Institute of Medical Semeiotics and Second Chair of Medicine, University of Padua Medical School, Padua, Italy
| | - M Randi
- Institute of Medical Semeiotics and Second Chair of Medicine, University of Padua Medical School, Padua, Italy
| | - A Casonato
- Institute of Medical Semeiotics and Second Chair of Medicine, University of Padua Medical School, Padua, Italy
| | - N Scattolo
- Institute of Medical Semeiotics and Second Chair of Medicine, University of Padua Medical School, Padua, Italy
| | - A Girolami
- Institute of Medical Semeiotics and Second Chair of Medicine, University of Padua Medical School, Padua, Italy
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13
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Affiliation(s)
- M L Randi
- Institute of “Semeiotica Medica”, University of Padua Medical School, Padua, Italy
| | - F Fabris
- Institute of “Semeiotica Medica”, University of Padua Medical School, Padua, Italy
| | - A Casonato
- Institute of “Semeiotica Medica”, University of Padua Medical School, Padua, Italy
| | - A Girolami
- Institute of “Semeiotica Medica”, University of Padua Medical School, Padua, Italy
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14
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Abstract
ZusammenfassungDie kongenitalen und erworbenen Faktor-VII-Mangelzustände und Varianten sind jetzt gut bekannte klinische Einheiten. Der kongenitale Faktor-VII-Mangel ist eine autosomal inkomplett rezessiv vererbte Erkrankung. Er ist charakterisiert durch den Mangel an Faktor-VII-Aktivität und Faktor-VII-Antigen (echter Mangel) oder durch den Mangel an Aktivität und verschiedene Mengen von Antigen (Variante oder abnorme Formen). Außerdem zeigen einige Patienten mit normalem Faktor-VII-Antigen eine unterschiedliche Reaktivität mit verschiedenen Gewebethrombo-plastinen. Faktor VII Padua z.B. zeigt eine normale Reaktivität mit Ochsenhirn-Thromboplastin und eine niedrige Aktivität mit Kaninchenhirn-Thromboplastin. Die Klassifizierung des kongenitalen Faktor-VII-Defektes muß daher beide Fakten berücksichtigen, nämlich das Fehlen oder die Gegenwart von Antigen (VII_, VIIred und VII+) und die Reaktivität mit Gewebethromboplastin verschiedener Herkunft. Die Blutungsmanifestationen sind variabel und nicht spezifisch. In schweren Fällen sind Hämarthro-sen beschrieben worden. Bei manchen Patienten ist die Blutungsneigung mild. Gelegentlich sind auch thrombo-embolische Manifestationen beschrieben worden, was bedeutet, daß ein Mangel an Faktor VII kein Schutz gegen thrombotische Phänomene ist. Die Diagnose des Faktor-VII-Defekts basiert auf dem Nachweis einer verlängerten Prothrombinzeit gemeinsam mit einer normalen partiellen Throm-boplastinzeit und Stypven-Cephalin-Gerinnungszeit. Der Faktor-VII-Aktivitätstest kann unterschiedlich stark vermindert sein und Gewebethrombo-plastine verschiedener Herkunft sollten in diesem Test verwendet werden. Bei Fällen mit klassischem Mangel wird keine sichere Diskrepanz bei Verwendung verschiedener Thromboplastine beobachtet. Ein immunologischer Test ist notwendig, wenn eine Diskrepanz von mehr als 15% bei einem Faktor-VII-Aktivitätsspiegel von 40-60% der Norm erhalten wird und die Patienten vollständig asymptomatisch sind. Die Substitutionstherapie beruht auf der Verabreichung von Plasma, Prothrombinkomplex-Konzentraten und Faktor-VII-Kon-zentraten. Eine große Häufigkeit von Virushepatitis scheint die Verwendung der Faktor-VII-Konzentrate einzuschränken. Erworbene Faktor-VII-Defekte sind mit dem Mangel an anderen Faktoren des Prothrombinkom-plexes verbunden.
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15
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Abstract
We report the case of a 65-year-old man who developed a symptomatic splenomegaly due to spleen metastasis from thyroid follicular carcinoma. In 1982, at the age of 53, the patient had undergone a thyroid lobectomy for a cold node, followed one year later by a second intervention for a microfollicular adenoma. He was subsequently administered thyroid suppressive therapy with no further follow-up. The diagnosis of spleen metastases from thyroid cancer was first suspected on the basis of history, high serum thyroglobulin (Tg) levels, and the presence of pulmonary 99Tc uptake. The patient underwent a splenectomy, during which vast infiltration involving the diaphragm, spleen, stomach, colon and pancreas, was found. Histological and immunohistochemical results showed that the spleen and diaphragm metastases derived from thyroid follicular carcinoma. Radioiodine uptake by the pulmonary metastases confirmed the thyroid source. Retrospective re-evaluation of the thyroid tissue removed in 1983 revealed a histological pattern consistent with follicular carcinoma, which could not be unequivocally attributed to the widely or minimally invasive form. To our knowledge this is the first report of splenomegaly as the first manifestation of thyroid cancer metastases. In this paper cases of splenomegaly due to metastatic spread are reviewed and the management of the present case is discussed.
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Affiliation(s)
- R Paolini
- IVth Chair of Internal Medicine, University of Padua Medical School, Italy
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Dittadi R, Meo S, Fabris F, Gasparini G, Contri D, Medici M, Gion M. Validation of Blood Collection Procedures for the Determination of Circulating Vascular Endothelial Growth Factor (VEGF) in Different Blood Compartments. Int J Biol Markers 2018. [DOI: 10.1177/172460080101600202] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Aims of the study. Studies on circulating VEGF have reported mixed results, possibly due to a lack of standardization of the pre-analytical phase. The aim of our investigation was to standardize the sampling procedure for the determination of VEGF in different blood fractions. Basic procedures. We evaluated various clotting times for obtaining serum in 30 subjects, as well as different procedures for the preparation of plasma Edinburgh anticoagulant mixture (EDTA, PGE1, theophylline) and CTAD. VEGF was also assayed in lysed whole blood. In vitro platelet activation was monitored by measuring the levels of PF4. VEGF and PF4 were measured using commercially available enzyme-linked immunoassays. Main findings. Clotting time increased the release of VEGF, which reached a plateau between 2 and 4 hours. The percent increase of VEGF at 2 hours ranged from 118% to 4515% (median 327%) compared to samples centrifuged within 10 min from withdrawal. VEGF was not different and PF4 was very low or undetectable in Edinburgh plasma and CTAD plasma, while it was significantly higher in sodium citrate plasma. VEGF in CTAD plasma was not correlated with platelet count or leukocytes. Serum VEGF did not correlate with the leukocyte number, but it correlated significantly with the platelet count. Principal conclusions. The procedures for sample collection described above are highly standardized and easy to perform in a routine setting. We therefore suggest systematic evaluation of VEGF in CTAD plasma, in serum (clotting for 2 hours at room temperature) and in whole blood, until prospective controlled clinical studies will have clarified in which blood compartment(s) VEGF provides clinically relevant information.
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Affiliation(s)
- R. Dittadi
- Center for the Study of Biological Markers of Malignancy, Regional General Hospital ULSS 12, Venice
| | - S. Meo
- Center for the Study of Biological Markers of Malignancy, Regional General Hospital ULSS 12, Venice
| | - F. Fabris
- Department of Surgical and Medical Sciences, University of Padua, Padua
| | - G. Gasparini
- Division of Medical Oncology, Azienda Complesso Ospedaliero S. Filippo Neri, Rome
| | - D. Contri
- Central Laboratory, Regional General Hospital ULSS 12, Venice
| | - M. Medici
- Division of Medical Oncology, Regional General Hospital ULSS 12, Venice - Italy On behalf of the Quality Control Committee in Laboratory Oncology
| | - M. Gion
- Center for the Study of Biological Markers of Malignancy, Regional General Hospital ULSS 12, Venice
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Panzavolta C, Benvegnù L, Aghi A, Biolo M, Giannini S, Noale M, Tripepi G, Plebani M, Veronese N, Messa P, Rossini M, Gallieni M, Sella S, Fabris F, Manzato E, Previato L, Bertocco S, Zambon A, Fusaro M, Zambon S. Statin therapy reduces phospate levels in dialysis patients: Results from the epidemiological vitamin K Italian study (VIKI study). Atherosclerosis 2016. [DOI: 10.1016/j.atherosclerosis.2016.07.437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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18
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Palese A, Ambrosi E, Fabris F, Guarnier A, Barelli P, Zambiasi P, Allegrini E, Bazoli L, Casson P, Marin M, Padovan M, Picogna M, Taddia P, Salmaso D, Chiari P, Marognolli O, Canzan F, Saiani L. Nursing care as a predictor of phlebitis related to insertion of a peripheral venous cannula in emergency departments: findings from a prospective study. J Hosp Infect 2016; 92:280-6. [DOI: 10.1016/j.jhin.2015.10.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2015] [Accepted: 10/19/2015] [Indexed: 11/15/2022]
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19
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Abstract
Improved high yield syntheses of the larger pillar[6]arenes (P[6]) bearing different alkoxy substituents through cation templated syntheses using a series of small organic and organometallic cations is reported.
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Affiliation(s)
- M. Da Pian
- Dipartimento di Scienze Molecolari e Nanosistemi
- Università Ca' Foscari di Venezia
- Mestre (VE)
- Italy
| | - O. De Lucchi
- Dipartimento di Scienze Molecolari e Nanosistemi
- Università Ca' Foscari di Venezia
- Mestre (VE)
- Italy
| | - G. Strukul
- Dipartimento di Scienze Molecolari e Nanosistemi
- Università Ca' Foscari di Venezia
- Mestre (VE)
- Italy
| | - F. Fabris
- Dipartimento di Scienze Molecolari e Nanosistemi
- Università Ca' Foscari di Venezia
- Mestre (VE)
- Italy
| | - A. Scarso
- Dipartimento di Scienze Molecolari e Nanosistemi
- Università Ca' Foscari di Venezia
- Mestre (VE)
- Italy
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Girolami A, Bertozzi I, de Marinis GB, Bonamigo E, Fabris F. Activated FVII levels in factor VII Padua (Arg304Gln) coagulation disorder and in true factor VII deficiency: a study in homozygotes and heterozygotes. Hematology 2013; 16:308-12. [DOI: 10.1179/102453311x13085644680069] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
- A Girolami
- Department of Medical and Surgical SciencesUniversity of Padua Medical School, Italy
| | - I Bertozzi
- Department of Medical and Surgical SciencesUniversity of Padua Medical School, Italy
| | - G Berti de Marinis
- Department of Medical and Surgical SciencesUniversity of Padua Medical School, Italy
| | - E Bonamigo
- Department of Medical and Surgical SciencesUniversity of Padua Medical School, Italy
| | - F Fabris
- Department of Medical and Surgical SciencesUniversity of Padua Medical School, Italy
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21
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Foresta C, Strapazzon G, De Toni L, Fabris F, Grego F, Gerosa G, Vettore S, Garolla A. Platelets express and release osteocalcin and co-localize in human calcified atherosclerotic plaques. J Thromb Haemost 2013; 11:357-65. [PMID: 23206207 DOI: 10.1111/jth.12088] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Although vascular-calcification mechanisms are only partially understood, the role of circulating calcifying cells and non-collagenous bone matrix proteins in the bone-vascular axis is emerging. In spite of the fact that platelets represent a cellular interface between hemostasis, inflammation and atherosclerosis, and have a myeloid precursor, a possible involvement in the modulation of vascular calcification has rarely been investigated. We investigated if osteocalcin (OC) is released by platelets and described OC expression in patients with carotid artery occlusive disease. METHODS Expression and release of OC were determined by Western blot, immunofluorescence, fluorescence-activated cell sorting (FACS) and ELISA in human resting and activated platelets and megakaryocytes. Co-localization of platelet aggregates, macrophages, OC and calcifications was studied in carotid endarterectomy specimens and normal tissues. RESULTS Human platelets expressed OC and co-localized with CD63 in δ-granules. Upon activation with an endogenous mechanism, platelets released OC in the extracellular medium. Expression of OC in megakaryocytes suggested lineage specificity. The OC count in circulating platelets and the released amount were significantly higher in patients with carotid artery occlusive disease than in healthy controls (P < 0.0001) in spite of similar serum levels. In atherosclerotic plaques, OC strongly overlapped with CD41+ platelets in the early stage of calcification, but this was not seen in normal tissues. CD68+OC+ cells were present at the periphery of the calcified zone. CONCLUSIONS Given the active role played by platelets in the atherosclerotic process, the involvement of OC release from platelets in atherosclerotic lesions and the impact of genetic and cardiovascular risk factors in mediating bone-marrow preconditioning should be investigated further.
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Affiliation(s)
- C Foresta
- Section of Clinical Pathology and Human Reproduction Pathology Service, Department of Histology, University of Padova, Padova, Italy.
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22
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Marchini C, Fornasier A, Fabris F, Lo Cascio C, Marsala SZ. P4.14 Segmental analysis of orthodromic sensitive conduction velocity in distal tracts of tibial nerve with superficial electrodes derivation: normative data. Clin Neurophysiol 2011. [DOI: 10.1016/s1388-2457(11)60253-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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23
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Ferrario E, Molaschi M, Cappa G, Seccia L, Villata E, Fabris F. Nutritional patterns in elderly patients with dementia of Alzheimer type. Arch Gerontol Geriatr 2009; 22 Suppl 1:23-7. [PMID: 18653002 DOI: 10.1016/0167-4943(96)86907-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Body weight and some nutritional serum parameters (albumin, urea nitrogen, creatinine, glycemia, hemoglobin, total cholesterol, triglycerides, potassium) were analyzed in 44 subjects aged over 60 in order to evaluate weight loss and its possible link with the progression of dementia. Patients were consecutively admitted to our Day Hospital with the complaint of psychogeriatric symptoms. They all were living at home, no one presented risk factors for malnutrition and their cognitive impairment did not exceed the 4th degree of GDS (Global Deterioration Scale). Subjects were divided into two groups on the basis of diagnosis at discharge: (i) Possible or probable dementia of Alzheimer type (30 subjects, mean age 72.1 +/- 5.9 years), (ii) Age-associated memory impairment (14 subjects, mean age 73.6 +/- 6.2 years). One year later, a second control of body weight and nutritional parameters was performed. Differences between these latter measures versus the initial values were not significant when analyzed in the total group of demented patients or in the subgroups with different degree of cognitive impairment and physical activity. A possible hypothesis to explain the absence of differences among groups is that the caregivers were very carefully looking after all the patients examined.
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Affiliation(s)
- E Ferrario
- Institute of Gerontology, University of Turin, Corso Bramante 88, l-10126 Torino, Italy
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24
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Paternoster DM, Cester M, Memmo A, Scandellari R, Fabris F, Girolami A. The management of feto-maternal alloimmune thrombocytopenia: Report of three cases. J Matern Fetal Neonatal Med 2009; 19:517-20. [PMID: 16966118 DOI: 10.1080/14767050600746563] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We report herein three cases of severe fetal thrombocytopenia due to anti-human platelet antigen (HPA)- 1a maternal antibodies. The first and the third cases were diagnosed on the basis of previously affected siblings and treated successfully by maternal intravenous human immunoglobulins and corticosteroids. In the second case an unexpected neonatal thrombocytopenia was found after birth without previously affected siblings and treated subsequently with intravenous immunoglobulins. Our experience supports a switch from an invasive management, including early FBS (fetal blood sampling) and platelet transfusions, to a more cautious approach. Also in severe HPA-1a alloimmunization and in 'high risk' fetuses, prenatal maternal treatment could be performed, without previous FBS, only on the basis of a risk score defined by sibling history and parents' genotypes.
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Affiliation(s)
- D M Paternoster
- Department of Gynaecological Sciences and Human Reproduction, University of Padova, Padova, Italy.
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25
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Vettore S, Scandellari R, Moro S, Lombardi AM, Scapin M, Randi ML, Fabris F. Novel point mutation in a leucine-rich repeat of the GPIb chain of the platelet von Willebrand factor receptor, GPIb/IX/V, resulting in an inherited dominant form of Bernard-Soulier syndrome affecting two unrelated families: the N41H variant. Haematologica 2008; 93:1743-7. [DOI: 10.3324/haematol.12830] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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26
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Marson P, Bagatella P, Bortolati M, Tison T, De Silvestro G, Fabris F, Pengo V, Ruffatti A. Plasma exchange for the management of the catastrophic antiphospholipid syndrome: importance of the type of fluid replacement. J Intern Med 2008; 264:201-3. [PMID: 18341530 DOI: 10.1111/j.1365-2796.2008.01942.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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27
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Girolami A, Fabris F, Casonato A, Randi ML. Potentiation of anticoagulant response to warfarin by sulphinpyrazone: a double-blind study in patients with prosthetic heart valves. Clin Lab Haematol 2008; 4:23-6. [PMID: 7067372 DOI: 10.1111/j.1365-2257.1982.tb00055.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
The effect of Sulphinpyrazone on the anticoagulant response to Warfarin was evaluated by a double-blind study in 11 patients with prosthetic heart valves. Six patients received Warfarin and Sulphinpyrazone and 5 Warfarin and placebo. Sulphinpyrazone potentiated the anticoagulant effect of Warfarin. Patients receiving Sulphinpyrazone needed about half the amount of Warfarin as compared to the control group. There were four bleeding episodes in the Sulphinpyrazone group and one episode in the control group. It was difficult to regulate the dose of Warfarin in patients also receiving Sulphinpyrazone.
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28
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Randi ML, Fabris F, Rossi C, Girolami A. Which tests are most useful in distinguishing between reactive thrombocytosis and the thrombocytosis of myeloproliferative disease? Clin Lab Haematol 2008; 14:267-8. [PMID: 1451409 DOI: 10.1111/j.1365-2257.1992.tb00376.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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29
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Taino G, Gazzoldi T, Marandola P, Fabris F, Ferrari M, Imbriani M. [Work integration of impaired workers in a type-B social cooperative]. G Ital Med Lav Ergon 2008; 30:155-161. [PMID: 19068863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
This research aims to evaluate job occupation results of impaired workers in a type-B social cooperative, taking into consideration not only specific occupational risks' analysis and assessment, but also organisational, relational and psycho-social matters essential for their stable job occupation. The impaired workers involved were all those hired by a type-B social cooperative from Jan 1999 until Dec 2007, ie. 16 workers (M 8, F 8), equal to 40% of employees' total number. Every impaired worker has been submitted to preventive health surveillance in order to evaluate the degree of disability and residual job ability in relation to the job tasks suitable for him/her. In order to find available tasks which can be performed by disadvantaged workers, the personnel chart has been analyzed, and 10 of the 16 workers (equal to 62.5%) have been considered fit for the specific task without limitations. The other 6 (37.5%) have been considered capable of the specific task with limitations and/or prescriptions, and for 2 of them (12.5%) a tutorial supervision prescription was also necessary. Among those 6 workers with limitations and/or prescriptions, 4 were psychologically impaired (67%) and 2 were physically impaired (37%). The situation of these 16 impaired workers has been periodically verified and followed up for 8 years. Not only have the fifteen workers continued to perform the task initially considered suitable for their health status, but for some of them (5 workers), an increase in job performance, in both complexity and shift duration, has been observed. Moreover, with the only exception of a psychologically impaired worker who did alternate between good comfort times and occasional disease acute phases, all other workers have shown good and stable gains in psychological and physical health conditions, performing requested tasks not only with efficiency, but also with commitment and motivation. All workers have shown a remarkable improvement in their ability to form relationships, mainly within the work environment amongst colleagues and supervisors, but also in a social and family environment. A special mention is deserved in the case of the only worker hired in our research who left the cooperative after many years of work activity where, after having attended specific professional courses, steadily and successfully joined a company still in the social field but not exclusively dedicated to impaired workers. It may be observed that when one faces the work integration of impaired workers, the usual risk evaluation processes cannot be enough for the reason that these workers, due to their 'disability', find themselves in hypersusceptible conditions in respect to occupational risk factors which are generally acceptable for the other workers. In risk assessment it is therefore necessary to perform an accurate and all-round study in every aspect of the job duty, even around those considered irrelevant which, as a result, may show to be unsuitable to the worker's health status or might alter his/her often precarious psychological-physical condition. In conclusion, in the risk assessment process used prior to the work integration of impaired workers considered by our research, the organisational, relational and psycho-social aspects of work activity have often played a primary role in respect to traditional risk factors usually monitored and evaluated.
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Affiliation(s)
- G Taino
- U.O. Medicina Ambientale e Medicina Occupazionale, IRCCS Fondazione Salvatore Maugeri, Pavia, Italy
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30
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Peyvandi F, Lavoretano S, Palla R, Feys HB, Vanhoorelbeke K, Battaglioli T, Valsecchi C, Canciani MT, Fabris F, Zver S, Reti M, Mikovic D, Karimi M, Giuffrida G, Laurenti L, Mannucci PM. ADAMTS13 and anti-ADAMTS13 antibodies as markers for recurrence of acquired thrombotic thrombocytopenic purpura during remission. Haematologica 2008; 93:232-9. [DOI: 10.3324/haematol.11739] [Citation(s) in RCA: 197] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Castelli R, Cassinerio E, Cappellini MD, Porro F, Graziadei G, Fabris F. Heparin induced thrombocytopenia: pathogenetic, clinical, diagnostic and therapeutic aspects. Cardiovasc Hematol Disord Drug Targets 2007; 7:153-62. [PMID: 17896955 DOI: 10.2174/187152907781745251] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Heparin induced thrombocytopenia (HIT) in addition to bleeding complications are the most serious and dangerous side effects of heparin treatment. HIT remains the most common antibody-mediated, drug-induced thrombocytopenic disorder and a leading cause of morbidity and mortality. Two types of HIT are described: Type I is a transitory, slight and asymptomatic reduction of platelet count occurring during 1-2 days of therapy. HIT type II, which has an immunologic origin, is characterized by a thrombocytopenia that generally onset after the fifth day of therapy. Despite thrombocytopenia, haemorrhagic complications are very rare and HIT type II is characterized by thromboembolic complications consisting in venous and arterial thrombosis. The aim of this paper is to review new aspects of epidemiology, pathophysiology, clinical features, diagnosis and therapy of HIT type II. There is increasing evidence that platelet factor 4 (PF4) displaced from endothelial cells, heparan sulphate or directly from the platelets, binds to heparin molecule to form an immunogenic complex. The anti-heparin/PF4 IgG immune-complexes activates platelets through binding with the Fcgamma RIIa (CD32) receptor inducing endothelial lesions with thrombocytopenia and thrombosis. Cytokines are generated during this process and inflammation could play an additional role in the pathogenesis of thromboembolic manifestations. The onset of HIT type II is independent from dosage, schedule, and route of administration of heparin. A platelet count must be carried out prior to heparin therapy. Starting from the fourth day, platelet count must be carried out daily or every two days for at least 20 days of any heparin therapy regardless of the route of the drug administration. Patients undergoing orthopaedic or cardiac surgery are at higher risk for HIT type II. The diagnosis of HIT type II should be formulated on basis of clinical criteria and confirmed by in vitro demonstration of heparin-dependent antibodies detected by functional and antigen methods. However, the introduction of sensitive ELISA tests to measure anti-heparin/PF4 antibodies has showed the immuno-conversion in an higher number of patients treated with heparin such as the incidence of anti-heparin/PF4 exceeds the incidence of the disease. If HIT type II is likely, heparin must be immediately discontinued, even in absence of certain diagnosis of HIT type II, and an alternative anticoagulant therapy must be started followed by oral dicumaroids, preferably after resolution of thrombocytopenia. Further studies are required in order to elucidate the pathogenetic mechanism of thrombosis and its relation with inflammation; on the other hand large clinical trials are needed to confirm the best therapeutic strategies for HIT Type II.
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Affiliation(s)
- R Castelli
- Department of Medicine and Medical Specialities Division of Internal Medicine, IRCCS Fondazione Ospedale Maggiore Policlinico of Milan, Via Pace 9 Milan, Italy. Castelli39@interfree
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Taino G, Gazzoldi T, Marandola P, Valoti E, Fabris F, Imbriani M. [Reactive anxiety crisis: a unique case of work injury]. G Ital Med Lav Ergon 2007; 29:630-631. [PMID: 18409875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The present study aims to describe a unique case in view of the disease diagnosed, the conditions of onset and the management by INAIL (Italian National Institute of Insurance for Injuries at Work and Occupational Diseases). A worker, after a verbal, animated dispute with some collegues, had an acute psychiatric agitation attack and went to the nearest emergency room, where he was investigated. No neuropsychiatric alteration was diagnosed, but based on anamnestic data, the physicians diagnosed an anxiety crisis reactive to work environment. A medical certificate for injury at work was produced and sent to the Insurance Board (INAIL). The worker was off work for 105 days diagnosed with a persistent anxious depressive syndrome, secondary to the traumatic event. INAIL reassessed the case later and confirmed only the first 30 days as due to work accident, while the following period was judged as related to affectivity disturbance due to common disease, not to work environment. Our case opens new perspective for the occupational physician in the assessment of ASD as work injury and of PTSD as professional disease, suggesting to give more attention to psychiatric health of workers.
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Affiliation(s)
- G Taino
- U.O. Medicina Ambientale e Medicina Occupazionale, IRCCS Fondazione Salvatore Maugeri, Pavia.
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33
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Casonato A, Fabris F, Pontara E, Cattini MG, Zocca N, Gallinaro L, Girolami A, Pagnan A. Diagnosis and follow-up of thrombotic thrombocytopenic purpura by means of von Willebrand factor collagen binding assay. Clin Appl Thromb Hemost 2006; 12:296-304. [PMID: 16959682 DOI: 10.1177/1076029606291385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Thrombotic thrombocytopenic purpura (TTP) is characterized by intravascular thrombosis leading to consumption of large or unusually large von Willebrand factor (VWF) multimers. The usefulness of VWF collagen binding (VWF:CB) assay was assessed in detecting the decrease/absence of large VWF multimers or the presence of abnormally large forms in patients with TTP. Nine patients with TTP were studied during the acute phase of the disorder and the absence of large VWF multimers was demonstrated by means of the VWF:CB assay. These findings were confirmed by VWF multimer pattern analysis; VWF:CB deficiency appeared to correlate with abnormalities in large VWF multimers. The diagnostic potency of VWF:CB was especially evident when the values were expressed as VWF:CB/VWF:Ag ratio. VWF:CB was also used during the follow-up of the disorder to document improvement or restoration of large VWF multimers. VWF:CB was able to detect the absence or decrease of large VWF multimers better than VWF ristocetin cofactor (VWF:RCo); in fact, VWF:CB was defective when large VWF multimers persisted to be decreased, in contrast with what observed with VWF:RCo. In conclusion, VWF:CB is a simple test that appears to be useful, together with clinical symptoms and reduced platelet count, for the diagnosis and follow-up of TTP.
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Affiliation(s)
- A Casonato
- University of Padua Medical School, Italy.
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34
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Taino G, Ferrari M, Mestad IJ, Fabris F, Imbriani M. [Asthenopia and work at video display terminals: study of 191 workers exposed to the risk by administration of a standardized questionnaire and ophthalmologic evaluation]. G Ital Med Lav Ergon 2006; 28:487-97. [PMID: 17380951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
VDT (Visual Display Terminals) are commonly used in a wide range of occupational fields. Over the last ten years a number of studies have shown that ocular symptoms are the form of discomfort most frequently experienced by subjects who work at VDT. The symptoms as a whole characterize a complex syndrome named "asthenopia" and have been seen as a consequence of prolonged, fixed and closely oriented vision. In our study we have evaluated data derived from a standardized questionnaire (a series of questions elaborated and promoted by the Italian Society of Occupational Medicine and Industrial Hygiene). It was administered to a group of 191 workers who utilise VDT for more than 20 hours each week. We also took into consideration the results of ophthalmologic medical examinations performed on this particular group of workers. Prevalence of occupational asthenopia we found to be lower in this group than in the case of other reported investigations, though it proved to be higher in the case of female subjects. According to the Literature, symptoms intensity is related to the duration of weekly VDT use, there being no significant association with the number of years spent working at VDT. Our results show that prevalence of asthenopia was not significantly influenced by refractive alterations and this unexpected outcome might be explained by taking into account the small-size group of subjects affected by hypermetropic defects. It is well known that these are the most important factors in conditioning asthenopia. Our finding indicates the need for further research, which should include a larger group of VDT workers with refractive alterations and furthermore take into consideration environmental variables such as climate and illumination, since these are co-aetiological factors, known or suspected, of occupational asthenopia.
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Affiliation(s)
- G Taino
- IRCCS Fondazione S. Maugeri, Istituto Scientifico di Pavia, U.O. Medicina Ambientale e Medicina Occupazionale
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Girolami A, Ruzzon E, Fabris F, Varvarikis C, Sartori R, Girolami B. Myocardial infarction and other arterial occlusions in hemophilia a patients. A cardiological evaluation of all 42 cases reported in the literature. Acta Haematol 2006; 116:120-5. [PMID: 16914907 DOI: 10.1159/000093642] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2005] [Accepted: 02/02/2006] [Indexed: 01/16/2023]
Abstract
Myocardial infarction and other arterial occlusions are considered to be rare in hemophilia A. However, a systematic study of the subject has never been attempted. All case reports of myocardial infarction or other arterial occlusions have been now gathered and properly evaluated from a cardiological point of view. Thirty-six patients with myocardial infarction and 6 patients with documented cerebrovascular event were retrieved from the literature. The age of the patients varied between 7 and 79 years, with a mean of 44 years. In 16 cases, the arterial occlusion occurred in men <40 years of age. The majority of myocardial infarctions (MIs) were anterolateral (12 cases). Posterior-inferior MI was present in 6 cases whereas it was of the non-Q type in 4 patients. It was multiple in 6 cases, and in the remaining patients the type of infarction could not be determined. In 26 cases, the thrombotic event (22 myocardial infarctions and 4 ischemic cerebrovascular accidents) occurred during or after the infusion of factor VIII concentrates and, more frequently, after prothrombin complex concentrates (activated or non-activated ones) or recombinant factor VIIa preparations. In 3 cases, the vascular complication occurred after intravenous desmopressin administration. MI was fatal in 7 instances. After the event, signs and symptoms of heart failure were seen as sequels in 7 patients. One patient had to undergo cardiac transplant 5 months after the MI. No death occurred after ischemic cerebrovascular accidents. Since not all hemophilia patients develop inhibitors and therefore are not usually treated with activated concentrates, this series of patients is somewhat biased and does not allow general conclusions. The high prevalence of MI and other arterial complications which occurred after transfusion therapy, usually in patients with inhibitors, clearly indicates the need for a careful evaluation of the appropriate therapeutic approach in each single patient.
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Affiliation(s)
- A Girolami
- Department of Medical and Surgical Sciences, University of Padua Medical School, Padua, Italy.
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Randi ML, Ruzzon E, Tezza F, Tezza F, Pacquola E, Fabris F. Monoclonal gammopathy in human leishmaniasis. Neth J Med 2006; 64:50-1. [PMID: 16517989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
A 64-year-old female with IgGk monoclonal components (total 45 g/l) and 30% abnormal plasma cells and plasmoblasts in bone marrow is reported. After the identification of leishmania in the bone marrow, liposomal amphotericin B was used and a progressive resolution of the gammopathy was documented.
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Affiliation(s)
- M L Randi
- Department of Medical and Surgical Sciences, Internal Medicine, University of Padua Medical School, Padua, Italy.
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Randi ML, Putti MC, Pacquola E, Luzzatto G, Zanesco L, Fabris F. Normal thrombopoietin and its receptor (c-mpl) genes in children with essential thrombocythemia. Pediatr Blood Cancer 2005; 44:47-50. [PMID: 15390356 DOI: 10.1002/pbc.20185] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Following the observation of thrombopoietin (TPO) gene abnormalities as the cause of familiar cases of thrombocythemia similar derangements of TPO and/or its receptor (c-mpl) might be surmised to be at the root of increased platelet count also in non-familiar (sporadic) cases. Although this was not demonstrated in adults, little data exist about childhood. PROCEDURES We studied the molecular biology of TPO and c-mpl in seven children with non-familiar essential thrombocythemia (ET) and one child with secondary thrombocytosis (ST). Plasma TPO content was measured using a commercially available kit. Genomic DNA was extracted from whole blood by standard methods and TPO and c-mpl genes were amplified by polymerase chain reaction (PCR) and sequenced. RESULTS Plasma TPO levels were normal in all our patients. No alteration was detected in either coding region, including the flanking intronic sequences of TPO and c-mpl genes. As compared to the published normal sequence of the TPO gene, one allelic base change in a non-coding region of intron 1 was found in all children with ET and ST, but this was reported as a common finding in normal subjects as well. CONCLUSIONS High platelet count in our series of sporadic ET of childhood is not due to an abnormality either of TPO or c-mpl gene.
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Affiliation(s)
- M L Randi
- Department of Medical and Surgical Sciences, University of Padua Medical School, Padua, Italy.
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Girolami A, Zocca N, Girolami B, Lombardi AM, Fabris F. Pregnancies and Oral Contraceptive Therapy in Severe (Homozygons) FXII Deficiency: A Study in 12 Patients and Review of the Literature. J Thromb Thrombolysis 2004; 18:209-12. [PMID: 15815884 DOI: 10.1007/s11239-005-0348-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Twelve women with severe Factor XII (FXII) deficiency were under observation for an average period of about 16 years. During this time, these women had 19 pregnancies without any bleeding or thrombotic complications. The evaluation of the literature has shown that three patients manifested deep vein thrombosis during pregnancy. Five women also showed mild bleeding at delivery . The significance of these findings is not clear since thrombotic and bleeding complications may occur occasionally even in normal women. Five of our patients took oral contraceptive therapy during their fertile life for a variable period of time (2-10 years). No thrombosis was noted in any of these patients. From the scanty data gathered, in this respect, from the literature, it was shown that only three women with severe FXII deficiency took oral contraceptives and no thrombosis was noted. Altogether these results seem to indicate that the FXII deficiency does not play any significant role in the pathogenesis of bleeding and of thrombotic complications in pregnancy. However, the occurrence of deep vein thrombosis in 3 out of the 64 patients for whom sufficient data could be gathered indicates the need for further studies. This is more so if one considers that 3 out of the 6 cases of venous thromboses described altogether in the literature for females with severe FXII deficiency occurred during pregnancy or puerperium.
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Affiliation(s)
- A Girolami
- Departement of Medical and Surgical Science, Second Chair of Medicine, University of Padua Medical School, Padua, Italy
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Fabris F, Molaschi M, Aimonino N, Ponzetto M, Maero B, Tibaldi V, Nicola E, Varetto O, Barresi O, Cavallero ML, Boschis D, Plastino V, Vitale R. Home care for demented subjects: new models of care and home-care allowance. Arch Gerontol Geriatr 2004:155-62. [PMID: 15207409 DOI: 10.1016/j.archger.2004.04.022] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study on home care for demented patients is one of the finalized research projects sponsored by the Ministry of Health. The teams involved are: the Home Hospitalization Service (HHS) of S. Giovanni Battista Hospital of Torino, the "Azienda Sanitaria Locale n 20" (ASL 20) of Alessandria and Tortona and the "Presidio Ospedaliero Riabilitativo Fatebenefratelli" of San Maurizio Canavese (Torino). Aim of the study is to assess the feasibility and usefulness of taking care of elderly demented patients at home and to improve the quality of life of patients and their relatives, involving training experiences and economic help. The Geriatric Department of San Giovanni Battista Hospital started a randomized controlled study on 109 severely demented subjects admitted to the emergency room of the hospital. Fifty-three patients were transferred to the traditional geriatric ward and 56 to the HHS. The team of ASL 20 of Alessandria and Tortona selected and evaluated 45 elderly demented patients living at home. These subjects, stratified for their cognitive and functional impairment, were randomly allocated to two different groups: a group receiving an economic help for one year and a control group. In the first setting of research the degree of dementia was severe, mini mental state examination (MMSE) score was 10.0 +/- 5.2 for patients at home, and 10.5 +/- 6 for the second group. The majority of patients followed at home (78.6 %) were discharged, while only 47.2 % of the in-patients returned home (p < 0.001). Seventeen out of 53 patients (32.1 %) admitted to the traditional ward and only two of home-hospitalization patients had to be sent to nursing home (p <0.001). The 45 subjects evaluated by the team of ASL 20 were divided into two groups.Twenty-four subjects were allocated to receive a home care allowance. Their functional status was impaired. Their MMSE score was 12.6 +/- 5.4 and clinical dementia rating scale(CDR) score 2.7 +/- 0.9. A control group of 21 subjects (17 women and 4 men) showed similar characteristics as the previously described group.
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Affiliation(s)
- F Fabris
- Dipartimento Patologie ad Alto rischio invalidante, Azienda Ospedaliera San Giovanni Battista -Molinette di Torino, Corso Bramante, 88, I-1 0126 Tori-no, Italy
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de Franchis R, Dell'Era A, Fabris F, Iannuzzi F, Fazzini L, Sotela JC, Reati R, Primignani M. Medical treatment of portal hypertension. Acta Gastroenterol Belg 2004; 67:334-43; discussion 344-5. [PMID: 15727078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
Prevention of the first variceal haemorrhage should start when the patients have developed medium sized to large varices. Non-selective beta-blockers are the first-line treatment; band ligation is roughly equivalent to beta-blockers and is the first choice for patients with contraindications or intolerance to beta-blockers. Treatment of acute bleeding should aim at controlling bleeding and preventing early rebleeding and complications, especially infections. Combined endoscopic and pharmacological treatment with vasoactive drugs can control bleeding in up to 90% of patients. All patients who survive a variceal bleed should be treated with beta-blockers or band ligation to prevent rebleeding. All patients in whom bleeding cannot be controlled or who continue to rebleed can be treated with salvage TIPS or, in selected cases, with surgical shunts. Liver transplantation should be considered for patients with severe liver insufficiency in which first-line treatments fail.
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Affiliation(s)
- R de Franchis
- Department of Internal Medicine, University of Milan, Italy.
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Zanocchi M, Ponzetto M, Francisetti F, Maero B, Giona E, Amati D, Nicola E, Corsinovi L, Cerrato F, Luppino A, Margolicci A, Molaschi M, Fabris F. [The dependence medical index (DMI): validation and comparison with the activity daily living and the instrumental activity daily living]. Minerva Med 2004; 95:143-51. [PMID: 15272249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
AIM The aim of this study was the validation of the dependence medical index (DMI), a disability medical assessment tool in the elderly. METHODS Study sample included 1054 subjects aged 65 and over, consecutively admitted to the University Department of Geriatric Medicine of Turin, Italy. A total of 356 of these subjects was classified as dependent to activity of daily living (ADL) and instrumental activity of daily living (IADL) scales. Some conditions causing medical dependence were detected, such as strength and/or motility impairment, incontinence, pressure sores, disturbances in speech and communication, decline in sight and/or hearing, terminal illness (death expected within 6 months), need for multiple and complex therapies, episodic disorientation, dizziness with tendency to fall, use of the wheel-chair. The relationship between dependence and the DMI was studied by discriminant analysis. A scale was created using the discriminant scores of each 15 medical indications for disability. RESULTS The discriminant model of DMI was validated by cross-validation statistical method: its application permitted to classify correctly 73.1% of the sample. The DMI permitted to classify the dependent subjects in variable percentages: from 67% (DMI score > or =1) to 90% (DMI score > or =7). The best ratio between specificity and sensibility was for score 4 to DMI. CONCLUSION The conclusion is drawn that DMI can be used to detect and evaluate the disability for medical reasons in elderly people.
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Affiliation(s)
- M Zanocchi
- Dipartimento di Discipline Medico Chirurgiche, Università degli Studi di Torino, Sezione di Geriatria, ASO S. Giovanni Battista, Turin, Italy
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Abstract
BACKGROUND AND AIM The relationships between C-reactive protein (CRP) levels, adipose tissue and metabolic alterations have not been clearly established in healthy non-obese subjects. We investigated the relationships between body fat, CRP levels and metabolic variables in healthy, non-obese sons of patients affected by metabolic syndrome (MS). METHODS AND RESULTS Age, CRP and interleukin 6 (IL-6) levels, anthropometric measures (body mass index, BMI; waist circumference and waist-to-hip ratio, WHR), total and regional fat content (as determined by means of dual X-ray absorptiometry, DXA), total and LDL cholesterol, and the metabolic variables related to MS (HDL-cholesterol, triglyceride, glucose and insulin levels; the fasting insulin resistance index, FIRI; blood pressure) were evaluated in 85 healthy non-obese sons of MS patients. Linear and multiple regression analyses were used to evaluate the relationships between body fat, metabolic variables and CRP levels, and to investigate whether the association between body fat content and metabolic variables persists after adjustment for CRP levels. Body fat was associated with all of the investigated variables. CRP levels were associated with total and regional body fat, the anthropometric index of weight, age, and with some metabolic alterations (HDL-cholesterol and triglyceride levels, systolic blood pressure, and fasting insulin and LDL-cholesterol levels). The associations between total body fat and the metabolic variables did not change after adjustment for CRP levels. Total body fat was the best predictor of CRP levels (p<0.0001). CONCLUSIONS In healthy, non-obese sons of MS patients, total body fat is the best predictor of CRP levels, and remains closely associated with metabolic abnormalities after adjustment for CRP levels. These findings strongly support the hypothesis that body fat is the main determinant of metabolic abnormalities and a low inflammatory state, at least in healthy subjects.
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Affiliation(s)
- M Bo
- University of Turin, Department of Medical and Surgical Disciplines, Geriatrics Section, Torino, Italy.
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Tibaldi V, Aimonino N, Ponzetto M, Stasi MF, Amati D, Raspo S, Roglia D, Molaschi M, Fabris F. A RANDOMIZED CONTROLLED TRIAL OF A HOME HOSPITAL INTERVENTION FOR FRAIL ELDERLY DEMENTED PATIENTS: BEHAVIORAL DISTURBANCES AND CAREGIVER’S STRESS. Arch Gerontol Geriatr 2004:431-6. [PMID: 15207444 DOI: 10.1016/j.archger.2004.04.055] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
A Geriatric Home Hospitalization Service (GHHS) has been operating in Torino at S. Giovanni Battista Hospital since 1985. GHHS allows us to perform diagnostic and therapeutic interventions, which are usually made in hospital, also at home. GHHS team includes geriatricians, nurses, physiotherapists, social workers and counselors. Between February 1999 and April 2002, the GHH Service conducted a randomized controlled trial on 109 elderly, demented patients requiring admission to the Hospital Emergency Department (ED)for acute illnesses. Objective of the study was to identify the benefits of the care in a GHHScompared to a general medical ward (GMW) in reducing behavioral disturbances in elderly patients with advanced dementia and in lowering caregiver's stress. Patients were randomly assigned to GHHS (56 patients) or to GMW (53 patients). Both groups were examined using the same protocol and were evaluated on admission and on discharge. All patients had a severe form of dementia as shown by the clinical dementia rating (CDR) scale mean value (3.7 +/- 0.9) with an important functional impairment and a relevant degree of comorbidity.The main reasons for hospitalization were infections, cerebrovascular accidents and malnutrition. Mortality of total sample was 19.3 %, without significant differences in the two settings of care. On discharge, in GHHS patients there was a significant reduction of behavioral disturbances. The use of anti-psychotic drugs was significantly lower in GHHS patients compared to the GMW group (p < 0.001). The stress of caregivers on discharge was reduced only in GHHS group and not in the control ones. In conclusion, we can say that a GHHS continuous support allows us to reduce the family caregiver's stress. When treated at home, demented patients do not have to change their environment or routine and it is possible to have a better control on behavioral disturbances.
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Affiliation(s)
- V Tibaldi
- Department of Medical and Surgical Disciplines, Geriatric Section, University of Torino. Ospedale S. Giovanni Battista, I -10126 Torino, Italy.
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Zanocchi M, Ponzetto M, Scarafiotti C, Maero B, Giona E, Francisetti F, Nicola E, Corsinovi L, Amati D, Fabris F. Is ankle/arm pressure predictive for cardiovascular mortality in older patients living in nursing homes? Panminerva Med 2003; 45:145-50. [PMID: 12855939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
AIM To identify whether Ankle/Arm Index (AAI) is a predictive factor for cardiovascular mortality in institutionalised elderly. METHODS DESIGN longitudinal descriptive study. SETTING 2 large nursing homes in Turin, Italy. SUBJECTS 418 dependent elderly (83 males, 335 females, mean age 83.7+/-8.5 y, range 55-102) living in the nursing homes. MEASUREMENTS the prevalence of peripheral arterial disease (PAD) was evaluated using a Doppler Ultrasound measurement of AAI (Ankle/Arm blood pressure Index). Death causes according to ICD-9-CM were ascertained on patient's clinical records. RESULTS Diagnosis of PAD was made in 122 subjects (29.2%) with AAI <0.90. After a 3 year follow-up 203 patients (48.6%) died. The presence of PAD was not related to total mortality or to mortality for ischemic heart disease (IHD), cerebrovascular disease or other causes. IHD mortality was significantly and independently related to low haemoglobin values, previous cerebrovascular disease, polypharmacy and poor mobility conditions. CONCLUSION The prevalence of PAD is high in nursing home residents. AAI is not predictive for IHD mortality in this population. In very frail elderly traditional risk factors and PAD are less important predictors of death compared to poor functional status, nutritional factors and previous cardiovascular disease.
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Affiliation(s)
- M Zanocchi
- Geriatric Section, Department of Medical and Surgical Disciplines, University of Turin, Turin, Italy.
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Fabris F, Luzzatto G, Soini B, Ramon R, Scandellari R, Randi ML, Girolami A. Risk factors for thrombosis in patients with immune mediated heparin-induced thrombocytopenia. J Intern Med 2002; 252:149-54. [PMID: 12190890 DOI: 10.1046/j.1365-2796.2002.01021.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND As reported by major clinical series in the literature, about 2% of patients receiving unfractionated heparin (UFH) develop immune-mediated (type II) heparin-induced thrombocytopenia (HIT) that may be complicated in 30-75% of cases by a paradoxical thrombotic syndrome (HITTS), either arterial or venous. HITTS carries relevant rates of mortality and morbidity, amongst which cerebral and/or myocardial infarction and limb amputations. It is unclear as yet why some patients suffer from isolated thrombocytopenia (HIT), whilst others have HITTS. The aim of the present study was to look for clinical and laboratory features related to the occurrence of HITTS. PATIENTS AND METHODS We retrospectively analysed the clinical records of 56 patients with proven HIT, as diagnosed on clinical grounds and by in vitro demonstration of immunoglobulin (IgG)/IgM against the PF4/heparin complex. Thirty-four patients (61%) had HITTS (19 venous thrombosis, seven arterial thrombosis, five arterial and venous thrombosis, two skin necrosis, one diffuse intravascular coagulation), whereas 22 had uncomplicated HIT. Amongst HITTS patients, two had limb amputation, five had recurrent thrombosis and seven died. Amongst HIT patients three died from causes unrelated to HIT. RESULTS No significant difference in sex, age, previous exposure to heparin, UFH route of administration or dose, duration of therapy, time of onset of thrombocytopenia and platelet count recovery, nor antiheparin/PF4 antibodies subtype (IgG or IgM) was detected when comparing HIT and HITTS. In contrast, in the HITTS group a higher prevalence of orthopaedic surgery (15 of 34 vs. 2/22; P=0.01), a significantly lower platelet count nadir (43 +/- 32 vs. 75 +/- 63 x 109/L; P=0.01) and a significantly higher titre of antiheparin/PF4 antibodies, expressed as optical density of enzyme-linked immunosorbent assay (ELISA); (1989 +/- 1024 vs. 1277 +/- 858; P=0.009), were observed in comparison with the HIT group. Amongst HITTS patients, the prevalence of venous thrombosis was significantly higher in orthopaedic patients and in those being treated for venous thromboembolism (18/24 vs. 1/9 patients, chi2 8.4, P=0.004), whilst arterial thrombosis (ART) occurred more often in heparin treatment for arterial disease (3/4 vs. 4/29 patients, chi2 4.6, P=0.03). CONCLUSIONS Orthopaedic surgery, the severity of thrombocytopenia and high antiheparin/PF4 antibodies titre are adverse prognostic or concurrent factors in the development of HITTS.
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Affiliation(s)
- F Fabris
- Clinica Medica II, Department of Medical and Surgical Sciences, University of Padua Medical School, Padova, Italy.
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Zanocchi M, Maero B, Maina P, Ponzetto M, Francisetti F, Giona E, Nicola E, Neirotti M, Fabris F. [Factors predicting a prolonged hospital stay in elderly patients]. Minerva Med 2002; 93:135-43. [PMID: 12032445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Abstract
BACKGROUND Aim of our prospective study was to evaluate risk factors for prolonged hospitalization in elderly patients. METHODS The study sample included 1054 patients admitted to University Department of Geriatric Medicine in Turin, Italy. We analysed: demographic variables (age, sex, marital status, economic status and living condition), affective status (GDS), cognitive status (SPMSQ), functional status (ADL-IADL), medical dependence (DMI), medical diagnosis, systolic and diastolic blood pressure, some haematological parameters (haemoglobin, creatinine, albumin, sodium, potassium). RESULTS Average length of stays was 18+/-20.6 days; 178 patients died during hospitalization and their length of stay significantly longer (21.8+/-25.59) than survivors (17.4+/-19.3). We find that DMI dependence, impaired IADL and ADL score were associated with longer hospital stays. Medical diagnosis related to a prolonged hospitalization were: neoplasm, chronic bronchitis, hip fracture and peripheral arterial disease (PAD) with critical ischemia. Longer hospitalisation was associated also with high level of creatinine and low level of albumin and sodium. Indipendent predictors variables of prolonged hospital stay were: ADL impairment, pressure sores, hip fractures, PAD with critical ischemia, low sodium value. CONCLUSIONS Multidimensional assessment among hospitalized elderly allows to identify risk factors for prolonged hospital stay.
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Affiliation(s)
- M Zanocchi
- Dirigente Medico di I livello nell'Unità Operativa e Direzione Universitaria Geriatria, Università degli Studi di Torino, Azienda Ospedaliera S. Giovanni Battista, Turin, Italy
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47
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48
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Affiliation(s)
- M Ponzetto
- Medical and Surgical Department, Geriatric Section, University of Torino, Italy
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Abstract
Essential thrombocythaemia (ET) is usually considered a disease of the middle-aged but, with the advent of automated platelet counting, ET is diagnosed with increasing frequency in young adults and, even more rarely, in children. We report five paediatric patients (four girls and one boy, mean age 89 months) diagnosed with ET in agreement with Polycythaemia Vera Study Group criteria. The patients had a persistent thrombocytosis over 900 x 10(9)/l and, at the time of diagnosis, their platelet count ranged between 1,112 and 3,178 x 10(9)/l. A 9-month-old girl had thrombosis of the inferior cava vein, two children had headaches and two others remained asymptomatic throughout the follow-up period. Megakaryocytes in the bone marrow were increased in number. The chromosomal analysis was normal, and bcr rearrangement was always negative. None of the patients had spontaneous BFU-E or altered levels of serum erythropoietin and thrombopoietin. Two patients showed alteration of platelet aggregation, and all had decreased levels of intraplatelet serotonin. In spite of the diagnosis of ET in our patients, we are not sure that the cases reported here are really myeloproliferative disorders. The features could suggest that the cases observed may be affected by an 'idiopathic thrombocytosis' without myeloproliferation. Possible variants of ET are described in young adults, and the heterogeneous nature of ET is also suggested by our paediatric patients. Only careful long-term follow-up of patients such as these will clarify the natural history of these disorders and suggest therapeutic management.
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Affiliation(s)
- M L Randi
- Department of Medical and Surgical Science, University of Padua Medical School, Italy
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Bo M, Grassone D, Fabris F. [Unexpected diagnosis of thorotrast-induced cirrhosis]. Recenti Prog Med 2001; 92:667-9. [PMID: 11765659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
It is presented the clinical case of a 73 year old man admitted to hospital with dyspnea and productive cough. Clinico-instrumental investigations demonstrated monolateral pleural effusion and ascites in a severe cirrhotic chronic liver failure. After evacuation of the pleural and peritoneal effusion, chest radiography showed the presence of a double accumulation of radiopaque material in left cervical region and in left paramediastinic site. Chest and abdominal CT scan showed a systemic accumulation of this material in liver, spleen and glands. The characteristics of the iperreflecting substance accumulated were compatible with that of Thorotrast. In the mean time, a prostate cancer with skeletal metastases was diagnosed. Despite therapy, the chronic liver failure causes a rapid deterioration of clinical conditions, with irreversible hepatic coma and death.
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Affiliation(s)
- M Bo
- Sezione di Geriatria, Dipartimento di Discipline Medico-chirurgiche, Università, Torino
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