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Biomedical subjects

A Barbera

Publications and source records attributed to A Barbera.

At least 19 recordsLinked to original sources
PubMed2002

[Primary non-Hodgkin's lymphoma of the colon: a rare but possible location. Therapeutic approach. Description of a clinical case and review of the literature].

On the basis of a case of large cell, highly malignant, non-Hodgkin's lymphoma of the colon, the authors describe the special features of this rare location; the general aspects of this rare pathology of the colon are then considered. The clinical case relates to a large cell, highly malignant, non-Hodgkin's colic lymphoma located in the caecum at two thirds proximally of the ascending colon of which it occupies half the lumen. The patient had come to our observation for a quite aspecific symptomatology characterised by digestive disturbances and a tendency to stipsis. In disaccord with certain literature reports, surgical treatment was considered by the authors the key to the therapeutic approach. Surgical exeresis should be as radical as possible to permit complementary therapies (chemotherapy and radio-therapy) to act with most effectiveness and thus offer the patient a better life.

Humans↗
PubMed2001

Inducible nitric oxide synthase knockout mice exhibit resistance to the multiple organ failure induced by zymosan.

In the present study, by comparing the responses in wild-type mice (+/+) and mice lacking (-/-) the inducible (or type 2) nitric oxide synthase (iNOS), we investigated the role played by iNOS in the development of non-septic shock. A severe inflammatory response characterized by peritoneal exudation, high peritoneal levels of nitrate/nitrite, and leukocyte infiltration into peritoneal exudate was induced by zymosan administration in iNOS +/+ mice. This inflammatory process coincided with the damage of lung, liver, and small intestine, as assessed by histological examination. Lung, small intestine, and liver myeloperoxidase (MPO) activity, indicative of neutrophil infiltration and lipid peroxidation, were significantly increased in zymosan-treated iNOS +/+ mice. Peritoneal administration of zymosan in the iNOS +/+ mice induced also a significant increase in the plasma levels of nitrite/nitrate and in the levels of peroxynitrite at 18 h after zymosan challenge. Immunohistochemical examination demonstrated a marked increase in the immunoreactivity to nitrotyrosine and to poly ADP-ribose synthetase (PARS) in the lung, liver, and intestine of zymosan-treated iNOS +/+ mice. The intensity and degree of nitrotyrosine and PARS were markedly reduced in tissue section from zymosan-iNOS -/- mice. Zymosan-treated iNOS -/- mice showed a significantly decreased mortality and inhibition of the development of peritonitis. In addition, iNOS -/- mice showed a significant protection on the development of organ failure since tissue injury and MPO were reduced in lung, small intestine, and liver. Furthermore, a significant reduction of suppression of mitochondrial respiration, DNA strand breakage, and reduction of cellular levels of NAD+ was observed in ex vivo macrophages harvested from the peritoneal cavity of iNOS -/- mice subjected to zymosan-induced non-septic shock. In vivo treatment with aminoguanidine (300 mg/kg 1 and 6 h after zymosan administration) significantly prevents the inflammatory process. Taken together, our results clearly demonstrate that iNOS plays an important role in zymosan-induced non-septic shock.

Animals↗
PubMed2000

Right ventricular systolic pressure load alters myocyte maturation in fetal sheep.

The effects of right ventricular (RV) systolic pressure (RVSP) load on fetal myocyte size and maturation were studied. Pulmonary artery (PA) pressure was increased by PA occlusion from mean 47.4 +/- 5.0 (+/-SD) to 71 +/- 13.6 mmHg (P < 0.0001) in eight RVSP-loaded near-term fetal sheep for 10 days. The maximal pressure generated by the RV with acute PA occlusion increased after RVSP load: 78 +/- 7 to 101 +/- 15 mmHg (P < 0.005). RVSP-load hearts were heavier (44.7 +/- 8.4 g) than five nonloaded hearts (31.8 +/- 0.2 g; P < 0.03); heart-to-body weight ratio (10.9 +/- 1.1 and 6.5 +/- 0.9 g/kg, respectively; P < 0.0001). RVSP-RV myocytes were longer (101.3 +/- 10.2 microm) than nonloaded RV myocytes (88.2 +/- 8.1 microm; P < 0. 02) and were more often binucleated (82 +/- 13%) than nonloaded myocytes (63 +/- 7%; P < 0.02). RVSP-loaded myocytes had less myofibrillar volume than did nonloaded hearts (44.1 +/- 4.4% and 56. 1 +/- 2.6%; P < 0.002). We conclude that RV systolic load 1) leads to RV myocyte enlargement, 2) has minor effects on left ventricular myocyte size, and 3) stimulates maturation (increased RV myocyte binucleation). Myocyte volume data suggest that RV systolic loading stimulates both hyperplastic and hypertrophic growth.

Animals↗
PubMed2000

[Posterior approach in the treatment of sacrococcygeal chordoma: a rare, locally infiltrating, destructive and recurrent tumor. A case report and review of the literature].

Based on personal observation of a case of recurrent chordoma in the sacrococcygeal region four years after the first excision with subtotal resection of the coccyx using a posterior approach, the authors describe the unique characteristics of this rare neoplasm and underline the simplicity of this method of treatment. The surgical technique used to treat the recurrent form also used a posterior approach, with complete resection of the neoplasm including the scar of the previous operation and the last remaining segment of the coccyx. No intra- or postoperative complications were reported. The authors examine the clinical and histological aspects of this neoplasm, concluding that the correct form of treatment must aim both to protect the adjacent anatomic structures and to achieve radical exeresis, as well as achieving a simpler surgical approach unhampered by complications. The authors believe that this approach is simpler than the abdominal-dorsal approach, although this is necessary in the event of intra-abdominal infiltrations.

Aged↗
PubMed1999

Relationship of umbilical vein blood flow to growth parameters in the human fetus.

OBJECTIVE: Our purposes were to determine the relationship of the growth of umbilical blood flow to growth in body measurements of human fetuses in uncomplicated pregnancies. The study also aimed to assess the relative contributions of growth in umbilical vein diameter and of increased velocity to the increase in umbilical blood flow. STUDY DESIGN: An animal study was conducted to assess the accuracy of umbilical vein blood flow measurements obtained by triplex mode ultrasonography. Seven pregnant ewes underwent triplex mode umbilical vein flow determination. These results were compared with historical flow data obtained by a steady-state diffusion technique in 34 ewes matched for gestational age and weight. In a separate study performed on human beings, reproducibility and precision of triplex mode flow determination were assessed, as were the relationships between umbilical vein flow and gestational age and head and abdominal circumferences. This cross-sectional study was performed with 70 healthy fetuses ranging from 20 weeks' gestation to term. Best-fit interpolating equations and confidence limits were calculated for blood flow measurements versus gestational age and head and abdominal circumferences. RESULTS: In the validation study performed on sheep there were no significant differences between triplex mode and steady-state measurement groups with respect to gestational age or weight. The umbilical vein flows were similar between triplex mode and steady-state measurement groups (P =.881). In the human study the intraobserver and interobserver coefficients of variation for the vein diameter, mean velocity, and absolute umbilical vein blood flow varied from 2.9% to 12.7%. The mean duration of examination was 3 +/- 1 minutes. The umbilical vein diameter and mean velocity increased throughout pregnancy. The absolute umbilical vein flow increased exponentially from 97.3 mL/min at midgestation to 529.1 mL/min at 38 weeks' gestation, whereas umbilical vein flow per kilogram of fetal weight did not change significantly with gestational age. There was a strong correlation between absolute umbilical vein flow and the fetal head and abdominal circumferences. CONCLUSIONS: The triplex mode ultrasonographic technique can play an innovative role in obtaining quick and reproducible measurements of umbilical vein blood flow. The approach was validated with a sheep model. Umbilical vein blood normalized for fetal weight (milliliters per minute per kilogram of fetal weight) and absolute flow (in milliliters per minute) are consistent with previous human studies. We have established new reference values of umbilical vein blood flow relative to head and abdominal circumferences. The growth of umbilical venous diameter accounted for most of the growth in umbilical vein flow.

Animals↗
PubMed1999

Relationship of fetal growth to duration of heat stress in an ovine model of placental insufficiency.

OBJECTIVE: Intrauterine growth restriction in an ovine model occurs after exposure to environmental heat stress for 80 days beginning at 35 days' gestation. Our objective was to determine whether intrauterine growth restriction is reversible on removal of the heat stress after only 55 days of exposure; that is, does a brief exposure at a critical point of development suffice? STUDY DESIGN: Five pregnant ewes were exposed to heat stress beginning at 35 days' gestation and were removed after 55 days of exposure. Five ewes in a control group were studied as contemporaneous controls and added to data from 37 ewes in a control group previously studied. Serial fetal biometric ultrasonographic measurements (biparietal diameter, abdominal circumference, femur length, and tibia length) were obtained beginning at 50 days' gestation. Growth curves were calculated for each parameter, and comparisons were made between fetuses in the group exposed to heat stress for 55 days and 42 fetuses in the control group and 4 fetuses from a previous study that were exposed to heat for 80 days. Regression lines, 95% confidence intervals, and slopes were determined for each study group. RESULTS: Both the 55-day and the 80-day heat exposure groups showed a significant reduction in fetal and placental weights compared with the control group. Animals in the 80-day group had significantly lower fetal and placental weights than the animals in the 55-day group (P <.05). Indexes of somatic growth (abdominal circumference, femur length, and tibia length) for the control group were significantly greater than those of either the 55-day group or the 80-day group (P <.001). Asymmetric growth restriction was evident in both heat groups by a biparietal diameter/abdominal circumference ratio that was significantly higher than in the control group (P <.004 for the 55-day group and P <.001 for the 80-day group). The slopes for somatic parameters (abdominal circumference, femur length, and tibia length) versus time became significantly different between the control and 55-day groups at 77, 101, and 80 days' gestation, respectively. The 55-day group had abdominal circumference and femur length measurements that were significantly greater than those in the 80-day group. CONCLUSION: The fetuses in the 55-day and 80-day groups reflect a pattern of asymmetric intrauterine growth restriction. Our findings suggest that the initial insult affecting fetal and placental growth occurs early in gestation, but removal of fetuses after only 55 days of exposure significantly reduces the degree of fetal growth restriction compared with that found in those fetuses exposed for 80 days.

Abdomen↗
PubMed1998

[Evaluation of the treatment with disodium cromoglycate in the ulcerative rectocolitis. Our experience].

BACKGROUND AND AIMS: This study highlights the possibility of treating recidivating ulcerative rectocolitis with oral disodium cromoglycate based on the assay of plasma IgE. METHODS: The study was performed from January 1995 to December 1997 in 28 patients suffering from recidivating ulcerative rectocolitis whose main symptom was hematic diarrhoea. Total plasma IgE were assayed in all patients and oral disodium cromoglycate treatment was commenced at a dose of 1.500 mg pro/die with follow-up at 2, 6, 12 and 24 months to evaluate general and endoscopic clinical conditions. RESULTS: Patients with a high titre of total IgE showed a full remission of symptoms and no recidivation. CONCLUSIONS: The authors conclude by emphasising the importance of immunological factors in the pathogenesis of the disease and underline the stabilising effect of oral disodium cromoglycate on mast cells.

English Abstract↗
PubMed1998

[Spontaneous rupture of the spleen in a patient treated with chemotherapy and growth factors for stem cell mobilization].

The Authors report a case of spontaneous spleen rupture in a woman with breast cancer treated with chemotherapy and growth factors for stem cell mobilization. After a wide review of the literature, they suppose this therapy, causing a considerable increase of immature cells, that promote the stasis of the splenic microcirculation, can sometime elicit a spontaneous rupture of the organ.

Adult↗
PubMed1998

[Our experience in using a synthetic prostacyclin analog in the treatment of critical ischemia of the extremities].

The authors, after examination of pharmacologic profile of Iloprost, prostacyclin synthetic analogue, report their clinical experience from January 1992 to June 1997 on 105 patients with severe ischaemia of inferior limbs. They utilize two protocols: 0.5-2 ng/kg/min x 6 hs once a day x 28 days and 1-1.5 ng/kg/min x 6 hs twice a day x 12 days. The first protocol were practise along the first 2 years; the second on following period as long as today. The results, evaluated on clinical criteria, are referred entity and time of pain remission and decrease of analgesic use, performance status improvement, increase of gear autonomy and, if present, wound healing. The incidence of amputation was 4.76% (5 pts). The authors issue that Iloprost is a conservative treatment, often alternative with amputation, giving sometimes to patients a longtime functional "restitutio ad integrum".

Arterial Occlusive Diseases↗
PubMed1997

Metabolic alterations in the fetal hepatic and umbilical circulations during glucocorticoid-induced parturition in sheep.

Fetal hepatic amino acid metabolism has unique features in comparison to postnatal life. Thus, it seemed likely that this metabolism might be changed by the endocrine changes which precede birth. To explore the changes in placental and fetal carbohydrate and amino acid metabolism that occur during parturition, labor was induced in six ewes at 131 +/- 1 d gestation with a fetal infusion of dexamethasone. For purpose of chemical analysis, blood was withdrawn before and approximately 3 and 25 h from the start of the infusion from maternal arterial, uterine venous, umbilical venous, fetal arterial, and left hepatic venous catheters. Fetal oxygenation remained normal. At 25 h, both fetal and maternal arterial plasma glucose concentrations increased (p < 0.01 and p < 0.02, respectively) and umbilical glucose uptake decreased (p < 0.05). Fetal glutamate showed a significant reduction in its hepatic output (p < 0.05) with a concomitant reduction in fetal arterial plasma concentration (p < 0.05) and placental uptake (p < 0.01). Fetal plasma concentrations of several other amino acids were markedly increased. The reduction in placental glutamate uptake was temporally associated with a decline in progesterone release by the pregnant uterus. These data suggest the hypothesis that glutamate plays a role in integrating the complex changes in placental and fetal hepatic metabolism that occur during parturition.

Animals↗
PubMed1995

Ultrasonographic assessment of fetal growth: comparison between human and ovine fetus.

OBJECTIVE: Our purpose was to evaluate the rate of ovine fetal growth for several body parameters by serial ultrasonographic measurements and to compare them with analogous data in the human fetus. STUDY DESIGN: Forty-three ewes with singleton gestations were studied. Four parameters were measured: biparietal diameter, abdominal circumference, femur length, and tibia length. Ultrasonographic examinations were performed weekly from 50 to 138 days of gestation (term 147 days). Quadratic regression analysis was used to describe each data set. RESULTS: The biparietal diameter showed a significant deceleration of its growth rate. The abdominal circumference showed a linear growth pattern. Both femur and tibia revealed a significant acceleration of the growth rate. CONCLUSION: The ovine fetal growth pattern is different from that observed in the human fetus, in which all four parameters show deceleration of the growth rate in late gestation. In comparison to the ovine, the human fetus reaches similar abdominal circumference and femur length values at term, but in a gestational period that is twice as long. In sharp contrast to abdominal circumference and femur length growth, the biparietal diameter has a similar growth rate in both species. Thus the human fetus has a slower rate of somatic growth and its greater biparietal diameter at term results from the longer gestational period.

Abdomen↗
PubMed1995

Early ultrasonographic detection of fetal growth retardation in an ovine model of placental insufficiency.

OBJECTIVE: Our aims were as follows: (1) to determine whether fetal growth retardation can be detected noninvasively with ultrasonography in ewes and (2) to establish the time interval between exposure of ewes to environmental stress that causes growth retardation (heat stress) and detection of growth lag for specific fetal body measurements. STUDY DESIGN: Four ewes were exposed to heat stress for 80 days starting at 35 days' gestation. (The duration of pregnancy in sheep is 147 days). Serial ultrasonographic measurements of fetal biparietal diameter, abdominal circumference, and femur and tibia lengths were obtained beginning at 50 days' gestation. Growth curves were calculated for each parameter and compared with growth curves obtained from 43 normal fetuses. RESULTS: Biparietal diameter measurements deviated significantly from normal starting at 90 days' gestation (p < 0.05). Abdominal circumference diverged at 70 days' gestation (p < 0.05), and both femur and tibia length diverged at 80 days (p < 0.05). The regression lines showed significant differences for all the parameters in both slope (p < 0.01) and intercept (p < 0.01). CONCLUSIONS: Fetal growth retardation can be detected noninvasively by ultrasonography after approximately 5 weeks of exposure to heat stress. Fetal growth continues throughout gestation but at a slower rate than normal and according to a pattern similar to that observed in asymmetrically growth-retarded human fetuses. Early detection of stunted fetal growth in an animal model is important for testing intervention strategies in the treatment of fetal growth retardation.

Abdomen↗
PubMed1995

Peak velocity of the outflow tract of the aorta: correlations with acid base status and oxygenation of the growth-retarded fetus.

OBJECTIVE: To correlate the peak velocities of the aortic outflow tract of growth-retarded fetuses with fetal acid base status and oxygenation measured in utero. METHODS: Thirty-one growth-retarded fetuses with abnormal umbilical pulsatility index (PI) measurements underwent fetal blood sampling. Blood pH, carbon dioxide pressure (PCO2), oxygen pressure (PO2), oxygen saturation, lactate concentration, and hemoglobin concentration were measured. Using color Doppler equipment, we measured the peak velocities of the outflow tract of the aorta, pulmonary artery, and ductus arteriosus before fetal blood sampling. RESULTS: The peak velocities measured in the outflow tract of the aorta, pulmonary artery, and ductus were significantly lower in growth-retarded fetuses than in 140 normal fetuses of comparable weight. The correlation observed between pulmonic and aortic peak velocities was significant (r = 0.84), as was that between pulmonic and ductal peak velocities (r = 0.74). Growth-retarded fetuses with abnormal aortic peak velocities had significantly lower values of PO2, oxygen content and pH, and had higher lactate concentration and PCO2 than did growth-retarded fetuses with normal peak velocities. Estimated fetal weight and umbilical PI (mean +/- standard deviation) were not significantly different in these two groups. Moreover, significant direct correlations were found between proximal aortic peak velocities and lactate concentrations (correlation coefficient 0.71, P < .0001) and O2 content (P < .02, r = 0.42). CONCLUSION: For growth-retarded fetuses, Doppler peak velocity in these vessels is significantly lower than in normal fetuses of comparable weight. Aortic, pulmonic, and ductal peak velocity correlated significantly. Growth-retarded fetuses with abnormally low peak velocity in the outflow tract of the aorta have a higher risk of acidemia and hypoxia than those with normal velocities.

Aorta↗
PubMed1994

Substantial reductions in blood pressure after bilateral nephrectomy in fetal sheep.

The role of the kidneys in the maintenance of arterial blood pressure was examined in fetal sheep. Surgery was performed on 11 pregnant sheep (8 twin pregnancies) at approximately 125 days. All 19 fetuses were instrumented with hindlimb arterial and venous catheters. Eleven of the fetuses (but only 1 of each twin) were also bilaterally nephrectomized. Fetal arterial blood pressure was measured several times between 2 and 14 days after surgery. Arterial blood pressure in the intact fetuses increased from 44 +/- 1 to 47 +/- 1 mmHg (SE) but gradually decreased from 37 +/- 4 to 25 +/- 3 mmHg in the nephrectomized group. Whereas the arterial blood pressures measured on the first day of the experiment were not statistically significantly different between the two groups, by the final day of the experiment the arterial blood pressure of the intact fetuses was much higher than that of the nephrectomized fetuses. Venous blood pressure was similar in the two groups. We conclude that bilateral nephrectomy in fetal sheep not only stops the normal gestational increase in arterial blood pressure but also leads to a progressive decline.

Animals↗
PubMed1993

Intra-amniotic pressure is not affected by amniocentesis between 13 and 18 weeks of gestation.

Changes in amniotic fluid pressure before and after amniocentesis fell within the range of +/- 5 mmHg, except when uterine contractions were present. Intra-amniotic pressure is not affected by amniocentesis between 13 and 18 weeks of gestation. Amniotic fluid pressure was recorded in 82 pregnancies of patients undergoing genetic amniocentesis to determine whether sampling of amniotic fluid between 13 and 18 weeks changed intra-amniotic pressure. Pressures were recorded through a needle and saline filled catheter with a zero-level at the needle tip. Amniotic fluid pressure was unrelated to gestational age (P = 0.962) during the weeks we performed our measurements. Fluid samples of 12.6% of the total volume in a group of early genetic amniocentesis (n = 65) and of 7.5% of the total volume in a group of late genetic amniocentesis (n = 17) did not change significantly amniotic fluid pressure values. An increase in pressure of more than 5 mmHg only occurred in cases where uterine contractions were present. Other than these cases, all pressure change values fell within the range of +/- 5 mmHg. No difference in pregnancy outcome were present within the two groups. An argument for a standard method for stationing pressure is presented.

Amniocentesis↗
PubMed1992

Convention for reporting amniotic fluid pressure.

A proposed convention sets zero pressure at atmospheric pressure at the level of the surface supporting the supine patient and takes the cm of water as the unit of measurement. This ensures that measurements made in different clinics will be comparable. Statements about 'higher' and 'lower' pressures, in different patients or in the same patient in different situations, should specify the level of the uterus to which the statement applies.

Amniotic Fluid↗
PubMed1992

Dementia and the nursing home: association with care needs.

OBJECTIVE: To determine whether RUG reimbursement categories accurately predict requirements for care in nursing homes. DESIGN: Prospective descriptive study of residents in lower reimbursement categories according to RUG. SETTING: Three nursing homes in New York City. PARTICIPANTS: Convenience sample of 173 residents who agreed to participate, not significantly different from 201 who did not agree to participate. MAIN MEASURES: Chart review; assessment of residents' cognitive and functional abilities; nursing assistants' ratings of residents' functional abilities, behavioral problems, the amount of effort required in care; and time-motion studies of staff-resident interactions. RESULTS: Both the residents' RUG classification (P less than 0.01) and the level of ADL independence (P less than 0.001) had significant impacts on the staff effort required in their care, with more dependent residents requiring greater effort. The residents' level of cognitive impairment also had a significant impact on the staff effort, with the severely impaired requiring greater effort (P less than 0.05). The time-motion analysis indicated that residents within the same RUG category differed in the number of staff-resident interactions based on their level of cognitive impairment. CONCLUSIONS: Cognitive impairment is a significant morbidity (or co-morbidity) in determining the quantity of staff effort required by the resident, and behavioral interventions are an important care component. There is marked heterogeneity within lower (RUG) reimbursement categories which translates into strikingly different care requirements.

Activities of Daily Living↗