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Biomedical subjects

A Fontanella

Publications and source records attributed to A Fontanella.

At least 19 recordsLinked to original sources
PubMed2006

Molecular and clinical conditions associated with venous thromboembolism in oncological patients.

The association between cancer and thrombophilia has been known since 1865 since Trousseau described it. However in the last three decades an increased interest has been raised on this issue related to several molecular and condition that are involved in the daily management of oncological patients. This brief review has been focused on molecular conditions underlying cancer acquired thrombophilia then to further clinical aspects inducing thrombophilia in oncological patients such as surgery, chemotherapy, concomitant medical illness and inherited thrombophilia.

Blood Coagulation Tests↗
PubMed1999

Endoscopic microsurgery in herniated cervical discs.

The purpose of this study was to make public our results using endoscopic microsurgery in herniated cervical discs. This technique allows us to avoid complications due to conventional exposure, as is the case in traditional approaches. This study was carried out from January 1991 to January 1998. One hundred and seventy-one patients should have undergone traditional surgery for 296 herniated cervical discs. They were, instead, treated by using endoscopic microsurgical techniques. In 273 herniations the surgical procedure was performed by a paramidline right anterior approach, and in 23 herniations by a paramidline posterior approach, with a working sleeve of 4.6 mm outer diameter in both cases. In the anterior approach the tube was firmly placed against the anterior longitudinal ligament and the edge of the anterior part of the vertebral bodies. The neurovascular structures were placed lateral to the working sleeve and the visceral structures were placed medial to the working sleeve. Then, under endoscopic coaxial control, removal of the herniated part was performed, through the intervertebral discs, with microsurgical instruments. In the posterior approach, the tube was placed instead between the inferior and superior lamina, then under the nerve root up to the herniation, which was removed. This posterior approach was used only in the lateral disc herniations. There were no incidents or major complications following these operations. After one month the success rate was 94.7%, after three months 95.9%, after six months 96.4% and after one year 97%. There were no cases of relapse during the follow-up period of these patients. This study suggests that for herniated cervical discs, the endoscopic microsurgical technique is an extremely advantageous and safe method. Moreover, longer follow-up periods and an increased number of patients treated with this procedure should further confirm the usefulness of this technique.

Adolescent↗
PubMed1996

Prolonged and high dose recombinant interferon alpha-2b alone or after prednisone priming accelerates termination of active viral replication in children with chronic hepatitis B infection.

BACKGROUND: There is no generally accepted treatment for chronic hepatitis B (HB) infection in children. OBJECTIVES: To evaluate the efficacy of a prolonged course of high dose interferon alone or after prednisone priming in children with chronic HB infection. METHODS: The outcome of 31 children with HB e antigen (HBeAg)-positive chronic hepatitis who randomly received either no treatment (n = 9) or 10 million units of interferon alpha-2b/m2, alone (n = 13) or after prednisone priming (n = 9), three times weekly for 1 year was studied. RESULTS: One patient withdrew from treatment. By the end of the first year treatment induced a loss of HB virus DNA and HBeAg from serum in 10 of 21 patients (48%), and a loss of HB surface antigen (HBsAg) in 4 (19%). Alanine aminotransferase values became normal in one patient (4.8%). Response rates in the two groups of treated patients were similar. In controls only one patient lost HBeAg and HBV DNA (11%; P = 0.05), and none lost HBsAg or showed alanine aminotransferase normalization (P = 0.21 and 0.70, respectively). After a posttreatment 2-year follow-up there were still no differences in the response rates of the two treatments; of the 21 pooled treated patients, 61% lost HBeAg and DNA and 67% normalized alanine aminotransferase (vs. 33 and 44% of controls, respectively; P = 0.32 and 0.40). Reversion to HBeAg and HBV DNA negativity in treated patients occurred significantly earlier (P = 0.02 and 0.006, respectively) than in controls. No further patient lost HBsAg, but one reacquired HBsAg. Treated patients had posttreatment histologic scores better than controls (P = 0.03). CONCLUSIONS: Our medium term follow-up results indicate that a prolonged course of high dose interferon in children with chronic HB infection, regardless of prednisone priming, poorly affects response rates but significantly speeds termination of active viral replication.

Adolescent↗
PubMed1996

[Rehabilitation of deafness in the elderly: multidisciplinary intervention in experimental university center].

The loss of hearing abilities can be seen as a complex event because psychological discomfort and relational inhibitions interact and lead to behaviours and attitudes which are insidious and dangerous for the quality of life of the patient. The complexity of the psychological-organic inconvenience, such as impairement disability and handicap led to the testing of recovery patterns. In this specific context interventions coming from different fields sustained from a complex operative model where different professional competences and evaluation processes interact. Therapeutic interventions have been carried out by an audiologist, an audiometrist, a speech therapist, an audioprostethist and a psychologist, all sharing the obtaining of the same result. The role of the audiologist is simply clinical and concerns the knowledge of the entire process of rehabilitation through the use of a prosthesis. This process concerns the audiologist, who operates in close collaboration with the audiometrist and the audioprosthesist: it is therefore a therapeutic activity that is interested mainly in the prescription of the prosthesis and the restoring of the communicative function. The speech therapist and the psychologist carry their interventions through a relationship with the patient, which places the respect of the patient's personality before any other procedural and technical aspect. Therefore they pay attention more to ergonomic factors than to the hearing loss, through the obtaining of the patient's self-confidence and of a better general psychological situation. Therefore the main purpose of each intervention is to create a process of rehabilitation aimed at restoring the communicative functions and the individual motivation in trying to do so both in the domestic and in the social environment. The authors refer the experience and the informations put together during three years of research activity. The results of the therapeutic intervention have brought to the acceptance of the prosthesis help, the adaptation to amplification, the reduction of the subjective and relational uneasiness for the use of prosthesis, the use of the prosthesis, the reintroduction to the world of sounds, the restoring of levels of autonomy and of self-estime, the discover of eventual abilities, which had never been used or underestimated, the reactivation of more rewarding social relationships and the reduction of the conditions of dependency related to the hearing disability.

Aged↗
PubMed1994

Persistent hyperaminotransferasemia resolving after weight reduction in obese children.

Nine obese children were referred to our liver disease unit because of asymptomatic, long-standing (range, 4 to 49 months) hyperaminotransferasemia of unknown origin. Ultrasonography showed a "bright" liver in most patients. A hypocaloric diet was prescribed, and the hepatic abnormalities of the complaint patients showed a prompt and persistent improvement that paralleled the loss of excess weight.

Alanine Transaminase↗
PubMed1993

Elevated serum aminotransferase activity as an early manifestation of gluten-sensitive enteropathy.

Six children in whom long-standing hypertransaminasemia of unknown cause led to an initial diagnosis of chronic or protracted cryptogenic hepatitis were found to have asymptomatic celiac disease. Administration of a gluten-free diet caused a prompt improvement of both hepatic and intestinal biochemical/histologic abnormalities. Hepatic damage may be another "atypical" form of celiac disease in children.

Celiac Disease↗
PubMed1992

Cryptogenic chronic liver disease and hepatitis C virus infection in children.

The clinical features of 'cryptogenic' chronic liver disease and the prevalence of antibody to hepatitis C virus (HCV) in serum have been investigated in 33 Italian children (mean age 5 years). The diagnosis was based on the persistence of increased alanineaminotransferase values for longer than 6 months after the exclusion of biliary diseases, of extra-hepatic causes of hypertransaminasemia, of infection with known hepatotropic viruses and of autoimmune or metabolic disorders. Five patients had been transfused early in life, three had undergone surgery and one girl's mother had had acute non-A, non-B hepatitis during pregnancy. The remaining patients had no history of overt parenteral exposure. At presentation only 11 patients were symptomatic, the others had been referred after a check-up for intercurrent diseases. Liver histology performed in 21 cases showed persistent or mild active hepatitis in 18 cases and severe hepatitis or cirrhosis in three cases. Anti-HCV antibodies were found in 48% of the cases, including 88% with obvious exposure and 33% of the remaining cases. During a mean follow-up period of 5 years (range 1-14 years) only 11% of the cases achieved sustained biochemical remission, although none developed signs of liver failure. There was no significant difference in the clinical features and outcome of the disease between anti-HCV-positive and -negative patients. The results of this study suggest that HCV is implicated in most cases of 'cryptogenic' chronic liver disease observed in Italian children with a history of parenteral exposure and in at least one-third of the cases without overt exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

Alanine Transaminase↗
PubMed1992

Vaccination against hepatitis B in preschool children with Down's syndrome.

Twenty-nine healthy HBsAg- and HBsAb-negative children with Down's syndrome who were living at home (mean age 42 months; 19 M, 10 F) were vaccinated against hepatitis B virus either with recombinant DNA or plasma-derived vaccine. Both groups of children responded well to the vaccination schedules, with HBsAb seroconversion rates close to 100%. Vaccination against hepatitis B in preschool children with Down's syndrome is effective in spite of the existing abnormalities of the immune function.

Child, Preschool↗
PubMed1991

Monitoring of serum alpha-fetoprotein levels in children with chronic hepatitis B virus infection.

Changes in serum alpha-fetoprotein (alpha FP) levels were investigated by radioimmunoassay during the follow-up (17 +/- 12 months, two to three times per year) of 50 children with chronic hepatitis B virus infection (mean age of 8 years, 30 males) and of 35 healthy age- and sex-matched controls. Eleven of 50 were healthy carriers; 7 had chronic persistent hepatitis, 29 had chronic active hepatitis, and 3 had cirrhosis-associated chronic active hepatitis. Serum alpha FP levels in controls were found to be always lower than 5 ng/ml (0.1-4.4 ng/ml, mean +/- SD of 1.34 +/- 1.32 ng/ml). Statistical analysis after logarithmic transformation showed a significant difference between mean levels (ng/ml) in controls and in patients [geometric mean = 0.83 C.L. (95% confidence limits of 1.19/0.58) vs. 3.43 (95% C.L. of 4.79/2.45); p = 0.0001]. Mean values of serum alpha FP levels at entry were higher than those found at the end of the follow-up period [geometric mean = 3 (95% C.L. of 4.69/1.92) vs. 1.48 (95% C.L. of 2.13/0.95); p = 0.038]. Only three patients repeatedly showed high alpha FP levels (76.7, 122.8, and 1,600 ng/ml at entry): alpha FP values became normal after a mean follow-up of 17 +/- 7.8 months as well as liver enzymes, with no changes in serum "e" antigen-antibody and anti-delta antibody status being observed. Mean values of serum alpha FP levels in HBeAg-positive patients were significantly higher than in HBeAg-negative patients both at entry and during the follow-up (p = 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1989

Effect of prednisone on DR-positive T cells in children with chronic active hepatitis B.

The effect of short-term immunosuppressive treatment on the percentage of circulating DR-bearing T cells was investigated in 16 children with HBsAg-positive chronic active hepatitis. DR-positive T cells, thought to represent activated T cells, were significantly increased in all patients as compared to 10 age-matched controls [14.5 +/- 4.2% (mean +/- SD) vs. 0.4 +/- 0.1%, p less than 0.001]. Fifty-six percent of patients showed a decrease in the percentage of DR-positive T cells after 72 h of prednisone therapy. A response did not correlate with the presence of HBeAg, anti-HBeAg, or anti-delta antibodies. There was an inverse relationship (r = -0.56; p less than 0.05) between the decrease of the percent of DR-positive T cells during immunosuppression and pretreatment alanine aminotransferase levels. The persistence of high levels of circulating DR-bearing T cells during therapy may represent the immunological counterpart of more severe disease, and of nonresponsiveness to corticosteroids.

Adolescent↗