Biomedical subjects

A Chiesa

Publications and source records attributed to A Chiesa.

At least 19 recordsLinked to original sources

PubMed1992

Comparison of spontaneous ascites filtration and reinfusion with total paracentesis with intravenous albumin infusion in cirrhotic patients with tense ascites.

OBJECTIVE: To compare the effectiveness and safety of spontaneous ascites filtration and reinfusion and total paracentesis plus intravenous albumin infusion in cirrhotic patients with tense ascites. DESIGN: Randomised trial of the two treatments. SETTING: Teaching hospital and district general hospital in Milan. PATIENTS: 45 consecutive cirrhotic patients with recurrent tense ascites and urinary sodium excretion rate less than 20 mmol/day. 35 fulfilled admission criteria and completed the study. 17 received spontaneous ascites filtration and 18 paracentesis plus albumin infusion. MAIN OUTCOME MEASURES: Body weight; urinary volume; serum and urinary electrolyte, serum fibrinogen, and plasma aldosterone concentrations; and plasma renin activity before the procedure and 24 hours and eight days afterwards. RESULTS: Both procedures were effective in all patients. Weight decreased in both groups and showed no substantial increase after eight days. In patients receiving ascites filtration, values decreased significantly (p less than 0.01) after 24 hours for platelet count (mean relative change 0.92; 99% confidence interval 0.86 to 0.98) and serum fibrinogen concentration (0.92; 0.88 to 0.98) but returned to pretreatment values after eight days; no laboratory and clinical signs of disseminated intravascular coagulation were noted. Three patients in this group had fever, which receded spontaneously. One patient in each group had dilutional hyponatraemia. CONCLUSIONS: Spontaneous ascites filtration and reinfusion is an effective treatment for tense ascites. Reinfusion of the patient's concentrated proteins provides savings without compromising safety.

Adult↗

PubMed1992

Gadolinium-pentetic acid magnetic resonance imaging in patients with relapsing remitting multiple sclerosis.

Ten patients with relapsing-remitting multiple sclerosis have been studied by serial gadolinium-pentetic acid magnetic resonance imaging (MRI) every 14 days for 3 months. At the end of the follow-up, seven relapses occurred in six patients; no therapy was administered during the study. Ninety-three enhancing lesions were collected in eight patients. With regard to the duration of the enhancement, 32 lesions were detected in only one MRI scan and 32 were found in more MRI scans (most of the lesions occurring in two serial examinations). Four old lesions increased their size with delayed enhancement. Correlation was found between the relapses and the gadolinium-pentetic acid-enhancing areas only for one brain-stem and two cervical spinal cord lesions. Gadolinium-pentetic acid MRI provides useful information about activity of the disease that cannot be obtained clinically even if the dynamic of the lesions may be undervalued in old plaques.

Adult↗

PubMed1992

A new case of occupational asthma from reactive dyes with severe anaphylactic response to the specific challenge.

A case of occupational asthma in a wool and cotton dyer handling reactive dyes is described. The patient was skin positive, but asymptomatic to house dust mites. A bromoacrilamidic dye (Lanasol Yellow 4G) has been identified through chamber inhalation challenge as being responsible for the sensitization. A very short (4-minute) exposure produced a severe immediate obstructive ventilatory defect followed by arterial hypotension and urticaria. Bronchial hyperresponsiveness as tested through metacholine challenge was absent both in basal conditions and after the dye challenge. Both prick and patch test for the dye were positive in the absence of any sign of contact dermatitis.

Adult↗

PubMed1992

Phorone (diisopropylidene acetone), a glutathione depletor, decreases rat glucocorticoid receptor binding in vivo.

The exact mechanism by which carcinogens and tumor promoters act on the glucocorticoid receptor system in vivo is not known. Based on earlier studies that sulfhydryl-reducing agents stabilize glucocorticoid receptor binding in vitro, some workers have postulated that endogenous reducing factors may be important for glucocorticoid receptor function in vivo. To test whether glutathione (GSH) may serve this purpose, we investigated the effects of phorone, an agent that partially depletes intracellular GSH, on the hepatic cytosolic glucocorticoid receptor (GRc) binding characteristics in intact and 7-10 day adrenalectomized (ADX) adult female Sprague-Dawley rats. Biochemical analysis revealed that a single treatment of phorone (300 mg/kg) to both intact and ADX rats significantly decreased the liver GSH concentration (70-90% of control levels) as well as the GRc maximum binding concentration (30% of control levels). The decrease in GSH levels preceded the reduction in GRc maximum binding concentrations; both effects were reversible after 24 h of treatment. The phorone-mediated decrease of GSH levels was maximum at doses greater than 75 mg/kg, whereas GRc maximum binding concentrations in vivo appeared dose dependent up to 400 mg/kg. Pretreatment with phorone or the carcinogens mirex and 3-methylcholanthrene significantly decreases GRc binding and nuclear uptake in vivo, as well as diminishes intracellular cytosolic GSH levels. Although a temporal relationship between the GSH levels and the GRc maximum binding concentrations in vivo was observed, there was no quantitative relationship between these two parameters based on our phorone dose-response and the carcinogen pretreatment data. Our findings suggest that during the early phases of carcinogenesis, the hepatocellular GSH does not play a direct role upon the biochemical action of certain carcinogens and tumor promoters on the glucocorticoid receptor binding in the liver.

Animals↗

PubMed1991

Duration of immune protection after hepatitis B vaccine in newborns from HBsAg-positive carrier mothers.

A group of 43 healthy neonates born from HBsAg-positive mothers were evaluated for the presence of protective HBsAb titre after administration of hepatitis B plasma-derived vaccine and hepatitis B hyperimmune-globulin. At 36 months of life we found that a significant number of children had a low HBsAb serum level. This suggests that a close serologic follow-up is necessary to evaluate the optimal timing for the administration of a booster dose of the vaccine.

Carrier State↗

PubMed1991

[Echography versus nuclear magnetic resonance in the preoperative dynamic evaluation of plastic penile induration].

Recently Ultrasonography (US) and Magnetic Resonance Imaging (MRI) has been successfully used as painless and non invasive techniques for depicting dense fibrous connective tissue of Peyronie's Disease (PD). The purpose of this study is to demonstrate the extent of disease and to prove the accuracy of US versus MRI. Twenty patients (aged 20-70; mean 43) with clinical diagnosis of PD were studied. All patients were studied with flaccid and erected penis after an intracavernous injection of Papaverine (variable dose). US and MRI examinations were performed independently by 2 groups of observers who knew clinical findings but not the results of the other technique. Both methods gave satisfactory images: they show the capacity to depict and to measure Peyronie's plaques clinically appreciated. US in 4 patients and MRI in 3 patients identified not palpable lesion which infiltrate the septum. Although the most common area of PD involvement is the dorsal surface of tunica albuginea, sometimes fibrous plaques are along the septum between the corpora cavernosa and the corpus spongiosum. In the present study, US and MRI are too able to identify not palpable lesion in the septum. In our opinion US has to be used for its high accuracy and low cost.

Adult↗

PubMed1991

[Operational and economic evaluation of a Laser Printer Multimodality system].

The increasing application of digital techniques to diagnostic imaging is causing significant changes in several related activities, such as the reproduction of digital images on film. In the Department of Diagnostic Imaging of the University of Brescia, about 70% of the whole of images are produced by digital techniques; at present, most of these images are reproduced on film with a Multimodality System interfacing CT, MR, DSA, and DR units with a single laser printer. Our analysis evaluates the operative and economic aspects of image reproduction, by comparing the "single cassette" multiformat Camera and the Laser Printer Multimodality System. Our results point out the advantages obtained by reproducing images with a Laser Printer Multimodality System: outstanding quality, reproduction of multiple originals, and marked reduction in the time needed for both image archiving and film handling. The Laser Printer Multimodality System allows over 5 hours/day to be saved--that is to say the working day of an operator, who can be thus shifted to other functions. The important economic aspect of the reproduction of digital images on film proves the Laser Printer Multimodality System to have some advantages over Cameras.

Evaluation Studies as Topic↗

PubMed1991

The association of "standard ELISA" and HIV (env) ELISA for detection and confirmation of HIV antibodies in human sera.

Sera from various population of subjects, including patients with AIDS and ARC, drug-addicts seropositive for HIV and healthy blood donors were screened with "standard ELISA" and HIV (env) ELISA. In the present study all 80 specimens from patients with AIDS and all 60 patients with ARC were positive by HIV (env) ELISA, and 1507 specimens from HIV drug positive by W.B. were detected as positive by HIV (env) ELISA. The specificity of HIV (env) ELISA was defined in terms of percentage of non-reacting persons in a low risk population is 100%. Furthermore the HIV (env) ELISA is highly specific and sensitive and could be used in association with "standard ELISA" for detection and confirmation of HIV antibodies in human sera and plasma.

AIDS Serodiagnosis↗

PubMed1990

Endoscopic Nd-YAG laser therapy as palliative treatment for esophageal and cardial cancer. Parameters affecting long-term outcome.

The aim of this study was to report long-term results of endoscopic Nd-YAG laser therapy in the palliative treatment of 144 esophageal and cardial carcinomas and to define parameters that could predict the long-term outcome in order to better define the indications and limitations of Nd-YAG laser therapy for esophagocardial cancer. One hundred nineteen men and 25 women were treated. The mean age was 67 +/- 12 years. Histology showed 94 patients with squamous cell carcinoma and 50 with cardial or esophageal adenocarcinoma. Improvement of dysphagia was achieved in 119 of the 144 patients (83%) after a median of 2.9 sessions. For the 105 patients initially symptomatically improved by the first laser course, the cumulative probability of remaining symptomatically improved at three and six months was respectively 38.5 +/- 5% and 22 +/- 4%. Four perforations and nine esophagotracheal fistulas occurred. In the stepwise regression analysis (Cox model), among 11 variables, three variables had an independent prognostic value at six months. The importance of improvement after the initial laser treatment (P less than 0.005) and the presence of an adenocarcinoma (P less than 0.05) were positively correlated with the symptom improvement duration. The initial tumor length (P less than 0.01) was negatively correlated with the symptomatic improvement duration. Therefore, in inoperable patients, we think that laser therapy should be proposed first for adenocarcinoma and for squamous cell carcinoma less than 6 cm in length.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗

PubMed1990

Evaluating the digital storage requirements for a partial picture archive and communication system.

The study evaluates the volume of digital images produced in a department of diagnostic imaging, with the primary goal of identifying the requirements of digital storage for a partial picture archive and communication system (PACS). The daily activity of digital units (one computed tomography unit, one magnetic resonance imaging, two ultrasonography, and one digital subtraction angiography), which perform 25% of total examinations in the department, was analyzed to determine the number of images produced by digital techniques. They account for 65% to 70% of the total images. The storage capacity necessary to contain all digital data produced in a 800-bed hospital reaches nearly 100 Gbyte/yr without compression. The study emphasizes that a partial PACS can be economically justified through reduced film-archiving costs. This goal could be achieved through a selection of significant images and examinations, considerably reducing the cost of film reproduction and allowing the amortization of a partial PACS in about 5 or 6 years.

Computer Systems↗

PubMed1990

[The noninvasive assessment of the effects of penbutolol on liver hemodynamics in cirrhotic patients using angioscintigraphy. A randomized controlled double-blind study].

This randomized double-blind controlled study analyzed the hemodynamic effects of penbutolol, a new levo-rotatory betablocker, using radionuclide angiography. Twenty cirrhotics with esophageal varices were randomized: 10 received 40 mg/day of penbutolol orally and the others a placebo. Angioscintigraphy was performed before and after an 8-day treatment period. Three cases in the penbutolol group were lost due to software damage, hence the data of 17 patients were analyzed. The two groups were similar for age, sex, etiology of cirrhosis and hepatic function. The index of portal perfusion decreased significantly (-29%; p = 0.018), and the hepatic artery index increased significantly (+23%; p = 0.018), whereas no changes were observed after placebo. The heart rate decreased significantly after penbutolol (-9%; p = 0.021); while neither penbutolol nor placebo modified the ejection fraction. In conclusion, penbutolol decreased portal perfusion index (the compensatory increase of hepatic artery index confirmed this change) without significant modification of total hepatic blood flow and systemic hemodynamics. Angioscintigraphy is reasonably accurate, reproducible, safe and can be considered suitable for routine use in the assessment of liver hemodynamics.

Administration, Oral↗

PubMed1990

[Delayed consolidation and pseudarthrosis in posttraumatic pathology of the carpal scaphoid. A magnetic resonance study].

Delayed unions and fibrous or sclerotic non-unions of the carpal scaphoid are frequent sequelae of non-diagnosed or not properly treated fractures. The most important cause of abnormal unions is ischemic necrosis, due to the terminal vascularity of the carpal scaphoid. Conventional X-rays, scintigraphy, and CT do not yield sufficient information for a complete diagnosis; at present, MR imaging represents a valuable alternative, for it is a noninvasive technique able to provide a "biological imaging" of bone. Fourteen patients underwent surgical/nonsurgical treatment, based on the findings supplied by MR imaging. MR reliability was evaluated in relation to the therapeutic results obtained. The study proved MR imaging to provide important information as to therapy planning; in case of surgical treatment, MR imaging helped in choosing the most appropriate location for the insertion of bone graft or screw.

Adolescent↗

PubMed1989

Prevalence of HIV in normal and at risk population (seroepidemiological investigation during two years).

In this work we reported the results obtained using two ELISA-tests (the seropositivity was confirmed by Western-Blot) for detection of HIV-Ab in normal and at risk population (according by the classification from C.D.C. 1982) exposed to screening for various, sanitary measures. Our results concerning the percentage of seropositivity to HIV-Ab in drug-addicts (49%) are in agreement with the results obtained in the most qualified Italian Centres. The incidence of congenital infection is high, pointed 50%; the 100% of seropositive children were infected by drug-addicts seropositive parents. Casuistry among haemophilic patients we have demonstrated a greater seropositivity in B haemophilic subjects than A haemophilic ones. The seropositivity (24%) verified among prisoners is totally related to drug-addiction. Prevalence of seropositivity among heterosexual partners of HIV positive subjects was 22% among female partners of infected men, and 9% among male partners of infected women. Checking performed upon nursing staff who casually were contaminated by seropositive patient's blood confirmed 100% of seronegativity after eight months. No seropositive subjects were performed in every not a risk group.

Adult↗

PubMed1986

[Immunopathology of HTLV III infection in drug addicts].

The authors are herewith reporting the results of an immunological screening performed on 15 drug addicts presenting serological positivity for anti HTLV III (Elisa and WB). The study has been carried out determining populations and subpopulations of lymphocytes (T3, T4, T8 and T4/T8) and performing cutaneus tests with multiple antigens (Tetanus--Candida--Diphtheria--Proteus--Streptococcus and Tricophyton). The results achieved by mean of the above mentioned tests seem to indicate the presence of an immunodeficit hitting mainly the cell-mediated immunity in all the patients examined.

Acquired Immunodeficiency Syndrome↗

PubMed1979