341 results on '"S, COCCHERI"'
Search Results
2. Intraoperative autotransfusion does not induce deterioration in haemorheologic conditions during and after cardiopulmonary by-pass surgery
- Author
-
P. Torricelli, S. Faenza, A. Zanoni, S. Coccheri, M. Poggi, F. Petrini, and G. Palareti
- Subjects
medicine.medical_specialty ,Physiology ,business.industry ,Hematology ,law.invention ,Surgery ,Circulacion extracorporea ,law ,Physiology (medical) ,Anesthesia ,Cardiopulmonary bypass ,Medicine ,Cardiology and Cardiovascular Medicine ,business ,Autotransfusion - Published
- 2016
- Full Text
- View/download PDF
3. High Altitude Expeditions: Haemorheologic effects
- Author
-
G. Palareti, P. Torricelli, S. Coccheri, M. Poggi, F. Cavazzuti, and M.G. Tricarico
- Subjects
Physiology ,Physiology (medical) ,Environmental science ,Hematology ,Physical geography ,Effects of high altitude on humans ,Cardiology and Cardiovascular Medicine - Published
- 2016
- Full Text
- View/download PDF
4. Haemorheological results in a large multicentre study of claudicants treated with ketanserin
- Author
-
H. Rieger, S. Lennie, A. Scheffler, Irène Juhan-Vague, M. Billerey, Gerard B. Nash, J.A. Dormandy, Gdo Lowe, M. Poggi, H. Larsson, S. Coccheri, G. Palareti, and S. Persson
- Subjects
medicine.medical_specialty ,Ketanserin ,Physiology ,business.industry ,education ,Hematology ,Lower limb ,Surgery ,Multicenter study ,Physiology (medical) ,Internal medicine ,medicine ,Cardiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,Claudication ,business ,After treatment ,medicine.drug - Abstract
An international, multi-centre trial was carried out to test the haemorheological effects of ketanserin, a serotonin antagonist, after treatment of intermittent claudicants for 1 year. Ha ...
- Published
- 2016
- Full Text
- View/download PDF
5. Relationship between peripheral arterial diseases and hemorheologic disorders. Pathophysiologic and therapeutic implications
- Author
-
G. Palareti and S. Coccheri
- Subjects
medicine.medical_specialty ,Physiology ,business.industry ,Physiology (medical) ,Internal medicine ,Cardiology ,Medicine ,Hematology ,Cardiology and Cardiovascular Medicine ,business ,Peripheral Arterial Diseases ,Pathophysiology - Published
- 2016
- Full Text
- View/download PDF
6. PLATELETS AND CONTACT ACTIVATION OF BLOOD CLOTTING. INFLUENCE OF SOME AGGREGATION INHIBITORS
- Author
-
M. Alessandri, V. Rosa, and S. Coccheri
- Subjects
Blood Platelets ,medicine.medical_specialty ,medicine.medical_treatment ,Pharmacology ,chemistry.chemical_compound ,Platelet Adhesiveness ,Polysaccharides ,Platelet adhesiveness ,Fibrinolysis ,Internal Medicine ,medicine ,Platelet ,Clofibrate ,Blood Coagulation ,Blood clotting ,Heparin ,business.industry ,Dipyridamole ,Surgery ,Adenosine Diphosphate ,Molecular Weight ,Butyrates ,Adenosine diphosphate ,chemistry ,Phosphatidylcholines ,business ,medicine.drug - Published
- 2009
- Full Text
- View/download PDF
7. Coagulation Studies in Chronic Active Hepatitis
- Author
-
S. Coccheri, F. Grauso, G. Gasbarrini, G. Palareti, and F. Miglio
- Subjects
Hepatitis ,medicine.medical_specialty ,Chronic hepatitis ,Chronic Active ,business.industry ,Internal medicine ,medicine ,Coagulation testing ,medicine.disease ,business ,Gastroenterology - Published
- 2015
- Full Text
- View/download PDF
8. Title Page / Table of Contents / Preface
- Author
-
Benvindo Justiça, E. Segalés, Gloria Saccani, Evy Bashardi, Andrew N. Nicolaides, Armando Tripodi, T. Fenyvesi, G. Origliani, J. Vermylen, R. Rossi, A. Nemmar, Alexander Koshkaryev, Silvia Navarro, S. Béguin, Francesco Violi, Tiziana Garofano, Antonella Tufano, Uri Seligsohn, Fabrizio Fabris, H.C. Hemker, G. Vilahur, Franco Semprini, R. Abbate, S. Fedi, Saul Yedgar, Sara Morais, C. Fatini, Licia Iacoviello, Irène Juhan-Vague, F. Gensini, Helga Grafenhofer, P. Giesen, S. Coccheri, B. Nemery, P. Carrasco, T. Grimaldi, Jacqueline Conard, G. Fantini, Ida Martinelli, Chiara Melloni, F.R. Rosendaal, Francesco Fallani, Gordon D.O. Lowe, E. Sticchi, Mónica Pereira, Joseph Loscalzo, J.I. Abad, V. Regnault, Juan Carlos Souto, T. Lecompte, Gregory Barshtein, Giovanni Romeo, V.V. Kakkar, Ingrid Pabinger, Ebrahim Shah, Giovanni Di Minno, A. De Fabritiis, F. Sofi, Pilar Medina, Alexandra Estevinho, Matteo Nicola Dario Di Minno, Justo Aznar, E. Conti, Grigoris T. Gerotziafas, George Geroulakos, E. de Smed, Maria Assunta Silvestri, Giuseppe G. Nenci, Fabio M. Pulcinelli, Luisa Lenti, Ismail Elalamy, B. Cosmi, Pierre Morange, Amparo Estellés, Angelo Branzi, Marie-Christine Alessi, Andrew H. Baker, Roberto Catasca, Raymond Verhaeghe, Samuele Nanni, V. Llorente, Francisco España, Andrea Ghiselli, F. Coppi, Domenico Prisco, Manuel Campos, M.F. Hoylaerts, P. Poredoš, Meyer Michel Samama, Stavros K. Kakkos, Giovanni Melandri, José Miguel P. Ferreira de Oliveira, Maura Griffin, David A. Lane, R. AlDieri, Augusto Di Castelnuovo, Serenella Rotondo, L. Badimon, J.J. Badimon, Giovanna Marchetti, Antonella Marcoccia, M.G. Modena, Henrik Sillesen, Joseph Emmerich, Daniela Turchetti, Luigina R. Mollica, Giovanni de Gaetano, Rossella Marcucci, Maria Benedetta Donati, José Manuel Cabeda, Pasquale Pignatelli, Giuseppe Germanò, Pierluigi Tricoci, J. Harenberg, Marie Hélène Horellou, Gianni Belcaro, Antonio Girolami, Bruno Girolami, R. Wagenvoord, Francesco Bernardi, M. Verstraete, P.M. Mannucci, Jean-Noël Fiessinger, I. Jörg, and Irene Pereira
- Subjects
medicine.medical_specialty ,business.industry ,Physiology (medical) ,medicine ,Table of contents ,Hematology ,Title page ,business ,Classics ,Surgery - Published
- 2003
- Full Text
- View/download PDF
9. The cardiovascular risk burden of intermittent claudication
- Author
-
S. Coccheri and G. Palareti
- Subjects
medicine.medical_specialty ,education.field_of_study ,business.industry ,medicine.medical_treatment ,Population ,Critical limb ischemia ,medicine.disease ,Intermittent claudication ,Amputation ,Intima-media thickness ,Internal medicine ,medicine ,Cardiology ,Myocardial infarction ,medicine.symptom ,Risk factor ,Cardiology and Cardiovascular Medicine ,education ,business ,Stroke - Abstract
Intermittent claudication is the main clinical feature of chronic symptomatic atherothrombotic disease of the lower limbs (peripheral arterial disease [PAD]). The natural history of these patients includes a relatively limited risk for deterioration toward acute or chronic critical limb ischaemia and amputation. Patients with PAD have a high cardiovascular mortality rate, however, which is related to acute myocardial infarction and stroke (fourfold to sixfold increase in l0-year risk for these conditions). In fact, PAD is often associated with multifocal atherothrombotic arterial involvement. The presence of diffuse atherothrombotic lesions in PAD patients significantly increases their cardiovascular risk burden. Conversely, in the general population as well as in coronary patients the presence of PAD is an independent risk factor for increased mortality. Evidence of plaque instability may occur simultaneously at different locations. Finally, increased intima-media thickness at the common carotid and femoral arteries can be associated with overt disease at other arterial regions.
- Published
- 2002
- Full Text
- View/download PDF
10. Biological and clinical effects of sulodexide in arterial disorders and diseases
- Author
-
S, Coccheri
- Subjects
Treatment Outcome ,Fibrinolytic Agents ,Animals ,Humans ,Arterial Occlusive Diseases ,Thrombosis ,Arteries ,Glycosaminoglycans - Abstract
Arteries, veins and capillaries share the feature of hosting the "endothelial organ", an ubiquitous structure lining the surface of the entire circulatory tree. Endothelial cells and their supporting elements as the basement membrane, the intracellular matrix, and the surface covering glycocalyx, although displaying significant regional differences, maintain a common response to injury and to pharmacological stimuli. Sulodexide (SDX), a highly purified extractive glycosaminoglycan (GAG), shows many biological actions indicating effectiveness in arterial disorders and diseases. In fact, SDX besides inhibiting experimental arterial thrombogenesis displays, especially by the oral route, a number of vascular protective actions that are largely independent of those affecting blood coagulation. Among the activities relevant to arterial disorders, the agent provides restoration of damaged glycocalyx and of degraded intracellular matrix, as well as antiproliferative, antinflammatory, antioxidant, anti-proteolytic and anti-ischemic activities. Among the latter properties, the inhibiting effect on the enzyme family of matrix metalloproteinases (MMPs), and especially on the expression of MMP9 and its precursor, seems of crucial importance given the role of these matrix degrading enzymes in the pathogenesis and progression of atherothrombosis in coronary, carotid and peripheral arteries. These important biological data, many of them very recent, supply clues for the interpretation of a number of previous clinical trials in arterial diseases. Studies published in the years 1990-2005, showing significant reduction of cardiovascular events after a myocardial infarction, as well as a marked improvement in the walking ability in patients with peripheral arterial disease, deserve today an active re-appraisal likely conducive to new clinical research protocols in the field of primary and secondary prevention of cardiovascular disease of atherothrombotic nature.
- Published
- 2014
11. PLATELET ADHESIVENESS AND AGGREGATION IN HYPERTENSIVE PATIENTS
- Author
-
P Fiorentini and S. Coccheri
- Subjects
Male ,medicine.medical_specialty ,Epinephrine ,business.industry ,Dietary Fats ,Platelet Adhesiveness ,Anesthesia ,Platelet adhesiveness ,Hypertension ,Internal Medicine ,medicine ,Physical therapy ,Humans ,Female ,business ,medicine.drug - Published
- 2009
- Full Text
- View/download PDF
12. A Placebo-controlled, Double-blind Study of Mesoglycan in the Treatment of Chronic Venous Ulcers
- Author
-
E. Arosio, G. Ferrari, L. Santoro, F. Gianese, S. Coccheri, AMATO, BRUNO, E., Arosio, G., Ferrari, L., Santoro, F., Gianese, S., Coccheri, and Amato, Bruno
- Subjects
Male ,medicine.medical_specialty ,Mesoglycan ,Chronic venous insufficiency ,Placebo ,Placebo group ,law.invention ,Varicose Ulcer ,Double blind study ,Randomized controlled trial ,Double-Blind Method ,Fibrinolytic Agents ,law ,medicine ,Humans ,Glycosaminoglycans ,Medicine(all) ,Wound Healing ,business.industry ,Middle Aged ,medicine.disease ,Randomised clinical trial ,Surgery ,Clinical trial ,Venous ulcers ,medicine.anatomical_structure ,Chronic Disease ,Female ,Ankle ,Cardiology and Cardiovascular Medicine ,business - Abstract
Objectives to assess the effect of treatment with mesoglycan, a sulphated polysaccharide compound, on the healing of venous ulcers. Design randomised, placebo-controlled, double-blind, multicentre trial. Methods non-diabetic outpatients with chronic venous insufficiency confirmed by duplex ultrasound, normal ankle/arm pressure index and presence of a leg ulcer were eligible. Patients were randomised to mesoglycan, 30 mg/day intramuscularly for 3 weeks followed by 100 mg/day orally, or matching placebo, as an adjunct to compression therapy and topical wound care. Treatment and observation were continued until complete ulcer healing or for 24±1 weeks. Time to ulcer healing and healing rates were estimated with the Kaplan–Meier method. Results One hundred and eighty-three patients were randomised and included in the analysis (92 mesoglycan, 91 placebo). Median ulcer area upon inclusion was 3.6 cm2in the mesoglycan group and 3.9 cm2in the placebo group. The estimated time to heal 75% of the patients was 90 days on mesoglycan versus 136 days on placebo, while the cumulative rate of healing by the end of observation was 97% versus 82%, respectively. The difference in favour of mesoglycan was statistically significant (p
- Published
- 2001
13. Thrombophilia in young women candidate to the pill: reasons for and against screening
- Author
-
S. Coccheri, B. Cosmi, Cosmi B., and Coccheri S.
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,Genetic testing ,Oral contraceptive ,Thrombophilia ,Contraceptives, Oral, Hormonal ,Physiology (medical) ,Epidemiology ,medicine ,Humans ,Mass Screening ,Family history ,medicine.diagnostic_test ,business.industry ,Hematology ,medicine.disease ,Pill ,Female ,business ,Psychosocial ,Venous thromboembolism ,Pharmacogenetics ,Human - Abstract
Screening for thrombophilia in women candidate to the pill is still a matter of debate. Oral contraceptives may trigger venous thromboembolic events in carriers of common inherited thrombophilic defects. General screening is not cost-effective from an epidemiological point of view if the objective is to prevent death due to venous thromboembolism during oral contraception (OC). However, clinicians deal with single patients and personal and/ or family history for venous thromboembolism have limited value for identifying those women at risk of VTE complications during OC. A pharmacogenetics approach in prescribing OC on the basis of each woman's genetic make-up could increase drug safety. A proper evaluation of the cost-effectiveness, the medical, psychosocial and legal consequences is needed before general screening with genetic testing for inherited thrombophilia can be recommended before OC. Copyright © 2002 S. Karger AG. Basel.
- Published
- 2002
- Full Text
- View/download PDF
14. Interaction between vitamin B6 deficiency and low EFA dietary intake on kidney phospholipids and PGE2 in the rat
- Author
-
S. Coccheri, Brunella Tolomelli, Magda Maranesi, Mario Marchetti, and V. Barzanti
- Subjects
Male ,Vitamin ,medicine.medical_specialty ,Clinical Biochemistry ,Phospholipid ,Biology ,Kidney ,Dinoprostone ,chemistry.chemical_compound ,Internal medicine ,medicine ,Animals ,Pyridoxine Deficiency ,Rats, Wistar ,Linolenate ,Phospholipids ,chemistry.chemical_classification ,Fatty Acids, Essential ,Body Weight ,Fatty Acids ,Organ Size ,Cell Biology ,Metabolism ,Pyridoxine ,Rats ,Endocrinology ,chemistry ,Eicosanoid ,Pyridoxal Phosphate ,Vitamin B 6 Deficiency ,Blood Chemical Analysis ,medicine.drug ,Polyunsaturated fatty acid - Abstract
Vitamin B6 is involved in the metabolism of long chain polyunsaturated fatty acids and phospholipids. We have studied the interaction between pyridoxine deficiency and low amounts of dietary essential fatty acids (EFA) in the rat. The fatty acid composition of kidney phospholipids of pyridoxine deficient animals shows a decrease of 20:3 n9 and an increase of 20:4 n6 in comparison with control and pair fed animals. This variation of fatty acid composition could be due to the simultaneous effect of vitamin B6 deficiency, which reduces the oxidation of linolenate, and of a low intake of EFAs which stimulates delta-6-desaturase. The dietary treatment also influences kidney Prostaglandin E 2 (PGE 2 ) levels which are higher in vitamin B6 deficient animals. This effect could be correlated with a higher response to sympathic stimulation caused by the simultaneous presence of vitamin B6 deficiency and low EFA availability. Also the higher level of arachidonate could be involved in promoting PGE 2 synthesis.
- Published
- 1993
- Full Text
- View/download PDF
15. Thromboxane Antagonism with terutroban in Peripheral Arterial Disease: the TAIPAD study
- Author
-
J N, Fiessinger, H, Bounameaux, M A, Cairols, D L, Clement, S, Coccheri, J P, Fletcher, U, Hoffmann, A G G, Turpie, and R, Koppensteiner
- Subjects
Adult ,Male ,Time Factors ,Adenosine Diphosphate/chemistry ,Platelet Aggregation ,medicine.drug_class ,Thromboxane ,Naphthalenes/*therapeutic use ,Blood Pressure ,Naphthalenes ,Pharmacology ,Placebo ,Placebos ,Peripheral Arterial Disease ,chemistry.chemical_compound ,Double-Blind Method ,Antithrombotic ,medicine ,Humans ,Aged ,ddc:616 ,Aspirin ,business.industry ,Thromboxanes ,Hematology ,Middle Aged ,Propionic Acids/*therapeutic use ,Receptor antagonist ,Peripheral Arterial Disease/*drug therapy ,Adenosine Diphosphate ,chemistry ,Terutroban ,Anesthesia ,Aspirin/therapeutic use ,Arachidonic acid ,Female ,Propionates ,business ,Thromboxanes/*antagonists & inhibitors ,Ex vivo ,medicine.drug - Abstract
BACKGROUND: Terutroban is a selective prostaglandin endoperoxide (TP) receptor antagonist with antithrombotic, antivasoconstrictive and antiatherosclerotic properties and is currently in development for long-term cardiovascular secondary prevention. OBJECTIVES: TAIPAD is an international, double-blind, randomized controlled study comparing the effects of five dosages of oral terutroban vs. aspirin and placebo on platelet aggregation in peripheral arterial disease (PAD) patients. PATIENTS/METHODS: After 10 day's placebo run-in, included patients (n = 435; ankle-brachial pressure index, 0.7 ± 0.1) were randomly allocated to aspirin 75 mg day(-1), terutroban 1, 2.5, 5, 10 or 30 mg day(-1) or placebo. On day 5, the placebo group was reallocated to one of the terutroban groups for the rest of the study (day 83). Ex vivo platelet aggregation induced by the thromboxane analog U46619 (7 μm) was measured 24 h after dosing, as well as platelet aggregation induced by arachidonic acid (AA), collagen and ADP. RESULTS: Terutroban dose-dependently inhibited U46619-induced platelet aggregation at days 5 and 83. At day 5, the inhibition was significant vs. placebo for all terutroban dosages (P < 0.001). Terutroban (5, 10 and 30 mg day(-1)) was at least as effective as aspirin in inhibiting platelet aggregation induced by arachidonic acid (AA), collagen and adenosine diphosphate (ADP). Terutroban was well tolerated, with a safety profile similar to aspirin. CONCLUSIONS: In PAD patients, terutroban dose-dependently inhibited platelet aggregation 24 h after dosing, and was at least as effective as aspirin at 5, 10 and 30 mg day(-1). Terutroban was well tolerated.
- Published
- 2010
16. Double-Blind, Randomized Comparison of Systemic Continuous Infusion of 0.25 Versus 0.50 mg/kg/24 h of Alteplase over 3 to 7 Days for Treatment of Deep Venous Thrombosis in Heparinized Patients: Results of the European Thrombolysis with rt-PA in Venous Thrombosis (ETTT) Trial
- Author
-
H Bounameaux, J D Banga, E Bluhmki, S Coccheri, J N Fiessinger, W Haarmann, D Lockner, F Mahler, J Ninet, P A Schneider, A de Torrente, J van der Meer, and and R Verhaeghe
- Subjects
Chemotherapy ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Hematology ,Heparin ,Thrombolysis ,medicine.disease ,Thrombosis ,law.invention ,Surgery ,Venous thrombosis ,Regimen ,Randomized controlled trial ,law ,Anesthesia ,medicine ,Thrombus ,business ,medicine.drug - Abstract
Thirty-two patients with acute, proximal-vein thrombosis were treated with heparin and alteplase (0.25 versus 0.5 mg/kg/24 h during 3-7 days) in a randomized, double-blind, multicenter, European (ETTT) trial. The treatment resulted in a decrease of the venographic Marder's score from 18 (6-25) to 13 (2-24) units (median, range) in Group I (0.25 mg/kg/24 h, n = 15, median decrease 3.0, p = 0.32) and from 17.5 (3-33) to 15.5 (0-27) in Group II (0.5 mg/kg/24 h, n = 16, median decrease 4.0, p = 0.23). Comparison of the sequential venograms could be performed in 14 cases of Group I and in 15 cases in Group II. A minority of patients showed substantial partial recanalization of the initially obstructed veins on the control venogram (one in each treatment group) and most of the control venograms showed either thrombus size reductions (5 in Group I, 7 in Group II) or no change or even deterioration (8 in Group I, 7 in Group II). Major bleedings were observed in 7 patients (7/32, 22%), 5 of them occurring in Group II (5/17, 29%). Thus, the results of the ETTT trial show that the used low dosages of alteplase administered intravenously over 3-7 days in heparinized patients cannot be recommended as a treatment for patients with deep venous thrombosis of lower limbs and/or pelvis. Further studies are needed to define a more suitable dosage regimen of alteplase in this indication.
- Published
- 1992
- Full Text
- View/download PDF
17. Influence of dietary fatty acids on phospholipid composition and prostaglandin E synthesis in rat kidneys
- Author
-
S. Coccheri, M. Cocchi, Magda Maranesi, G. Biagi, E. Turchetto, and V. Barzanti
- Subjects
Male ,medicine.medical_treatment ,Clinical Biochemistry ,Phospholipid ,Kidney ,Dinoprostone ,chemistry.chemical_compound ,Dietary Fats, Unsaturated ,medicine ,Animals ,Phospholipids ,chemistry.chemical_classification ,Arachidonic Acid ,Chemistry ,Fatty Acids ,Fatty acid ,Rats, Inbred Strains ,Cell Biology ,Rats ,medicine.anatomical_structure ,Biochemistry ,lipids (amino acids, peptides, and proteins) ,Composition (visual arts) ,Olive oil ,Prostaglandin E - Abstract
The effects of oils with different amounts of n6 and n3 fatty acid precursors and derivatives were evaluated on phospholipid composition and PGE 2 synthesis of rat kidneys. Dietary lipids were: olive oil, an olive-blackcurrant-fish oil mixture and a blackcurrant-fish oil mixture. We observed in the kidneys of rats fed the blackcurrant-fish oil mixture a significant decrease in PGE 2 synthesis, while arachidonate values did not show significant variations. A decrease of PGE 2 synthesis could be due to competitive and inhibitory effects of fatty acids other than arachidonate, observed in the kidney phospholipid composition in our dietary conditions.
- Published
- 1991
- Full Text
- View/download PDF
18. Has time come for a re-assessment of spa therapy? The NAIADE survey in Italy
- Author
-
F Di Orio, Giovanni Gasbarrini, G. Nappi, S. Coccheri, and Marco Valenti
- Subjects
Adult ,Male ,Atmospheric Science ,Pediatrics ,medicine.medical_specialty ,Health, Toxicology and Mutagenesis ,Spa treatments ,Health resources ,Hospital admissions . Sick-leave . Drug consumption ,Psychological intervention ,Disease ,Controlled studies ,Surveys and Questionnaires ,medicine ,Humans ,Longitudinal Studies ,Aged ,Aged, 80 and over ,Ecology ,business.industry ,Balneology ,Thermal cycle ,Middle Aged ,Disease phases ,Hospitalization ,Prescriptions ,Italy ,Family medicine ,Sick leave ,Family doctors ,Observational study ,Female ,Sick Leave ,business - Abstract
Goal of this study was to investigate whether appropriately applied spa therapy in several indications could be associated with a subsequent fall in the need for costly health services and missed working days due to sick-leave. The Naiade project was a multicenter observational, longi- tudinal, questionnaire-based study comparing an "entry" inquiry addressed to patients before an entry thermal cycle, and a "return" inquiry after 1 year. Routine statistical methods were used for comparisons. The study was carried out in 297 of the 340 certified Italian spa centers. Inquiries were managed by the spa doctor(s), with the collaboration of family doctors, and when necessary, hospitals, other health services, labour offices and employers. After exclusion of regular customers and of patients with acute disease phases or severe health conditions, 39,943 patients divided into eight diseases subgroups (rheumatic, respiratory, dermato- logic, gynaecologic, otorhynologic, urinary, vascular and gastroenteric) underwent entry inquiry and appropriate spa treatment. Patients who returned for treatment after 1 year ("index year") were 23,680 (59.2%) and received return inquiry. Outcomes considered were: frequency and duration of hospitalisation periods; missed working days; regular use of disease-specific drugs; and resort to "non-spa" rehabilita- tion therapies. The data collected at return inquiry were compared with those of entry inquiry. All the considered outcomes appeared to be significantly reduced in the index year in seven of the eight disease subgroups in comparison with the previous year. In conclusion, disease-appropriate spa treatments were followed by a reduction in the need of subsequent health interventions in most disease subgroups. The health promoting value of spa treatments should therefore undergo more rigorous assessment with rando- mised controlled studies.
- Published
- 2008
19. Atherothrombosis and the pill: what ratio(nale) for the RATIO studies?
- Author
-
Benilde Cosmi and S. Coccheri
- Subjects
Adult ,Peripheral Vascular Diseases ,medicine.medical_specialty ,business.industry ,Arterial Occlusive Diseases ,Thrombosis ,Hematology ,Risk Factors ,Internal medicine ,Pill ,medicine ,Cardiology ,Contraceptive Agents, Female ,Humans ,Female ,business - Published
- 2003
20. Venous thromboembolism, oral contraceptives and high prothrombin levels
- Author
-
C. Legnani, Benilde Cosmi, S. Coccheri, Ottavio Boggian, Lelia Valdrè, Francesco Bernardi, G. Palareti, Legnani C., Cosmi B., Valdre L., Boggian O., Bernardi F., Coccheri S., and Palareti G.
- Subjects
Adult ,medicine.medical_specialty ,Adolescent ,Prothrombin level ,Population ,Oral contraceptive ,Gastroenterology ,Deep vein thrombosi ,Internal medicine ,Deep vein thrombosis ,hemic and lymphatic diseases ,Thromboembolism ,medicine ,Humans ,Genetic Predisposition to Disease ,Risk factor ,education ,G20210A mutation ,Gynecology ,Family Health ,Venous Thrombosis ,education.field_of_study ,Oral contraceptives ,business.industry ,Risk Factor ,Hematology ,Middle Aged ,medicine.disease ,Confidence interval ,Venous thrombosis ,Quartile ,Embolism ,Risk factors ,Amino Acid Substitution ,Female ,Prothrombin ,business ,Blood sampling ,circulatory and respiratory physiology ,Contraceptives, Oral ,Human - Abstract
TheG20210A prothrombin mutation, associated with elevated prothrombin levels, is a risk factor for venous thromboembolism (VTE) and displays a strong interaction with oral contraceptives (OC). Nodata are available onVTE risk ofOCuse in women with high prothrombin levels, either associated or not with themutation. The aim of this study was to evaluate the risk of VTE in OC users with high prothrombin levels, either including or excluding carriers of the prothrombin mutation. Prothrombin levels were measured by a chromogenic assay in 152 women who suffered from VTE in reproductive age and in 296 healthy women. Subjects carrying thrombophilic alterations other than the G20210A prothrombin mutation were excluded. Prothrombin levels were stratified into quartiles. The OR of subjects in the upper quartile were 3.10[95%confidence interval (CI)1.73-5.55] and2.07(95%CI1.11-3.85)in all women and in those not carrying the prothrombin mutation, respectively. Among the 152 patients, 88 had experienced VTE during OC; in the control group we considered as OC users the women who had used OC for at least 6 months in the 2 years before presentation but had stopped the treatment at least 3 months before the time of blood sampling (n=127).For the interaction betweenOCand prothrombin levels only the two extreme strata of prothrombin were considered. Women with the lowest prothrombin levels and who did not use OC were used as reference category. The VTE risk of using OC in subjects with prothrombin levels in the upper quartile was increased5.4-fold (95%CI2.38-12.3) and3.5-fold (95%CI1.48-8.22) in all women and in those not carrying the prothrombin mutation, respectively. We conclude that elevated prothrombin levels, even in women without the G20210A prothrombin mutation, are associated with an increased risk for venous thromboembolism and that oral contraceptive use potentiates such association. © 2003 International Society on Thrombosis and Haemostasis.
- Published
- 2003
21. [Prevention of thromboembolism in non-valvular atrial fibrillation]
- Author
-
S, Coccheri and B, Cosmi
- Subjects
Fibrinolytic Agents ,Risk Factors ,Thromboembolism ,Atrial Fibrillation ,Humans - Published
- 2002
22. Changes in the use of health resources by patients with chronic phlebopathies after thermal hydrotherapy. Report from the Naiade project, a nation-wide survey on thermal therapies in Italy
- Author
-
S, Coccheri, G, Nappi, M, Valenti, F, Di Orio, E, Altobelli, and S, De Luca
- Subjects
Male ,Varicose Veins ,Italy ,Venous Insufficiency ,Data Collection ,Health Resources ,Humans ,Female ,Middle Aged ,Hydrotherapy - Abstract
Chronic venous disorders carry lifelong medical and social burdens. Within conservative approaches, spa hydrotherapy is popular among patients with venous disorders in Europe, but whether the practice is associated with health or social benefits remains controversial.The present work is a substudy of the nation-wide Italian Naiade Project, a large multicenter observational exercise on spa treatments in different disease groups. The "Chronic Phlebopathies" substudy included 2504 patients with primary or secondary varicosis or non-varicose venous insufficiency. After a first visit and administration of a detailed questionnaire, patients underwent a "thermal cycle" of 15-20 days consisting of underwater active and passive physical therapy with mineral waters. The same procedures were repeated after 1 year on the 1352 patients (54%) who spontaneously returned to the same spa. Primary endpoints of the study were some indicators of the use of health resources related to the year after the first thermal cycle, compared with the same indicators recorded at first visit using appropriate statistical methods.The occurrence of acute venous episodes, working days missed, number and duration of hospital admissions, consumption of drugs and physical therapies were all significantly reduced in the year after thermal therapy, thus indicating lesser use of health resources.The study suggests that thermal hydrotherapy in patients with chronic venous disorders is associated with health and social benefits.
- Published
- 2002
23. [Prevention of venous thromboembolism: what still remains to be known]
- Author
-
G, Licata and S, Coccheri
- Subjects
Thromboembolism ,Humans - Published
- 2002
24. P.15 Patent foramen ovale in pregnant and non-pregnant women
- Author
-
P. Limoni and S. Coccheri
- Subjects
medicine.medical_specialty ,business.industry ,Obstetrics ,Patent foramen ovale ,Medicine ,Hematology ,business ,medicine.disease ,Non pregnant - Published
- 2011
- Full Text
- View/download PDF
25. Increasing plasma homocysteine during follow-up in heart transplant recipients: effects of folate and renal function
- Author
-
L, Potena, F, Grigioni, G, Magnani, S, Sorbello, S, Sassi, L, Marinucci, R, Conti, V, Carinci, O, Leone, G, Arpesella, S, Coccheri, C, Magelli, and A, Branzi
- Subjects
Male ,Folic Acid ,Creatinine ,Cyclosporine ,Heart Transplantation ,Humans ,Female ,Prospective Studies ,Middle Aged ,Kidney ,Homocysteine ,Immunosuppressive Agents ,Follow-Up Studies - Abstract
Hyperhomocysteinemia is a common finding in heart transplant recipients and may represent a risk factor for graft failure. However, the time-course, determinants and effects of medical therapy on total homocysteine plasma levels after heart transplantation remain undetermined. The aim of this study was to prospectively analyze 1) the time-course of total homocysteine in heart transplant recipients; 2) the effects of folate supplements and cyclosporine A on total homocysteine; 3) the relation among renal function, serum vitamin levels, and total homocysteine.Fifty-two heart transplant recipients consecutively evaluated for routine follow-up during 1998 were included in the study (mean age 54 +/- 12 years; 28% female). Among the 52 patients, 10 patients were treated with folate for the entire period of the study (Group F), while 26 patients never received folate (Group NF). The remaining 16 patients who did not take folate on a regular basis were excluded from subgroup analysis. Total homocysteine and creatinine plasma levels were assayed at entry into the study (time 0) and at the end of the study, 12 months later (time 12).Homocysteinemia increased significantly from time 0 to time 12 (p0.001), regardless of creatinine plasma levels (p = 0.03) and folate intake (p0.01). However, total homocysteine levels were lower in Group F compared to Group NF at time 0 and time 12 (p0.02). On multivariate analysis, time of follow-up, serum creatinine and lack of folate intake were positive independent predictors of total homocysteine.Homocysteinemia increased over time in heart transplant recipients, regardless of renal function and folate administration. Lower total homocysteine levels were associated with folate intake, suggesting that folate supplements may play a role in the prevention of vascular allograft disease.
- Published
- 2000
26. [Proposed guidelines for the correct application of ultrasonography methods in the diagnosis of deep venous thrombosis of the legs]
- Author
-
A, Caniato, A, Amato, A, De Fabritiis, G, Palareti, and S, Coccheri
- Subjects
Venous Thrombosis ,Leg ,Clinical Protocols ,Humans ,Ultrasonography - Published
- 2000
27. [Diagnostic accuracy of various methods for the measurement of D-dimers in patients with suspected deep venous thrombosis]
- Author
-
C, Legnani, G, Palareti, C, Pancani, G, Guazzaloca, F, Grauso, G, Fortunato, G, Rodorigo, and S, Coccheri
- Subjects
Fibrin Fibrinogen Degradation Products ,Venous Thrombosis ,Humans ,Reproducibility of Results ,Sensitivity and Specificity - Published
- 2000
28. [Levels of total plasma homocysteine after methionine intake in a group of healthy subjects in Northern + Italy. Relationship with age, gender, and nutritional status]
- Author
-
S, Sassi, B, Cosmi, G, Palareti, C, Legnani, G, Grossi, and S, Coccheri
- Subjects
Adult ,Aged, 80 and over ,Male ,Adolescent ,Age Factors ,Nutritional Status ,Middle Aged ,Methionine ,Sex Factors ,Italy ,Humans ,Female ,Homocysteine ,Aged - Published
- 2000
29. [Recurrences and new vein thrombotic events during oral anticoagulant therapy in patients treated for previous vein thromboembolism. Data from the literature and results of the ISCOAT study]
- Author
-
G, Palareti, C, Manotti, C, Legnani, M, Poggi, G, Guazzaloca, and S, Coccheri
- Subjects
Venous Thrombosis ,Heparin ,Recurrence ,Thromboembolism ,Administration, Oral ,Anticoagulants ,Humans - Published
- 2000
30. Dermatan sulphate for the prevention of postoperative venous thromboembolism in patients with cancer. DOS (Dermatan sulphate in Oncologic Surgery) Study Group
- Author
-
V, Di Carlo, G, Agnelli, P, Prandoni, S, Coccheri, G F, Gensini, F, Gianese, and P M, Mannucci
- Subjects
Male ,Venous Thrombosis ,Heparin ,Injections, Subcutaneous ,Anticoagulants ,Dermatan Sulfate ,Middle Aged ,Injections, Intramuscular ,Postoperative Complications ,Treatment Outcome ,Fibrinolytic Agents ,Neoplasms ,Humans ,Female ,Aged - Abstract
Patients undergoing surgery for cancer are at high risk for venous thromboembolism (VTE). Agents that selectively inhibit thrombin, such as dermatan sulphate, have potential for a favourable benefit-risk ratio in the prevention of this complication.Patients scheduled for elective abdominal, thoracic, gynecologic or urologic surgery for cancer resection, were randomised to dermatan sulphate (600 mg intramuscularly on the second day before surgery, then 300 mg once daily), or calcium heparin (5,000 IU subcutaneously t.i.d., starting 2 hours before operation). Both treatments were continued until postoperative day 7 or until adequate mobilisation was achieved. Bilateral venography was scheduled at the end of treatment. Venograms were centrally assessed in blind conditions. The study outcomes were VTE (venographically proven deep vein thrombosis IDVT] or symptomatic, objectively confirmed pulmonary embolism) and bleeding complications.At 27 centres, 842 patients were randomised and underwent surgery (418 dermatan sulphate, 424 heparin). Efficacy was assessed in 521 patients with adequate venography and/or confirmed pulmonary embolism. DVT was observed in a total of 96 patients; symptomatic non-fatal pulmonary embolism developed in 2 patients (one per group), who also had DVT at venography. Postoperative VTE occurred in 40 of 267 patients on dermatan sulphate, 15.0%, versus 56 of 254 patients on heparin. 22.0% (p = 0.033). Relative risk reduction was 32.7% (95% confidence interval, 3.1 to 53.2%). The rate of bleeding complications in all operated patients was 6.9% with dermatan sulphate and 7.5% with heparin (confidence interval for the absolute risk difference, -4.1 to 2.9%). The inhospital mortality rate was 1.2% and 1.4%, respectively.In oncologic surgery, dermatan sulphate prevents VTE more effectively than heparin without increasing bleeding complications.
- Published
- 1999
31. [High negative predictive value for recurrence of venous thromboembolism with d-dimer carried out three months after the suspension of treatment with oral anticoagulants in patients over 60]
- Author
-
G, Palareti, G, Guazzaloca, C, Legnani, G, Fortunato, F, Grauso, V, De Rosa, G, Rodorigo, B, Cosmi, and S, Coccheri
- Subjects
Fibrin Fibrinogen Degradation Products ,Venous Thrombosis ,Predictive Value of Tests ,Recurrence ,Anticoagulants ,Humans ,Middle Aged ,Aged - Published
- 1999
32. [Venous color echo-doppler in diagnosis of proximal deep vein thrombosis: variability with different operators and comparison with phlebography]
- Author
-
A, De Fabritiis, G, Palareti, C, Legnani, A, Caniato, A, Guastarobba, M, Filippini, C, Pili, A, Amato, F, Losinno, and S, Coccheri
- Subjects
Male ,Observer Variation ,Venous Thrombosis ,Humans ,Female ,Phlebography ,Middle Aged ,Ultrasonography, Doppler, Color ,Aged - Published
- 1999
33. My remembrance of Tage Astrup (1908–2006)
- Author
-
S. Coccheri
- Subjects
business.industry ,Medicine ,Hematology ,business - Published
- 2007
- Full Text
- View/download PDF
34. A Guide to Oral Anticoagulant Therapy
- Author
-
S. Coccheri
- Subjects
medicine.medical_specialty ,business.industry ,Internal medicine ,Oral anticoagulant ,Medicine ,business - Published
- 1998
- Full Text
- View/download PDF
35. Thrombotic events during oral anticoagulant treatment: results of the inception-cohort, prospective, collaborative ISCOAT study: ISCOAT study group (Italian Study on Complications of Oral Anticoagulant Therapy)
- Author
-
G, Palareti, C, Manotti, A, DAngelo, V, Pengo, N, Erba, M, Moia, N, Ciavarella, G, Devoto, M, Berrettini, N, Leali, M, Poggi, C, Legnani, S, Musolesi, and S, Coccheri
- Subjects
Male ,Dose-Response Relationship, Drug ,Age Factors ,Administration, Oral ,Anticoagulants ,Hemorrhage ,Thrombosis ,Middle Aged ,Cohort Studies ,Italy ,Thromboembolism ,Humans ,Female ,Prospective Studies ,Aged ,Follow-Up Studies - Abstract
The paper reports on rate and type of thrombotic events occurring during the observational, prospective, inception-cohort, multicenter ISCOAT study. 2,745 unselected, daily practice patients, consecutively referring to 34 Italian anticoagulation clinics to monitor the oral anticoagulant treatment, were included in the study from beginning of their first anticoagulant course. During a total follow-up of 2,011 patient-years of treatment 70 thrombotic events (3.5 per 100 patient years) were recorded in 67 patients: 20 fatal (1%), 39 major (1.9%) and 11 minor (0.6%). 34/70 events occurred within the first 90 days of treatment (relative risk - at multivariate analysis - ofor =90 days vs.90 = 20.6, C.I. 12.7-33.5; p0.0001). The risk was higher in patients agedor =70 y (1.62, C.I. 1.0-2.61; p0.05), and when indication for anticoagulant treatment was peripheral/cerebral arterial disease (1.84, C.I. 1.01-3.36; p0.05). The frequency of thrombotic events was 17.5% when international normalised ratio (INR) levels were1.5, decreasing to 2.3% for INRs within the 2-2.99 category (relative risk of INRs2.0 vs.or =2 = 1.88, C.I. 1.16-3.07; p0.05). The recorded rate of thrombotic events was lower than that reported in the few available studies. A greater risk should be expected during the first 90 days of treatment, when anticoagulation levels are2.0 INR, in patients70 years and in those with cerebrovascular/peripheral arterial disease.
- Published
- 1998
36. Assessment of mental ability in elderly anticoagulated patients: its reduction is associated with a less satisfactory quality of treatment
- Author
-
G, Palareti, M, Poggi, G, Guazzaloca, A, Savino, and S, Coccheri
- Subjects
Aged, 80 and over ,Male ,Anticoagulants ,Brain ,Humans ,Female ,Mental Competency ,Middle Aged ,Aged - Abstract
Mental capacity was assessed in 311 apparently self-sufficient patients (or = 60 years of age, 170 men) under stabilised oral anticoagulant treatment (OAT) by administering the Hodkinson's Abbreviated Mental Test (AMT). The international normalized ratios (INR) recorded during the 3 months before and the 3 after the data of test administration were examined by the INR-Day software program. The percentage of time spent within, below or above the intended therapeutic range was calculated in patients who scored abnormally at AMT, and compared with matched controls with normal AMT results. Forty patients [12.9%; 28 women (19.8%) and 12 men (7.1%), P0.0011] had abnormal AMT results; the rate seemed to increase with age. Most of these patients (35, 75%) had only elementary education. Patients with abnormal AMT results spent more time outside the intended therapeutic ranges than 40 matched controls (20.9% of the observed time vs 13.7%, P0.0001; odds ratio 1.68, CI 1.53-1.84). Unsuspected reduction of mental ability or attention levels was found in a number of elderly patients receiving OAT; these patients presented longer periods of either under- or over-anticoagulation and were, therefore, exposed to a higher risk of thrombotic or bleeding complications. Anticoagulation clinics would be advised to assess mental abilities in elderly patients before starting OAT.
- Published
- 1997
37. [Deep venous thrombosis. Evaluation of a non-invasive diagnostic procedure based on compression ultrasonography and measurement of D-dimer plasma levels]
- Author
-
G, Guazzaloca, G, Palareti, C, Legnani, G, Fortunato, F, Grauso, G, Rodorigo, V, De Rosa, R, Golfieri, E, Gianpalma, D, Marri, M, Pazzaglia, R, Franchi, and S, Coccheri
- Subjects
Fibrin Fibrinogen Degradation Products ,Male ,Predictive Value of Tests ,Humans ,Female ,Phlebography ,Thrombophlebitis ,Ambulatory Care Facilities ,Ultrasonography - Abstract
Clinical diagnosis of deep venous thrombosis (DVT) of the leg is unreliable. An accurate diagnosis is important for therapeutic decision since anticoagulant treatment, though potentially dangerous, is useless in case of a false positive diagnosis, whereas a false negative diagnosis may lead to withdrawal of an extremely necessary anticoagulation. Contrast venography is still recognized as the gold standard method for the diagnosis of DVT, but in recent years a variety of accurate non-invasive methods has been developed. The ultrasound compression sonography (CUS) is considered a simple non invasive test highly sensitive and specific for proximal DVT in symptomatic outpatients, though non adequately sensitive and specific for isolated calf DVT. Plasma D-dimer levels (DD, fibrin degradation products) have a high negative predictive value for DVT. The aim of this study, performed in outpatients with suspected leg DVT, was to validate, versus venography, a non-invasive, easy to perform and fast diagnostic procedure based on a combination of CUS and D-dimer test. End points of the procedure were: confirmation or exclusion of proximal DVT; suspicion of isolated calf DVT in which case the test would be repeated in a few days to detect any possible proximalization of thrombosis.Sixty-eight consecutive outpatients, 37 male, with clinically suspected first episode of leg DVT were eligible and examined with CUS, DD test and venography.The results showed that the diagnostic procedure under examination has a high sensibility and specificity for DVT.It can thus be recommended as routine diagnostic procedure in symptomatic outpatients with suspected DVT reserving venography special cases only.
- Published
- 1997
38. Effect of diets containing different amounts of precursor and derivative fatty acids on serum TXB2
- Author
-
Magda Maranesi, Isabella Bosi, P. Pregnolato, V. Barzanti, M. Cocchi, M. Frascaro, and S. Coccheri
- Subjects
Docosahexaenoic Acids ,Clinical Biochemistry ,Linoleic Acid ,chemistry.chemical_compound ,Fish Oils ,Biosynthesis ,Animals ,Plant Oils ,Food science ,Rats, Wistar ,Olive Oil ,Triglycerides ,chemistry.chemical_classification ,Chemistry ,Fatty Acids ,Fatty acid ,Cell Biology ,Metabolism ,Lipids ,Rats ,Soybean Oil ,Thromboxane B2 ,Eicosanoid ,Biochemistry ,Eicosapentaenoic Acid ,Linoleic Acids ,Fruit ,Food, Fortified ,lipids (amino acids, peptides, and proteins) ,Fatty acid composition ,Derivative (chemistry) ,Polyunsaturated fatty acid ,Oleic Acid - Abstract
Dietary precursor and derivative polyunsaturated fatty acids influence metabolic parameters, such as eicosanoid synthesis. We have studied the effect of dietary intakes of lipids containing different amounts of precursor and derivative fatty acids (olive oil, olive-blackcurrant-fish oil mixture, blackcurrant-fish oil mixture, MCT (medium chain triglycerides)-soyabean oil mixture) on serum thromboxane B2 (TXB2) in four groups of rats. Plasma fatty acid composition showed differences related to dietary intakes. TXB2 levels were similar in all conditions except in the group receiving the mixture of olive-blackcurrant-fish oils which showed lower values.
- Published
- 1996
39. Bleeding complications of oral anticoagulant treatment: an inception-cohort, prospective collaborative study (ISCOAT). Italian Study on Complications of Oral Anticoagulant Therapy
- Author
-
G, Palareti, N, Leali, S, Coccheri, M, Poggi, C, Manotti, A, D'Angelo, V, Pengo, N, Erba, M, Moia, N, Ciavarella, G, Devoto, M, Berrettini, and S, Musolesi
- Subjects
Adult ,Aged, 80 and over ,Male ,Acenocoumarol ,Administration, Oral ,Anticoagulants ,Hemorrhage ,Middle Aged ,Cohort Studies ,Italy ,Cardiovascular Diseases ,Risk Factors ,Humans ,Female ,Prospective Studies ,Warfarin ,Aged - Abstract
Bleeding is the most serious complication of the use of oral anticoagulation in the prevention and treatment of thromoboembolic complications. We studied the frequency of bleeding complications in outpatients treated routinely in anticoagulation clinics.In a prospective cohort from thirty-four Italian anticoagulation clinics, 2745 consecutive patients were studied from the start of their oral anticoagulation (warfarin in 64%, acenocourmarol in the rest). The target anticoagulation-intensity was low (international normalised ratio [INR]or = 2.8) in 71% of the patients and high (2.8) in the remainder. We recorded demographic details and the main indication for treatment and, every 3-4 months, INR and outcome events. Such events included all complications (bleeding, thrombosis, other), although only bleeding events are reported here, and deaths. We divided bleeding into major and minor categories.43% of the patients were women. Nearly three-fifths of the patients were aged 60-79; 8% were over 80. The main indication for treatment was venous thrombolism (33%), followed by non-ischaemic heart disease (17%). Mean follow-up was 267 days. Over 2011 patient-years of follow-up, 153 bleeding complications occurred (7.6 per 100 patient-years). 5 were fatal (all cerebral haemorrhages, 0.25 per 100 patient-years), 23 were major (1.1), and 125 were minor (6.2). The rate of events was similar between sexes, coumarin type, size of enrolling centre, and target INR. The rate was higher in older patients: 10.5 per 100 patient-years in those aged 70 or over, 6.0 in those aged under 70 (relative risk 1.75, 95% Cl 1.29-2.39, p0.001). The rate was also higher when the indication was peripheral and/or cerebrovascular disease than venous thromboembolism plus other indications (12.5 vs 6.0 per 100 patient-years) (1.80, 1.2-2.7, p0.01), and during the first 90 days of treatment compared with later (11.0 vs 6.3, 1.75, 1.27-2.44, p0.001). A fifth of the bleeding events occurred at low anticoagulation intensity (INR2, rate 7.7 per 100 patient-years of follow-up). The rates were 4.8, 9.5, 40.5, and 200 at INRs 2.0-2.9, 3-4.4, 4.5-6.9, and over 7, respectively (relative risks for INR4.5, 7.91, 5.44-11.5, p0.0001).We saw fewer bleeding events than those recorded in other observational and experimental studies. Oral anticoagulation has become safer in recent years, especially if monitored in anticoagulation clinics. Caution is required in elderly patients and anticoagulation intensity should be closely monitored to reduce periods of overdosing.
- Published
- 1996
40. A prostacyclin-sparing effect of indobufen vs. aspirin
- Author
-
R, De Caterina, D, Giannessi, W, Bernini, G, Lazzerini, M, Lavezzari, E, Stragliotto, G, Biagi, and S, Coccheri
- Subjects
Adult ,Male ,Cross-Over Studies ,Aspirin ,Isoindoles ,Middle Aged ,Epoprostenol ,Phenylbutyrates ,Double-Blind Method ,Reference Values ,Prostaglandins ,Humans ,Cyclooxygenase Inhibitors ,Prospective Studies ,Platelet Aggregation Inhibitors - Abstract
Indobufen ((+/-)-2-[p-(1-oxo-2-insoindolinyl)-phenyl]-butyric acid, indo) is a drug inhibiting platelet function by a reversible block of the arachidonic acid metabolism at the level of cyclooxygenase. Since tolerability profile of such drugs is mostly linked to extra-platelet cyclooxygenase inhibition, we prospectively evaluated the extent of platelet and extra-platelet cyclooxygenase inhibition by in vivo administration of indo in comparison with ASA. We assessed the effects of the two drugs on the ex vivo generation of TXB2 and 6-keto-PGF1 alpha in whole blood, as indices of the production of TXA2 and PGI2 (prostacyclin), respectively, either after spontaneous clotting at 37 degrees C for 1 h (Study 1) or after the addition of 2 micrograms/ml collagen (Study 2). Generation of 6-keto-PGF1 alpha in whole blood is a mixed index of platelet and extra-platelet cyclooxygenase activity, deriving from both platelet and white blood cell arachidonic acid metabolization. Fifteen patients with ischemic heart disease and baseline serum TXB2 levels300 ng/ml were allocated to receiving one single administration of either indobufen 200 mg (n = 6) or aspirin 500 mg (n = 9). Whole blood prostanoid generation was assessed at 0, 1, 2, 4, 6, 8, 12 and 24 h after drug administration (Study I). Ten healthy male volunteers were allocated to a double-blind, randomized crossover comparison of indo 200 mg b.i.d. vs. ASA 300 mg/d for 7 days (Study 2). Prostanoid generation and whole blood platelet aggregation were performed before and at the end of each study period (Day 0 and Day 7). At each time-point after single dose administration (Study 1), indobufen caused less % inhibition of whole blood 6-keto-PGF1 alpha than of TXB2. At 2 h, TXB2 was reduced to a similar extent after ASA (98 +/- 4%) and indo (97 +/- 6%) (p = N.S.), while inhibition of 6-keto-PGF1 alpha was clearly different (98% after ASA, 81 +/- 2.5% after indo, p0.01). After one week of ASA or indo (Study 2) the maximum extent of whole blood platelet aggregation was similarly inhibited (from 17.2 +/- 1.4 ohms to 3.6 +/- 1.3 ohms with ASA; from 18.3 +/- 1.0 ohms to 1.6 +/- 0.7 ohms with indo (p ASA vs. indo = N.S.). Despite equal inhibition of whole blood TX production after collagen (from 49.0 +/- 4.3 ng/ml to 1.1 +/- 0.6 ng/ml with ASA, from 49.8 +/- 1.3 ng/ml to 1.4 +/- 0.6 ng/ml with indo), again, however, 6-keto-PGF1 alpha production was less affected by indo than by ASA (from 409 +/- 30 pg/ml to 37 +/- 13 pg/ml with ASA, inhibition = 91%; from 396 +/- 35 to 318 +/- 40 with indo, inhibition = 20%). These differential effects of indo and ASA might lead to a better platelet selectivity, tolerability and benefit/risk profile of indo vs. ASA, which are worthy of further assessment.
- Published
- 1996
41. Defibrotide as a possible anti-ischemic drug
- Author
-
S, Coccheri and M, Nazzari
- Subjects
Polydeoxyribonucleotides ,Endothelin-1 ,Ischemia ,Vasoconstriction ,Animals ,Humans ,Epoprostenol ,Antifibrinolytic Agents - Abstract
Defibrotide is a polydeoxyribonucleotide extracted from mammalian organs (porcine) and prepared by controlled depolymerization, resulting in a single-stranded deoxyribonucleotide with a mean molecular weight of 15 to 30 kDa. Early studies of experimental pharmacology in different animal species (1981-1986) were focused on an antithrombotic effect in arteries, veins, and the microcirculation, attributed to a dose-dependent activation of fibrinolysis. More recently, a number of new data have raised interest in an "anti-ischemic" action of the substance, as suggested by its evident protective effect in different models of tissue and organ ischemia. Protection from myocardial ischemia was demonstrated in different experimental models, and several ischemic features, such as heart muscle contracture, loss of high-energy substrates, decline in beta-adrenergic receptor sensitivity, and drop in infarct-related blood flow, were successfully prevented. Similar protective effects were observed during liver and kidney ischemia and in different types of experimental shock. The mechanisms involved in the anti-ischemic properties of defibrotide have been investigated in studies of experimental and human pharmacology. The substance has been shown to modulate arachidonic acid metabolism by enhancing the production and release of prostacyclin and prostaglandin E2 from tissues and whole blood, and inhibiting leukotriene B4 generation in leukocytes. Furthermore, an effect of defibrotide on activation of polymorphonuclear leukocytes and their incorporation into thrombi was described. Favorable effects on blood rheology were also reported. In summary, defibrotide deserves attention for therapeutic trials in clinical conditions characterized by organ or tissue ischemia.
- Published
- 1996
42. [Regression of the plaque after prolonged pharmacologic treatment]
- Author
-
S, Coccheri, A, De Fabritiis, and E, Conti
- Subjects
Clinical Trials as Topic ,Time Factors ,Arteriosclerosis ,Remission Induction ,Angiography ,Humans - Published
- 1995
43. Factor VIII: C levels during oral anticoagulation and after its withdrawal
- Author
-
G, Palareti, C, Legnani, M, Frascaro, G, Guazzaloca, and S, Coccheri
- Subjects
Factor VIII ,Administration, Oral ,Anticoagulants ,Humans ,Warfarin ,Substance Withdrawal Syndrome - Published
- 1995
44. Association of membranous nephropathy with familial resistance to activated protein C
- Author
-
V, Montinaro, S, Coccheri, G, Palareti, C, Legnani, B, Lunghi, F, Bernardi, and F P, Schena
- Subjects
Adult ,Male ,Popliteal Vein ,Drug Resistance ,Anticoagulants ,Humans ,Thrombosis ,Femoral Vein ,Glomerulonephritis, Membranous ,Pedigree ,Protein C - Published
- 1995
45. [Prevention and treatment of deep venous thrombosis: prevention of pulmonary embolism]
- Author
-
S, Coccheri and G, Palareti
- Subjects
Vena Cava Filters ,Anticoagulants ,Humans ,Thrombolytic Therapy ,Thrombophlebitis ,Pulmonary Embolism - Abstract
Deep vein thrombosis (DVT), if not properly treated, may be complicated by pulmonary embolism in about 50% of the cases within 3 months. Therefore, effective prevention of pulmonary embolism relies on three cornerstones: correct prophylaxis, early diagnosis, and correct treatment of DVT. In prophylaxis of DVT, low-dose heparin is effective in preventing postoperatory DVT and pulmonary embolism in medium risk operations, and also in "medical" DVT. In high risk operations and patients, personalized low-dose heparin, oral anticoagulants and especially low-molecular weight heparins have been used. The available controlled trials demonstrate that the low-molecular weight heparins are especially efficacious and also cost-effective in high risk situations as elective hip surgery. Validated techniques for early diagnosis of DVT are phlebography and, in symptomatic proximal DVT, also venous echotomography. Therapy of overt DVT is usually performed with infusional or subcutaneous heparin at therapeutic doses, followed by moderate range oral anticoagulants. In the initial treatment, low-molecular weight heparins at single subcutaneous daily dosing can substitute for standard heparin. Indication to thrombolytic therapy should be restricted to selected cases; thrombectomy has limited application. Caval filters may be useful in strictly selected indications, especially in presence of contraindications or resistance to anticoagulant treatments.
- Published
- 1994
46. Prolonged very low calorie diet in highly obese subjects reduces plasma viscosity and red cell aggregation but not fibrinogen
- Author
-
M, Poggi, G, Palareti, R, Biagi, C, Legnani, M, Parenti, A C, Babini, L, Baraldi, and S, Coccheri
- Subjects
Adult ,Erythrocyte Aggregation ,Male ,Diet, Reducing ,Fibrinogen ,Blood Proteins ,Middle Aged ,Blood Viscosity ,Obesity, Morbid ,Leukocyte Count ,Hematocrit ,Weight Loss ,Body Constitution ,Humans ,Female - Abstract
Epidemiological studies have shown that obesity, as well as haemorheological changes are risk factors for cardiovascular disease. The aim of this study performed in grossly obese subjects was to investigate: (a) the effects on haemorheological parameters of a 3 month period of very low calorie diet (VLCD, 514 and 470 Kcal/day in women and men respectively), and (b) the relationship between haemorheological test results at baseline and the different types of body fat distribution. Fifty-two obese healthy subjects (31 women), with BMI30, were examined at baseline; 34 of these (19 women), compliant with the diet, were also examined after 3 months VLCD. At baseline, the results of haemorheological variables were not significantly different for patients in the highest waist-to-hip ratio (WHR) tertile vs those in the other two tertiles. After VLCD, body weight and BMI decreased markedly. The values of Ht, plasma viscosity (PV), erythrocyte aggregation index (EAI) values (P0.001) and white blood cell (WBC) counts (P0.01) significantly dropped. Globulin levels decreased, while albumin levels increased leading to significantly (P0.001) higher A/G ratios. No significant changes in fibrinogen (Fgn) levels were recorded after diet. In conclusion, the present study demonstrates that prolonged VLCD associated with slimming in grossly obese subjects is effective in improving related haemorheological disorders, mainly of plasmatic type, except Fgn. Second, we found that, at least in these grossly obese subjects, there is no clear evidence of a relationship between the degree of haemorheological changes and WHR values.
- Published
- 1994
47. Pro-thrombotic states and their diagnosis
- Author
-
S, Coccheri and G, Palareti
- Subjects
Arteriosclerosis ,Humans ,Thrombosis ,Disease Susceptibility ,Blood Coagulation - Abstract
The authors define pro-thrombotic states as conditions associated with a high frequency of thrombosis; this association is based on pathogenetic or simply clinical and epidemiological relationships. Thrombophilic states have well-defined, specific causes: antithrombin III, protein C and S and similar deficiencies for inherited thrombophilias, and lupus anticoagulant, antiphospholipid antibodies for the acquired forms. Another identifiable group is made up of several conditions predisposing to thrombosis (CPT) characterized by less specific and multiple mechanisms (e.g. malignancy, inflammatory bowel disease, nephrotic syndrome, diabetes, obesity, etc.). These conditions may induce thrombosis by themselves or contribute to its clinical onset in patients with true thrombophilic states. This is especially the case for patients who are taking contraceptive drugs, are pregnant, have undergone surgery or trauma. The term hypercoagulability states is by no means equivalent to either thrombophilia or CPT. In fact, hypercoagulability may be defined as "activation of blood coagulation" in the presence of specific markers such as fibrinopeptide A and prothrombin fragment F1 + 2. Hypercoagulability is therefore a laboratory rather than a clinical condition and can be a transient feature appearing during certain phases of thrombophilia or CPT. Lastly, conditions involving the presence of hemostatic risk factors for atherothrombosis are simply terms used to describe a statistical-epidemiological relationship between certain hemostatic variables (fibrinogen, factor VII, PAI, etc.) involving the risk of cardiovascular morbidity and mortality but not necessarily indicating a hypercoagulability state.
- Published
- 1994
48. Contents Vol. 32, 2002
- Author
-
Giovanna Marchetti, Antonella Marcoccia, Domenico Prisco, Giovanni Melandri, J.J. Badimon, Mónica Pereira, Justo Aznar, Angelo Branzi, Roberto Catasca, Francesco Violi, Licia Iacoviello, P.M. Mannucci, Andrew N. Nicolaides, Jean-Noël Fiessinger, Francisco España, Gregory Barshtein, Fabrizio Fabris, Luisa Lenti, Maria Assunta Silvestri, Matteo Nicola Dario Di Minno, S. Coccheri, Samuele Nanni, F. Coppi, F.R. Rosendaal, T. Fenyvesi, Alexander Koshkaryev, M.F. Hoylaerts, Luigina R. Mollica, Andrea Ghiselli, Alexandra Estevinho, A. De Fabritiis, Silvia Navarro, P. Poredoš, Irène Juhan-Vague, H.C. Hemker, Pierluigi Tricoci, José Manuel Cabeda, R. Abbate, G. Vilahur, Antonella Tufano, P. Carrasco, S. Fedi, J. Harenberg, Tiziana Garofano, Fabio M. Pulcinelli, M.G. Modena, Saul Yedgar, Juan Carlos Souto, Henrik Sillesen, B. Cosmi, Meyer Michel Samama, Raymond Verhaeghe, Ingrid Pabinger, P. Giesen, Ebrahim Shah, Pasquale Pignatelli, Giuseppe Germanò, David A. Lane, Jacqueline Conard, Augusto Di Castelnuovo, T. Grimaldi, Pierre Morange, Marie-Christine Alessi, José Miguel P. Ferreira de Oliveira, Daniela Turchetti, Gloria Saccani, V. Regnault, Joseph Emmerich, Giovanni de Gaetano, Rossella Marcucci, Maria Benedetta Donati, Manuel Campos, J. Vermylen, Marie Hélène Horellou, Ida Martinelli, Serenella Rotondo, R. AlDieri, E. Sticchi, Giuseppe G. Nenci, F. Sofi, Sara Morais, Helga Grafenhofer, F. Gensini, C. Fatini, Chiara Melloni, Franco Semprini, R. Wagenvoord, Francesco Bernardi, M. Verstraete, I. Jörg, Grigoris T. Gerotziafas, Gianni Belcaro, Antonio Girolami, Bruno Girolami, Gordon D.O. Lowe, Joseph Loscalzo, Giovanni Romeo, V.V. Kakkar, Giovanni Di Minno, Irene Pereira, Benvindo Justiça, Ismail Elalamy, T. Lecompte, G. Fantini, Francesco Fallani, Pilar Medina, V. Llorente, L. Badimon, E. Conti, Armando Tripodi, G. Origliani, R. Rossi, Stavros K. Kakkos, Maura Griffin, George Geroulakos, E. de Smed, A. Nemmar, Amparo Estellés, Andrew H. Baker, Uri Seligsohn, B. Nemery, S. Béguin, J.I. Abad, E. Segalés, and Evy Bashardi
- Subjects
medicine.medical_specialty ,business.industry ,Physiology (medical) ,General surgery ,medicine ,Hematology ,business ,Surgery - Published
- 2002
- Full Text
- View/download PDF
49. Effects of a dried garlic preparation on fibrinolysis and platelet aggregation in healthy subjects
- Author
-
C, Legnani, M, Frascaro, G, Guazzaloca, S, Ludovici, G, Cesarano, and S, Coccheri
- Subjects
Adult ,Blood Platelets ,Male ,Plants, Medicinal ,Platelet Aggregation ,Platelet Function Tests ,Fibrinolysis ,In Vitro Techniques ,beta-Thromboglobulin ,Adenosine Diphosphate ,Thromboxane B2 ,Plasminogen Activators ,Plasminogen Inactivators ,Adenosine Triphosphate ,Double-Blind Method ,Humans ,Collagen ,Garlic ,Blood Coagulation - Abstract
The acute and chronic effects of a preparation of dried garlic powder (Sapec) in a total daily dose of 900 mg on fibrinolysis and platelet aggregation have been evaluated in a randomized, double-blind, placebo controlled cross-over study of 12 healthy subjects. Total euglobulin fibrinolytic activity and t-PA (tissue plasminogen activator) activity were significantly higher 4 and 6 h after garlic and placebo ingestion, and no differences were recorded between treatments. After 14 days of treatment, t-PA activity was significantly higher after garlic, with inter-treatment significance. No significant changes in PAI (Plasminogen Activator Inhibitor) activity and fibrinogen levels were recorded. Platelet aggregation induced by adenosine diphosphate and collagen, and especially beta-thromboglobulin (beta-TG) release after collagen stimulation were significantly inhibited 2 and 4 h after garlic ingestion; platelet aggregation values were also significantly lower after 7 and 14 days of garlic treatment. No significant changes were found in adenosine triphosphate release and serum TXB2 levels after acute garlic administration.
- Published
- 1993
50. Prophylaxis of venous thrombosis after gynaecological surgery: a controlled pilot study of defibrotide
- Author
-
G, Palareti, G, Guazzaloca, C, Legnani, N, Leali, P, Busacchi, G, Sani, M, Levorato, M G, Di Marco, and S, Coccheri
- Subjects
Risk ,Laparotomy ,Heparin ,Fibrinolysis ,Incidence ,Pilot Projects ,Middle Aged ,Thrombophlebitis ,Polydeoxyribonucleotides ,Fibrinolytic Agents ,Prevalence ,Drug Evaluation ,Humans ,Female ,Blood Coagulation Tests ,Genital Diseases, Female - Abstract
Defibrotide (Def), a new antithrombotic drug, has been proposed as a prophylactic agent in postoperative DVT. Most of the studies to date, however, have either not been controlled or have used unverifiable systems for asymptomatic DVT diagnosis. This randomized pilot study compared Def versus standard low-dose calcium heparin (CH) prophylaxis after gynaecological surgery, using objective criteria for DVT diagnosis.Forty-one pts received 400 mg Def intramuscularly twice a day starting the day before surgery; 40 pts received 5000 IU CH s.c. twice daily beginning 2h before surgery. The two groups were well matched for all relevant risk factors. DVT was diagnosed by means of the 125I fibrinogen uptake test (FUT) and venography. Blood coagulation and fibrinolysis tests were also carried out perioperatively.Isotopic DVT (FUT-positive for two consecutive days) was recorded in 6 (14.6%) of the Def and 5 (12.5%) of the CH groups. In cases where FUT was positive for at least three consecutive days (4 in Def and 1 in CH), venography confirmed DVT in 3 cases (all in the Def group). No side-effects were recorded in either group and the amounts of transfused blood were not different. No significant differences in blood coagulation or fibrinolysis tests were recorded, except for higher fibrinogen levels on the 8th post-operative day in the Def group.These results do not indicate any trend suggesting that Def, as a prophylactic agent in gynaecological surgery, offers any clinical or practical advantages over standard low-dose heparin prophylaxis.
- Published
- 1992
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.