1,720,971 research outputs found
Early treatment with ACTH-(1-24) in haemorrhagic shock in humans: futher data
No full textIntroduction. We have previously shown that in patients with aortic dissection-induced haemorrhagic shock, the addition of an early intravenous injection of the melanocortin peptide ACTH-(1-24) (10 mg) to the standard treatment significantly increased survival rate (75% reduction in mortality) (1). Here we present the results obtained in a larger patient population, that confirm and strengthen the previous data. Materials and Methods. In our Cardiac Surgery Unit of Villa Maria Cecilia Hospital, all patients in haemorrhagic shock were consecutively enrolled in this study during the period 2002-2004 (112 subjects in all): 105 patients had aortic dissection (95 type A, 10 type B) and 7 patients had massive post-operative haemorrhage (mean estimated blood losses >5L). The European score was >15 and systolic blood pressure was 25% and neurologic complications in more than >20% of these patients, when subjected to the standard treatment alone.
References.
1. Noera G., Lamarra M., Guarini S. and Bertolini A. (2002) The Lancet 358: 469-470
2. Sinatra R., Melina G., Pulitani I., Fiorani B., Ruvolo G. and Macino B. (2001) Ann. Thorac. Surg. 71: 33-3
Progetto Massa Lombarda - PRIT Misura 3-1, azione A, bando 7/2004
No full textIl progetto Massa Lombarda è orientato all'epidemiologia clinica, in particolare nel settore della diagnostica ultraprecoce e della prevenzione delle malatie cardiovascolari. Il protocollo base del Progetto è riportato in allegato (inserito in scheda ad hoc). Lo scopo specifico del PRIT era relativo alla definizione, progettazione e realizzazione e validazione del Bluec@ardio nel contesto della medicina preventiva territoriale; il PRIT è stato bandito nel 2004 e sviluppato negli anni successivi). Numerosi altri documenti sono disponibili a richiesta. In particolare quelli relativi allo specifico PRIT e ai suoi risultat
ACTH analogue in treatment of acute aortic dissection-Authors' reply.
No full textSir—The fact that the mortality rate inour patients who were assigned to thestandard treatment, without ACTH-(1-24) addition, was higher than thatreported in previous studies might beexplained by their severe haemodynamiccompromise. We selectedsubjects with type A aortic dissectioncomplicated by aortic rupture andcardiac tamponade, and with clinicaland laboratory signs of haemorrhagicshock.We share Olsson’s opinion thatACTH-(1-24) essentially modifies thecomplex pathophysiology of theperioperative period. Not only byimproving the cardiovascular function;indeed, several experimental datasuggest that melanocortins have also apeculiar, adrenal-independent antiinflammatoryactivity. They reduce theproduction of proinflammatorycytokines, such as interleukins 1, 1,and 6, and tumour necrosis factor(TNF) , and inhibit the activation ofthe transcription factor NF-kB, whileincreasing the production of the antiinflammatorycytokines interleukins 8and 10;1 in particular, in conditions ofhaemorrhagic shock, melanocortinsinhibit the overproduction of TNF,nitric oxide, and free radicals.2,3Moreover, melanocortins protectagainst the outcomes either of a shorttermmyocardial ischaemia followed byreperfusion or of the permanentocclusion of a coronary artery in rats.4Our patients underwent fluidreplacement en route and ventilatorysupport but no rescue surgery. Ourcardiac surgery unit is situated roughlyin the middle of a flat territory innorthern Italy, with a high populationdensity (about 1 million people), and areasonable road system. The time lapsefrom emergency call to arrival into thecasualty ward, by ambulance or byhelicopter, is 20–40 min.Our animal data suggest that thetime span of ACTH-(1-24) efficacy isbest if given within 5–15 min of shockinduction. We have fewer human data,but they suggest that treatment must bemade within 1 h of the first signs ofshock. In case of haemorrhagic shock(road or industrial accidents, &c), webelieve ACTH should be given asintravenous bolus injection at thescene, or en route in the ambulance.The effect of ACTH lasts a few hours
Massa Lombarda Project (Prevention and control of cardiovascular diseases: Instant Individual Definition and Bluc@ardio Project)
No full textIl Progetto Massa Lombarda è iniziato nei primi anni 2000 come Spin Off accademico e procede di anno in anno con sottoprogetti e con in controlli periodici dell'intera popolazione. Ha avuto il supporto e patrocinio del Presidente del Parlamento Europeo ed è stato presentato al Presidente della repubblica Italiana, Carlo Azelio Ciampi. Ha prodotto una intensa attività di ricerca, numerose pubblicazioni, rassegne stampa, convegni e brevetti. Si allegano alcuni documenti esemplificativi. Il materiale relativo può essere richiesto. Si può visionare il sito www.hrs.unibo.it. La scheda viene compilata nel 2010 in occasione del relativo controllo (mancano schede dedicate a qeuste specifiche attività di ricerca
ACTH-(1-24) restores blood pressure in acute hypovolaemia and haemorrhagic shock in humans.
No full textACTH-(1-24) restores blood pressure in acute hypovolaemia and haemorrhagic shock in humans
Assessment of the health status in the Massa Lombarda cohort: a preliminary description of the program evaluating cardio-cerebro-vascular disease risk factors and quality of life in an elderly population.
No full textThe Massa Lombarda program (MLP) is the first step of a European multi-center program, promoted and coordinated from Bologna University's Academic Spin off Health Research and Development, which attempts to manage advanced sanitary research in general population. The instant individual definition (IID) study is the first phase of the program concerning the study of risk factors (RF) and early diagnosis of coronary heart disease (CHD), through a new diagnostic technology called myocardial perfusion scoring system (MPS). The study consists
of a longitudinal observational epidemiological investigation of adult population (above 25 years of age) resident in Massa Lombarda (Ravenna), with the survey of social and biological parameters. The elderly part of the population (1000 subjects above 75 years) was submitted to a more complex analysis, as part of the
study on health status in European aging populations, aimed at revealing the determinants influencing the healthy aging, and at identifying their impact on mortality,cardiovascular and respiratory morbidity, disability and decline of quality of life. Laboratory analyses were aimed at identifying the following factors: (i) Genetic markers related to pro and anti-inflammatory cytokine- codifying genes. (ii) Oxidative stress-involved molecules, and inflammation-involved genes, and more in general genes involved in the brittleness(iii) (ApoE). Appraising the degree of interaction with non-genetic factors, like measurable immunological markers in the peripheral blood, markers
of reactions to oxidative stress,evaluation of metabolic parameters. Moreover, old population is expected to answer the questionnaires for evaluation of the dietary habits, physical activity, self-sufficiency,cognitive ability, motor coordination, perceived stress and social relationships
Influence of early treatment with ACTH-(1-24) on the outcome of aortic dissection
No full textInfluence of early treatment with ACTH-(1-24) on the outcome of aortic dissectio
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