N Cavallari

Sapienza University of Rome, Roma, Latium, Italy

Are you N Cavallari?

Claim your profile

Publications (26)30.97 Total impact

  • Digestive and Liver Disease - DIG LIVER DIS. 01/2011; 43.
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Patients with ulcerative colitis often receive thiopurines as immunomodulators (IMs) to maintain remission and avoid corticosteroids. If unresponsive or intolerant to these agents, patients are treated with methotrexate, an antimetabolite never assessed in paediatric ulcerative colitis. To describe the experience with methotrexate in children with ulcerative colitis. Thirty-two patients (median age 13.9 years) received methotrexate. Pediatric Ulcerative Colitis Activity Index (PUCAI) and use of corticosteroids were the main outcomes evaluated at baseline and at 3, 6 and 12 months. Indications to methotrexate were azathioprine unresponsiveness in 18 patients, azathioprine intolerance/toxicity in 10 and spondyloarthropathy in four. Response or remission was achieved in 72%, 63% and 50% of patients at 3, 6 and 12 months respectively. Mean PUCAI were 49.5 ± 23.3 at baseline and 32.9 ± 21.9, 29.5 ± 21.8 and 29.4 ± 19.9 at 3, 6 and 12 months respectively (P: 0.03). At the beginning of methotrexate, 16 patients (50%) received corticosteroids that were discontinued in 13 of them (81%) by 6 months. At the end of the study, 11 patients (33%) needed short courses of corticosteroids for disease relapse. Methotrexate may be useful in treating children with ulcerative colitis, although large, controlled trials are warranted to define better its effectiveness.
    Alimentary Pharmacology & Therapeutics 10/2010; 32(8):1017-22. · 4.55 Impact Factor
  • Digestive and Liver Disease - DIG LIVER DIS. 01/2010; 42.
  • Digestive and Liver Disease - DIG LIVER DIS. 01/2010; 42.
  • Journal of Pediatric Gastroenterology and Nutrition - J PEDIAT GASTROENTEROL NUTR. 01/2009; 48.
  • Digestive and Liver Disease - DIG LIVER DIS. 01/2009; 41.
  • Journal of Pediatric Gastroenterology and Nutrition - J PEDIAT GASTROENTEROL NUTR. 01/2009; 48.
  • Digestive and Liver Disease - DIG LIVER DIS. 01/2008; 40(10).
  • Digestive and Liver Disease - DIG LIVER DIS. 01/2008; 40(10).
  • N Cavallari, A Polistena, A Cavallaro
    [Show abstract] [Hide abstract]
    ABSTRACT: To examine the effect of University of Wisconsin solution (UWS) on the formation of postoperative peritoneal adhesions. Laboratory experiment. University hospital, Italy. 42 Sprague-Dawley rats. A standard lesion was made consisting of serosal trauma of the caecum and a parietal peritoneal defect. Rats were randomly divided into seven groups (n = 6 each): the first group acted as controls; the second had instilled normal saline 6 ml; the third Ringer's lactate 6 ml; the fourth UWS 6 ml; the fifth normal saline 12 ml; the sixth Ringer's lactate 12 ml; and the seventh UWS 12 ml. Adhesions were scored two weeks later for extent (0 to 4) and type (0 to 4). Adhesion strength was measured by a tensiometer. The mean (SEM) scores for extent and type of adhesions were significantly lower (p < 0.05) after instillation of Ringer's lactate 12 ml [1.0 (0.4) and 1.2 (0.4), respectively] than controls [3.5 (0.3) and 2.7 (0.2), respectively]. Adhesions were also significantly weaken (p < 0.05) [101 (33) g] than in controls [207 (6) g]. Intraperitoneal instillation of normal saline and UWS were ineffective in reducing the extent and type of adhesions. Although Ringer's lactate produced a significant reduction in severity, the effect was strongly volume related. This amount of fluid may be detrimental to a patient's postoperative course.
    The European Journal of Surgery 09/2000; 166(8):650-3.
  • [Show abstract] [Hide abstract]
    ABSTRACT: The significance of ambulatory venous pressure measurement in the diagnosis of chronic venous insufficiency of the lower limbs is evaluated. 190 limbs of 120 outpatients were investigated from 1991 through 1997; the study was performed whenever clinical and ultrasound evaluation did not allow to establish the diagnosis of "simple varices". The technique standardized according to Nicolaides was followed. The results of the study confirm the importance of ambulatory venous pressure measurement in the differential diagnosis of chronic venous hypertension of the lower limbs, especially when caused by vein compression, as well as in the follow-up of these patients when submitted to surgical treatment.
    Minerva cardioangiologica 07/1999; 47(6):185-9. · 0.43 Impact Factor
  • Journal of Vascular Surgery 02/1998; 27(2):385-6. · 2.88 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Injuries of endothelial and smooth muscle cells of autologous vein due to preservation in standard storage media may be responsible for graft failure. The effects of vein preservation with University of Wisconsin solution (UWs) on endothelial and smooth muscle cell function and morphology were compared to the effects of preservation with autologous whole blood (AWB) and normal saline (NS), which are frequently used in cardiovascular surgery. Canine external jugular and common femoral vein segments were preserved in the different solutions at 4 degrees C for 45 min and 24 hr. Rings (4-5 mm in length) from control and preserved veins were evaluated by isometric tension studies at 37 degrees C and by scanning and transmission electron microscopy. Differences between groups were evaluated by Student's t test or Mann-Whitney U test and by analysis of the variance, and considered to be significant at P < 0.05. Sensitivities to norepinephrine (NE) showed that a 45-min vein storage in AWB (5.7 +/- 0.2 mumol/L) but not in NS (5.8 +/- 0.2 mumol/L) or UWs (6.5 +/- 0.2 mumol/L) had a deleterious effect on function of smooth muscle (P < 0.05) when compared to control veins (6.6 +/- 0.2 mumol/L). Maximum contractile responses and sensitivities to NE were significantly altered (P < 0.05) after 24-hr vein storage in AWB (0.09 +/- 0.02 g/mm2 and 5.4 +/- 0.07 mumol/L) and NS (0.12 +/- 0.03 g/mm2 and 5.6 +/- 0.08 mumol/L) but not in UWs (0.36 +/- 0.06 g/mm2 and 6.4 +/- 0.07 mumol/L). With both storage times, acetylcholine-induced endothelium-dependent maximum relaxations and sensitivities were significantly reduced (P < 0.05) in veins stored in AWB and NS, but not in UWs, compared with controls. Similarly, transmission electron microscopy revealed marked neutrophil migration beneath the intimal surface of vessels and extensive separation and desquamation of endothelial cells with exposure of subendothelial structures in veins stored in AWB and NS. The results suggest that UWs is a suitable storage medium when compared to AWB and NS.
    Journal of Surgical Research 04/1997; 68(2):106-15. · 2.02 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Suboptimal preservation of autologous veins in storage solutions causes endothelial cell damage that can contribute to graft failure. The purpose of this study was to compare the effects of short-term storage of veins in autologous whole blood (AWB), 0.9% normal saline solution (NS), and University of Wisconsin solution (UWs) on vein structure and function after grafting. Autogenous jugular and femoral veins were atraumatically harvested from mongrel dogs. One vein segment was immediately implanted to serve as a control, and the other segments were stored for 45 minutes in AWB, NS, or UWs. The veins were implanted as reversed interposition graft in the carotid or femoral arteries. After 6 weeks light and scanning electron microscopy and isometric tension studies were performed on explanted vein grafts. Morphologic studies revealed an intact endothelium that stained positively for factor VIII. Intimal thickness was similar between controls (48 +/- 12 microns) and veins stored in UWs (53 +/- 8 microns) (p = not significant), but it was significantly increased in veins stored in AWB (151 +/- 29 microns) and NS (149 +/- 18 microns) (p < 0.05). Sensitivity and maximum contraction to norepinephrine were not altered in veins preserved in UWs (6.0 +/- 0.1 mumol/L and 0.19 +/- 0.02 gm/mm2) but were significantly reduced (p < 0.05) in those stored in AWB (7.2 +/- 0.1 mumol/L and 0.08 +/- 0.02 gm/mm2) and NS (7.0 +/- 0.3 mumol/L and 0.09 +/- 0.02 gm/mm2) compared with controls (5.9 +/- 0.2 mumol/L and 0.20 +/- 0.02 gm/mm2). The sensitivity and maximum relaxation to acetylcholine and sodium nitroprusside of veins preserved in AWB, NS, and UWs were similar to controls (p = not significant). Vein storage in UWs preserves smooth muscle cell function compared with veins stored in NS or AWB. Therefore UWs is a more suitable medium for short-term preservation of veins in cardiovascular operation.
    Surgery 01/1997; 121(1):64-71. · 3.37 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Ischemia produces functional and structural alterations in peripheral blood vessels. Our study was designed to investigate alpha-adrenoceptor modifications induced by prolonged ischemia and their role in enhancing the contractile response during reperfusion in canine femoral arteries. Unilateral vessel ischemia was created by double crossclamping a femoral artery and was maintained for 3 hr. Reperfusion was allowed for 1 hr. The contralateral femoral artery was utilized as a control. The vessels were harvested for contractile and binding studies. Isometric tension studies revealed that the magnitude of the maximum contractile response to norepinephrine (NE), potassium chloride (KCl), and methoxamine was 671 +/- 82 mg/mm2 versus 245 +/- 43 mg/mm2 (P < 0.01), 485 +/- 46 mg/mm2 versus 229 +/- 62 mg/mm2 (P < 0.05), and 486 +/- 88 mg/mm2 versus 126 +/- 38 mg/mm2 (P < 0.01), respectively for ischemic and nonischemic femoral arteries. EC50 values showed that ischemic vessels were more sensitive to NE, KCl, and methoxamine (P < 0.05). Sodium nitroprusside induced concentration-dependent and complete relaxation in all arterial rings (100% relaxation) but the ischemic femoral artery showed less sensitivity (P < 0.05). Binding studies showed that the number of binding sites (Bmax) for [3H]Prazosin and [3H]Rauwolscine were significantly increased in ischemic versus nonischemic vessels (1261 +/- 95 fmole/mg versus 704 +/- 113 fmole/mg, P < 0.03, and 490 +/- 86 fmole/mg versus 175 +/- 15 fmole/mg, P < 0.04, respectively). Furthermore, a significant decrease in affinity (Kd) for [3H]Prazosin and [3H]Rauwolscine was observed in ischemic versus nonischemic tissues (9.4 +/- 1.7 nM versus 4 +/- 0.2 nM, P < 0.02, and 6.4 +/- 1.5 nM versus 1.8 +/- 0.6 nM, P < 0.01, respectively). The increase in canine femoral artery vasoreactivity, following prolonged ischemia, seems to be also due to an increased density and functional activity of alpha-adrenoceptors expressed by the ischemic arterial smooth muscle cells.
    Journal of Surgical Research 05/1996; 62(2):192-6. · 2.02 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Aneurysmal dilatation of the femoral artery is a rare condition of uncertain aetiology. Between January 1972 and December 1992, 31 atherosclerotic femoral aneurysms in 22 patients were seen. There were 21 men and 1 woman; mean(s.d.) age was 70.1(10.4) years. Thirteen (42%) femoral aneurysms (group 1) were isolated aneurysms, two being bilateral. Eighteen (58%) were associated with a non-contiguous abdominal aortic aneurysm, four being unilateral and seven bilateral femoral aneurysms (group 2). The mean(s.d.) size of these aneurysms was 4.7(1.5) and 3.5(0.7)cm in groups 1 and 2 respectively (P< 0.01). Of the limbs in group 1,12 were treated by an interposition bypass. A ruptured profunda femoris artery aneurysm was ligated in one limb as an emergency operation. All patients in group 2 underwent an aortobifemoral graft. There was one operative death. Three early thromboses were observed; two autogenous saphenous vein interposition grafts and one limb of an aortobifemoral. One late thrombosis occurred in an expanded polytetrafluoroethylene graft in group 1. The five-year patency rate was 80% for group 1 and 88.9% for group 2 (P=n.s.). The overall 10-year limb salvage rate was 100%. These findings suggest that isolated femoral aneurysms are larger and more frequently symptomatic than femoral aneurysms associated with an abdominal aortic aneurysm. The association between femoral aneurysm and abdominal aortic aneurysm was found to be higher in patients with bilateral femoral aneurysms compared with those with unilateral lesions (P< 0.05). In the treatment of isolated femoral aneurysms better early results were obtained with expanded polytetrafluoroethylene interposition grafts.
    Cardiovascular Surgery 05/1996; 4(2):181-84.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Synthetic grafts are widely used for peripheral arterial reconstructions when autologous veins are not available, but their results have not been satisfactory. Venous allograft may be used as an alternative to synthetic prostheses. The aim of the study was to explore the immunosuppressive efficacy of Cyclosporine A (CyA) as a means of preventing venous allograft failures and rejection. We utilized 56 mongrel dogs. Immunological incompatibility was checked with the skin graft method. Donor inferior vena cava was transplanted into the infrarenal abdominal aorta of recipient animals. One group (group 1, 10 dogs) served as a control and three groups received CyA treatment regimens. Group 2 (10 dogs) received postoperative oral CyA treatment for 30 days. Group 3 (12 dogs) received a vein graft pretreated with a CyA solution without postoperative immunosuppressive therapy. Group 4 (9 dogs) received a vein graft pretreated with a CyA solution and postoperative CyA treatment for 30 days. Allografts were examined at 30 days for patency, aneurysmal dilatation, gross structural changes, inflammatory response, and lymphocytic infiltration. Sex chromatine assessment determined the origin (donor or recipient) of the endothelial cells. The allografts from groups 1 and 3 showed significant aneurysmal dilatation and perivenous inflammation when compared to dogs treated with oral CyA therapy (P < 0.0002). Moreover allografts treated with CyA therapy had a better-developed venous neointima (P < 0.009) with less fibrin (P < 0.02) and thinner medial (P < 0.0009) with less fibrin (P < 0.02), and thinner medial (P < 0.0009) and adventitial layers (P < 0.02). No significant differences were observed in neointimal thickness among the four groups. Lymphocytic infiltration was greater in the group of animals who did not receive oral CyA therapy (P < 0.0004). Barr bodies status showed significant differences between oral CyA treated groups and nontreated groups (P < 0.0003). Oral CyA therapy reduced aneurysmal dilatation and immunological response, promoted the development of a neoendothelium, and preserved the structure of the venous layers. Graft pretreatment with CyA flushing did not have a significant immunosuppressive effect.
    Journal of Surgical Research 04/1996; 62(1):95-102. · 2.02 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Recurrence or persistence of neurologic symptoms after surgical treatment of patients with thoracic outlet syndrome (TOS) are reported to be as high as 25%. To identify factors affecting the long-term outcome of surgical treatment of patients with TOS, we reviewed our 20-year experience. One hundred thirty-four transaxillary first rib resections were performed on 118 patients (43 men, 75 women, mean age 38 +/- 13 years). Eighty-three operations (61.9%) were undertaken to relieve symptoms resulting from compression of the lower roots of the brachial plexus, 37 (27.6%) for compression of both lower and upper roots, and 14 (10.5%) for lower root and vascular symptoms. All patients underwent a transaxillary extraperiosteal first rib resection with transection of the scalene muscles. In 73 cases (54.5%) a resection of the anterior scalene muscle was also performed. A cervical rib was removed in 28 cases (20.1%), and anomalous fibrous bands adjacent to the neurovascular bundle were resected in 41 cases (30.6%). No major complications were observed. Of 105 patients (118 procedures) followed up (mean follow-up, 99 +/- 72 months), good to excellent results were obtained in 96 cases (81.4%) and fair to poor results were recorded in 22 cases (18.6%). The presence of a long posterior first rib stump, measured from the chest x ray films, was the strongest determinant of the long-term results among the variables examined (p < 0.0001). Reoperation, consisting of neurolysis and resection of the stump, was performed in 16 patients. The results were excellent in all cases at a mean follow-up of 66 +/- 46 months. Primary and secondary 10-year, actuarial freedom rates from recurrent symptoms were 80.9% and 93.1%, respectively. Our results suggest that the long-term outcome after surgery for TOS was strongly influenced by the extent of the first rib resection.
    Surgery 11/1995; 118(5):840-4. · 3.37 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: This study was carried out to investigate if the University of Wisconsin solution (UWs) is suitable for long-term preservation of autogenous vein grafts (AVG) prior to transplantation, compared to autologous whole blood (AWB) and normal saline (NS). Autogenous jugular and femoral veins were harvested from adult mongrel dogs, using a "no-touch" technique. One segment of vein was immediately implanted to serve as a control, while other segments were stored for 24 hr at 4 degrees C in AWB, NS, or UWs. The control and the preserved veins were implanted as reversed interposition grafts in the common carotid or femoral artery positions. After 6 weeks, scanning electron microscopy revealed an intact endothelial cell monolayer in all vein grafts that was stained positively for factor VIII. The degree of intimal thickening, as assessed by light microscopy in the middle position of the grafts, was similar in controls (52.0 +/- 15.8 microns) and in veins stored in UWs (58.5 +/- 16.1 microns), but it was significantly increased (P < 0.05) in veins preserved in NS (198.9 +/- 19.5 microns) and in AWB (312.0 +/- 171.6 microns). Isometric tension studies revealed that maximum contraction and sensitivities (assessed by EC50) to norepinephrine were significantly reduced (P < 0.05) in AVG stored in AWB (0.05 +/- 0.02 g/mm2 and 5.5 +/- 2.8 microM), but not in UWs (0.16 +/- 0.03 g/mm2 0.92 +/- 0.34 microM) and NS (0.09 +/- 0.03 g/mm2 and 3.0 +/- 1.1 microM), compared with controls (0.17 +/- 0.03 g/mm2 and 0.99 +/- 0.38 microM). Acetylcholine (Ach)-induced maximum relaxations were similar in all of the veins.(ABSTRACT TRUNCATED AT 250 WORDS)
    Journal of Surgical Research 10/1995; 59(4):433-40. · 2.02 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: In order to determine any possible influence of climatic variables on the incidence of abdominal aortic aneurysm rupture, we reviewed 49,144 autopsies performed in two major hospitals in Rome, Italy, from January 1956 to March 1986. There were 297 subjects who were found to be sufferers of atherosclerotic abdominal aortic aneurysm for a prevalence of 0.6%. The aneurysm was intact in 220 cases (74%) and ruptured in 77 cases (26%). The highest incidence of ruptured aneurysm occurred during the Autumn and in the months May and July. The incidence of ruptured aneurysm was highest in case of significant changes of the atmospheric temperature. There was no correlation between the incidence of ruptured aneurysm and barometric pressure or humidity.
    Journal of the Royal College of Surgeons of Edinburgh 03/1995; 40(1):14-5.

Publication Stats

241 Citations
30.97 Total Impact Points

Institutions

  • 1995–2008
    • Sapienza University of Rome
      • Department of Surgery "Pietro Valdoni"
      Roma, Latium, Italy
  • 1995–1997
    • Creighton University
      • Department of Surgery
      Omaha, NE, United States
  • 1993
    • University of Nebraska at Omaha
      • Department of Surgery
      Omaha, NE, United States