Side-effects, structure, and H2-receptor antagonists.
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Drug Hypersensitivity↗
Biomedical subjects
A Bossi
Publications and source records attributed to A Bossi.
Diagnostic criteria for migraine and psychogenic headache in children.
The headache histories obtained from 214 children were analysed by computer to see whether it was possible to identify and classify migraine, and to distinguish children with psychogenic headache. During headache attacks, most children had no or very few associated symptoms. For classification, 175 patients were divided into four homogeneous groups; the remaining 39 could not be grouped. An overlap between the different groups was found. Psychogenic headache emerged as a clearly definable syndrome, characterised by psychological problems and daily headache for a period of at least one month (10 patients). When the 214 patients were grouped according to the classification of the Headache Classification Committee of the International Headache Society, distinguishing those children with psychogenic headache was no longer possible.
Age Factors↗
Proportionality of small for gestational age babies as a predictor of neonatal mortality and morbidity.
Neonatal mortality and morbidity of 2609 babies who weighed less than the fifth centile for gestational age were studied in order to evaluate the relationship between the type of intrauterine growth retardation and the short-term prognosis after birth. Of these babies, 1175 had both a birthweight and head circumference below the fifth centile ('proportionately small'); the others, whose body weight was below but head circumference above the fifth centile, were defined as 'disproportionately small'. The former group showed a consistently higher risk of death during the neonatal period. Morbidity defined by birth asphyxia, respiratory distress and neonatal infections was higher in those proportionately small babies who were delivered at term. The picture reversed for hyperbilirubinaemia, which was more frequent among disproportionately small babies. Proportionality, defined on the basis of the correspondence between birthweight and head circumference centiles, appears to be a simple and non-invasive clinical method to identify babies who are at higher risk of adverse outcome.
Asphyxia Neonatorum↗
[Exclusive radiotherapy of carcinoma of the hypopharynx. Retrospective study of a series of 100 patients].
From January 1980 to December 1987, 100 patients with carcinoma of the hypopharynx, staged according to TNM (UICC-1978) criteria, received exclusive radiation therapy at the Radiotherapy Department of the General Hospital of Varese. The median follow-up is 9 months (range: 1-97). Irradiation was delivered with 60Co or with 10 MV photons and tissue-equivalent bolus. Two opposed parallel lateral fields or rotational technique were used, with progressive shrinking of treated volume in order to spare the spinal cord after 45 Gy. Direct fields of electron beams (6-15 MeV) were employed as boosts on the residual nodes. Median total doses: 64.5 Gy to T and N1-3, 45 Gy to N0. A conventional fractionation (2 Gy once a day, 5 times a week) was used in 37 outpatients, while an accelerated hyperfractionated regimen (1.5 Gy twice a day, 5 times a week, with a six hours' interval between each fraction) was employed in 63 inpatients, in order to shorten hospitalization. The five-year overall survival (Kaplan-Meier) of the 100 treated patients is 10%, while the five-year disease-free survival of the 40 patients in complete clinical remission at the end of radiation therapy is 19.8%. The five-year loco-regional control rate after exclusive radiotherapy is 19.1%. Complete remission at the end of treatment seems to represent the only significant prognostic variable affecting survival: five-year overall survival is 32% for the 40 patients achieving complete remission and only 4.4% for the others (p less than 0.05). On the contrary, tumor extension (T class) seems to affect only the two-year local control rate: 35.2% and 10.9% for T1 + T2 and T3 + T4 respectively (p less than 0.1). The main cause of failure after radiation therapy is represented by the lack of control at the primary site (T) alone or associated with regional adenopathies (N). The analysis of isoeffect parameters, according to CRE model, has not shown any evident dose-response relationship for local control. Late effects were observed in 7% of the patients and were similar to those reported in the literature. The occurrence of both distant metastases, 3% in our experience, and secondary tumors (9%) is lower than those previously reported. The present retrospective study strongly reconfirms the inadequacy of exclusive radiation therapy as the sole treatment modality for carcinoma of the hypopharynx and suggests the need of combination therapy (surgery and radiation) as primary treatment.(ABSTRACT TRUNCATED AT 400 WORDS)
Adult↗
[Radiotherapy of rhinopharyngeal carcinoma: analysis of the caseload of Varese (1979-1986)].
From December 1979 to December 1986, 100 patients affected with nasopharyngeal carcinoma, staged according to TNM (UICC-1978) criteria received exclusive radiation therapy at the Radiotherapy Department of the General Hospital of Varese. The median follow-up is 36 months (range: 1-114). Irradiation was delivered with 10 MV photons (58 patients) or 60Co (42 patients), with two opposed parallel lateral fields and progressive shrinkage, or rotation technique. Direct fields of electron beams (6-15 MeV) were employed as boosts on the residual nodes. Median total dose: 60 Gy to T, 46 Gy to N0, 62 Gy to N1-3. A conventional fractionation (2 Gy once a day, 5 times a week) was used in 43 patients, while an accelerated hyperfractionated regimen (1.5 Gy twice a day, 5 times a week) was employed in 57 patients. Five-year overall survival (Kaplan-Meier) of the 100 treated patients is 54.9%, while 5-year disease-free survival of the 71 patients in complete clinical remission at the end of radiation therapy is 54.7%. The nodal status represents the most important prognostic variable: 5-year overall survival (100 patients) is 77.7% for N0 patients and 40.8% for N1-3 patients, while 5-year disease-free survival for the 71 patients in clinical remission at the end of radiation therapy is 78.9% and 48.8% for N0 and N1-3 patients respectively. Our findings confirm the high rescue rate (approximately 50%) of irradiation failures by re-irradiation and/or salvage surgery. The analysis of loco-regional recurrences and persistent disease, after radiotherapy, strongly suggests the need for an improvement in loco-regional control rates, by means of a more accurate treatment planning (with CT and MR) and more attention to isoeffect parameters (CRE). The incidence of distant metastases (14%) and difficulties in loco-regional control of advanced disease seem to suggest the use of combined chemo-radiotherapy modalities only for selected groups of patients and exclusively in randomized studies.
Adolescent↗
[Exclusive radiotherapy of locally advanced carcinoma of the larynx. Analysis of the caseload of Varese (1979-1986)].
The authors analyse a retrospective series of 90 consecutive patients (pts) affected with locally advanced laryngeal carcinoma (T3-4, N0-3--TNM, UICC 1978) who were radically irradiated from November 1979 to December 1986 at the Radiotherapy Department of the General Hospital of Varese. All the patients were treated with 60Co and two opposed parallel lateral fields and progressive shrinkage: 66 with conventional fractionation (2 Gy once a day, 5 times a week), 24 with an accelerated hyperfractionated regimen (1.5 Gy twice a day, 5 times a week). The median total dose delivered to the tumor and clinically involved nodes was 64 Gy (1678 reu, CRE). Median follow-up was 21 months (range: 3-113). The 5-year overall survival (Kaplan-Meier) was 40.5%. The 5-year disease-free survival, for 47 patients in complete remission at the end of radiotherapy, was 51.9% after irradiation alone and 56.7% with salvage surgery. There were no statistically significant differences in survival according to local spread (T3 vs. T4), nodal status (N0 vs. N1-3) and dose fractionation regimen (conventional vs. accelerated hyperfractionated). Isoeffect (CRE) values above 1751 reu obtained a 3-year loco-regional control rate of 65%, while, for isoeffect values under 1600 reu, the 3-year loco-regional control rate was 33.3%. Relevant late sequelae were not observed. Our findings suggest that primary radiotherapy with salvage surgery in reserve could be considered as an effective choice for locally advanced laryngeal carcinoma, at least in selected groups of patients.
Adult↗
Uncoated versus coated 5-aminosalicylic acid in Crohn's disease.
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Administration, Oral↗
[Effects of nifedipine in patients with chronic obstructive bronchitis and pulmonary hypertension undergoing artificial respiration].
During an acute decompensation of chronic obstructive pulmonary disease (COPD) associated with pulmonary arterial hypertension (PAHP), the right cardiac ventricle is unable to tolerate the increased workload required to overcome the increase in pulmonary arterial pressure (Ppa). As a result, the cardiac (CI) and systolic (SI) indices decrease much more than in those patients without PAHP. This study aimed to evaluate the effects of nifedipine on haemodynamic parameters and oxygen availability (QO2) when given to mechanically ventilated COPD patients with PAHP during an acute decompensation. The series included 14 patients aged 68 +/- 8 yr, admitted to an intensive care ward for an acute decompensation of COPD, with Ppa greater than 20 mmHg. They remained haemodynamically stable throughout the study period. The measurements were made 20 min after the Swan-Ganz and radial artery catheters were set up (t0), and one hour after administration of 10 mg sublingual nifedipine (t1). Thereafter this agent was given three times a day. A further set of measurements were carried out in seven patients, 24 h after the first dose of nifedipine (t2). At t1, there was a significant increase in CI (+12.3%) and QO2 (+14.1%), whereas Ppa, indexed pulmonary vascular resistances, indexed systemic vascular resistances (SVRI) and PaO2 decreased significantly (-9.2%; -20%; -12.8% and -6.4% respectively). At t2, QO2 was significantly higher (+18.4%), whereas Ppa and SVRI were significantly lower, than at t0. PaO2 and the shunt fraction (Qs/Qt) returned to basal values, with a significant decrease in Qs/Qt when compared with t1.(ABSTRACT TRUNCATED AT 250 WORDS)
Hemodynamics↗
Epidural spinal electrostimulatory system (ESES) in the management of diabetic foot and peripheral arteriopathies.
Epidural spinal electrostimulatory system (ESES) or dorsal column stimulation (DCS) may be used for the treatment of peripheral vascular diseases of the lower extremities. ESES has been used in our metabolic and surgical department as a way to ameliorate inadequate blood supply in patients suffering from diabetic foot (seven patients), painful chronic arterial narrowing, or inoperable occlusions (25 patients). The continuous stimulation by an implantable apparatus (Medtronic model Itrel, Medtronic, Inc., Minneapolis, MN, USA) led to a reduction or disappearance of pain, an improvement in plethysmographic curves, functional performance, and trophic lesions in about 75% of the patients. The system is safe and well-tolerated by patients.
Aged↗
Individual growth curves and longitudinal growth charts between 0 and 3 years.
From a statistical viewpoint, the construction of longitudinal growth norms involves two classes of problems: (a) the choice of a mathematical function having a few constants as possible, but suitable for describing individual growth process in the growth period of concern; (b) the estimation of the mean growth constants for a homogeneous group of subjects, and of the covariance matrix of data collected longitudinally, to compute tolerance intervals which enable us to draw growth charts. Although growth constants should have some biological interpretation, the choice of functions rests mainly on the criterion of following observed growth as closely as possible. As to the second problem, the simplest situation implies that growth function is linear in the constants and all subjects have measures on the same prefixed occasions: in this case, multivariate Potthoff-Roy model (1964) directly applies. In longitudinal growth studies, however, it happens that subjects do not come for measurements at exactly the age specified: two-stage models seem to be more appropriate to this latter case. They consist of (a) fitting individual growth curve on each subject to obtain estimates of 1st-stage constants; (b) obtaining estimates of 2nd-stage constants, characteristic of the whole group of subjects, in terms of weighted averages of the estimates of the 1st-stage constants. This paper deals with the application of a two-stage model to the growth in length of 203 girls and 217 boys born in Naples between 1977 and 1981. Children, whose growth records are used to trace longitudinal standards, have been measured at birth, and at least 5 times in the course of a follow-up made up of 8 visits, between 3 months and 3 years of life.
Child, Preschool↗
Behaviour and confidence of parents instructed in home management of febrile seizures by rectal diazepam.
The study was performed on a group of 91 children with their first febrile convulsion whose parents were then instructed in the use of rectal diazepam in the event of a further seizure. later, the families were periodically recalled for interviews. The aim was to study the acceptance and cooperation of the families, the psychological attitude and the relation between the findings and parents' educational level. At the end of the follow-up, 80% of the 91 families showed good cooperation and psychological benefits. There was no relationship between the findings at the end of the follow-up and families' educational level. Even in the presence of a favorable psychological attitude, recurrences of febrile convulsions were still a frightening experience for many parents.
Administration, Rectal↗
[Bronchial stenosis of vascular origin in pulmonary arterial hypertension].
A case is reported of bronchial stenosis due to a vascular cause in a patient with chronic obstructive lung disease, cor pulmonale and pulmonary arterial hypertension. This led to right lower lobe atelectasis and acute respiratory failure (pHa 7.24; PaCO2 85 mmHg; PaO2 44 mmHg) with important right-to-left shunting. This diagnosis was only suggested on day 7 by fibreoptic bronchoscopy and confirmed a week later by tomography and digital angiography. Nifedipine, used to reduce the pulmonary arterial hypertension, increased the cardiac index (31.min-1.m-2 to 3.3.1.min-1.m-2) and oxygen transport (488 ml.min-1.m-2 to 554 ml.min-1.m-2), despite increasing the shunt effect (Qs/QT: 26% to 31%). This and the antiinflammatory action of methylprednisolone were probably responsible for the favourable outcome.
Aged↗
Double diffusion and ELISA for the detection of IgG and IgM antibodies against Micropolyspora faeni.
Fifty-eight sera of subjects with suspected farmer's lung disease (FLD) were tested by double immunodiffusion and ELISA for the detection of IgG and IgM antibodies against Micropolyspora faeni. By comparing the two methods, we obtained a high concordance of results for IgG, but not so high for IgM. ELISA is therefore a sensitive and specific test in determining antibody concentration.
Actinomycetales↗
[Interaction of domestic and wild ruminants in the epidemiology of helminthiasis].
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Animal Population Groups↗
Gastrointestinal nematode infections in wild ruminants Rupicapra rupicapra and Dama dama: influence of density and cohabitation with domestic ruminants.
The distribution of gastrointestinal nematodes in different populations of wild ruminants has been studied with regard to density of the animals and the presence of domestic ruminants in the habitat. The degree of parasite overdispersion among the hosts has been examined in the hypothesis of a negative binomial model of distribution. The results show that the density has a greater weight than cohabitation with domestic ruminants, in destabilizing the host-parasite relationship.
Animals↗
Does breast feeding protect against the development of clinical symptoms of celiac disease in children?
A retrospective approach has been adopted to investigate the frequency and duration of breast feeding and the time of gluten introduction in the diet in 216 celiac children and their healthy siblings of three different centers--Naples, Milan, and Turin. In this matched case-control study, the selected controls were healthy siblings of the cases. Children formula-fed from birth, or breast-fed for less than 30 days, were found to have a relative risk of developing symptoms of celiac disease four times higher than children breast-fed for more than 30 days (p less than 0.0001). To investigate more deeply the effect of the duration of breast feeding as a possible protecting factor, the linear trend for different periods of breast feeding was tested and found to be highly significant (G1: 18.3 with 1 df). Therefore, increased duration of breast feeding is associated with decreased risk of developing celiac symptoms. On the contrary, there was no apparent relationship between early introduction of gluten into the diet and frequency of celiac disease. Our findings are consistent with the hypothesis that a wider diffusion of breast feeding is a factor underlying the recently reported decrease of the incidence of celiac disease in children.
Age Factors↗
Transfer function matrix of a compartmental model. A program for the rapid writing of its symbolic expression.
A method for the fast writing of the symbolic expression of the transfer function matrix of a compartmental model has been implemented on a FORTRAN G program. Special care has been devoted to the reduction of computations and memory by means of original subroutines. The program input is very simple and the output very clear to general users. The program may be employed for the study of all input-output relations of he considered compartmental model. Details on the computational methods adopted for its implementation are given. Application examples are reported.
Computers↗
Heart levels of adriamycin in normal and tumor-bearing mice.
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Animals↗