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A Falanga A P Bolognese Dalessandro B Casali M C Roncaglioni M B Donati 《International journal of cancer. Journal international du cancer》1987,39(6):774-777
Cancer Procoagulant (CP), a cysteine proteinase which triggers blood coagulation by directly activating Factor X (FX) in the absence of Factor VII (F VII), has recently been isolated from rabbit V2 carcinoma and biochemically characterized. We have studied the procoagulant activity of tissue extracts from 4 murine experimental tumors in order to define whether or not a F VII-independent activity with cysteine proteinase characteristics was present. The tumors studied were: Lewis lung carcinoma (3LL), B16 melanoma (B16), JW sarcoma (JWS) and the M4 variant of the mFS6 fibrosarcoma (M4). Extracts from 3LL, B16 and JWS tumor initiated coagulation in both the presence and absence of F VII, their procoagulant activity was sensitive to iodoacetamide (1 mM) and mercury chloride (0.1 mM). The procoagulant of M4 extract was dependent on the presence of F VII and was not significantly affected by the cysteine proteinase inhibitors. An Ouchterlony double immunodiffusion study showed immunological cross-reactivity of all but M4 extracts to a polyclonal antibody to purified CP. The present study suggests that the procoagulant(s) present in the murine tumors 3LL, B16 and JWS are enzymatically and immunologically indistinguishable from cancer procoagulant of the rabbit V2 carcinoma. 相似文献
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Maria Carla Roncaglioni Fausto Avanzini Daria Roccatagliata Lara Monesi Darina Tamayo-Benitez Massimo Tombesi Vittorio Caimi Paolo Longoni Davide Lauri Simona Barlera Gianni Tognoni 《European journal of cardiovascular prevention and rehabilitation》2004,11(3):233-238
BACKGROUND: Although risk assessment charts have been proposed to identify patients at high cardiovascular risk, in everyday practice general practitioners (GPs) often use their knowledge of the patients to estimate the risk subjectively. DESIGN: A cross-sectional study aimed to describe how GPs perceive, qualify and grade cardiovascular risk in everyday practice. METHODS: General practitioners had to identify in a random sample of 10% of their contacts the first 20 consecutive patients perceived as being at cardiovascular risk. For each patient essential data were collected on clinical history, physical examination and laboratory tests, for the qualification of risk. At the end of the process GPs subjectively estimated the overall patient's level of risk. General practitioners grading was compared with the risk estimate from a reference chart. RESULTS: Over a mean time of 25 days 3120 patients perceived as being at cardiovascular risk were enrolled. According to the inclusion scheme each GP had contact with more than 200 patients at cardiovascular risk every month. Thirty percent of these patients had atherosclerotic diseases. Up to 72% of patients without any history of atherosclerotic diseases but perceived to be at risk could be classified according to a reference chart as being at moderate to very high risk. Comparing GPs' grading of risk with a chart estimate there was agreement in 42% of the cases. Major determinants of GPs' underestimation of risk were age, sex and smoking habits, while obesity and family history were independently associated with overestimation. CONCLUSIONS: On the basis of their perception GPs properly identify patients at cardiovascular risk in the majority of cases. General practitioners subjective grading of risk level only partially agreed with that given by a chart. 相似文献
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M C Roncaglioni I Reyers C Cerletti M B Donati G de Gaetano 《Biochemical pharmacology》1988,37(24):4743-4745
It has previously been shown that salicylate (S) acts as a vitamin K (vit K)-antagonist inducing a decrease in plasma levels of vit K-dependent clotting factors and inhibiting the vit K-dependent carboxylation reaction in the liver. In this study we evaluated whether this biochemical effect had a possible functional role. Indeed, we tested in rats the antithrombotic potency of S (175 mg/kg/i.p. twice a day for 3 days) on experimentally induced venous thrombosis. Its possible haemorrhagic effect was evaluated by measuring the bleeding time. Low-dose warfarin (W) (0.2, 0.1, 0.1 mg/kg/i.v. for 3 days) was utilized as control drug. To check for a possible potentiation between S and W, we tested the effects of their combination (S + W). Thrombotest was used to monitor the anticoagulant effect of each treatment. The incidence of thrombus formation, after venous stasis, was not significantly affected by any of the treatments used, but a significant reduction in thrombus weight was observed after either S or W treatment. Both drugs partially prolonged the Thrombotest without affecting either the bleeding time or the peri-operative mortality (mainly due to internal bleeding). When the combination S + W was used, no significant benefit was observed on the prevention of thrombus incidence or weight, although a marked Thrombotest prolongation was recorded. On the other hand this combination resulted in a pronounced bleeding tendency, as expressed in a significant prolongation of bleeding time and increased total mortality. Thus S, at doses inducing moderate anticoagulation may prevent venous thrombosis without relevant bleeding complications. 相似文献
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Candelise L. Roncaglioni C. Aritzu E. Ciccone A. Maggioni A. P. the MAST-I Group 《The Italian Journal of Neurological Sciences》1996,17(1):5-21
Thrombolysis is proposed for the acute treatment of cerebral infarction as it is able to recanalize occluded arteries and thus potentially restore normal perfusion of the cerebral parenchyma, but the results concerning the efficacy of this treatment are still inconclusive. However, it has been fully demonstrated that thrombolytic treatment, leads to a significant reduction in mortality, in patients with acute myocardial infarction.Data from all of the pilot studies using SK or rPA treatment in acute stroke are described in this review, which underlines the incidence of hemorrhagic transformation (hemorrhagic infart and parenchymal hematoma) and its possible correlation to clinical worsening.Pharmacological, experimental and clinical studies encourage the carrying out of large-scale clinical trials using thrombolytics in patients with acute cerebral infarction.Significant data relating to ongoing controlled clinical trials will be available in the near future; only after the analysis of these results will it be possible to confirm the efficacy of thrombolytics in acute stroke.
Sommario La trombolisi è stata proposta nella fase acuta dell'infarto cerebrale quale terapia potenzialmente in grado di operare una ricanalizzazione arteriosa ed una conseguente riperfusione dell'area ischemica; ad oggi, però, i risultati degli studi eseguiti non permettono di provarne la reale efficacia. È già stato invece ampiamente dimostrato come il trattamento trombolitico determini una significantiva riduzione della mortalità nei pazienti colpiti da infarto miocardico acuto.In questa revisione vengono esaminati i risultati degli studi pilota condotti su pazienti con ictus acuto trattati con Streptokinasi o tPA, mettendo in luce l'incidenza delle trasformazioni emorragiche (infarto emorragico ed ematoma intraparenchimale) correlate all'evoluzione clinica.Gli studi farmacologici, sperimentali e clinici incoraggiano l'esecuzione di ampi studi con l'utilizzo della trombolisi anche in pazienti con infarto cerebrale.Prossimamente conosceremo i risultati degli studi in via di completamento: solo l'analisi di quei dati ci permetterà di confermare la reale efficacia di questo trattamento.相似文献
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Avanzini F Marelli G Donzelli W Busi G Carbone S Bellato L Colombo EL Foschi R Riva E Roncaglioni MC De Martini M;Desio Diabetes Diagram Study Group 《Diabetes care》2011,34(7):1445-1450
OBJECTIVE
The study objectives were 1) to assess the effectiveness and safety of a standardized protocol for the transition to subcutaneous insulin and oral feeding in diabetic or hyperglycemic patients with acute coronary syndrome (ACS) who were receiving intravenous insulin and glucose at the time of the transfer from the intensive cardiac care unit to a general ward and 2) to identify predictors of transition outcome.RESEARCH DESIGN AND METHODS
This was a prospective observational study. The protocol specifies that patients receive a 100% of their daily subcutaneous insulin requirement from the first day of oral feeding, calculated from the intravenous insulin rate during the final 12 h divided into two: 50% basal and 50% prandial.RESULTS
In 142 patients (93 male, 49 female, age range 47–88 years, 135 with known diabetes) the first day after transition, 44.8% of blood glucose (BG) measurements were within the strict range of 100–140 mg/dL before meals and 100–180 mg/dL after meals, and 70.8% were within the broader ranges of 80–160 mg/dL and 80–200 mg/dL, respectively. Pre- or postprandial hypoglycemia (BG <70 mg/dL) occurred in 11 patients (7.7%) on the first day and in 38 patients (26.8%) on the first 3 days after transition. Old age, high doses of intravenous insulin, and wide BG variations in the 24 h before insulin infusion was stopped were predictive of poor BG control after transition.CONCLUSIONS
This study shows the effectiveness and safety of a standardized protocol for the transition from intravenous to subcutaneous insulin in patients with ACS when regular oral feeding was resumed.In critically ill patients with diabetes or hyperglycemia who are admitted to intensive care units, intravenous infusion of insulin is the recommended treatment (1–6). During the postacute phase, many guidelines and recommendations suggest switching to subcutaneous insulin when patients begin eating regular meals and are moved to a lower-intensity care setting (1–6).There are few observational and intervention studies on the procedure for the transition from intravenous to subcutaneous insulin, and almost all concerned patients who had undergone operation and took little if any food (7–11). The transition is delicate because of the patients’ clinical condition and the organizational context in which they are transferred from an intensive care unit to a general ward. The few studies that have examined the course of blood glucose (BG) after interruption of intravenous insulin have documented inadequate control in the absence of a standardized transition protocol (9,12). In addition, the literature reporting the predictors of optimal transition is scarce and refers mainly to patients postsurgery (7,9,10).The objectives of this prospective observational study were to- assess the effectiveness and safety of a standardized protocol for conversion from intravenous to subcutaneous insulin therapy in patients with acute coronary syndrome (ACS) during the transfer from the intensive cardiac care unit (ICCU) to the general ward; and
- identify predictive factors of transition outcome.