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Biomedical subjects

A Montemarano

Publications and source records attributed to A Montemarano.

5 recordsLinked to original sources
PubMed2001

Dermatomyositis.

Dermatomyositis is an idiopathic inflammatory myopathy with characteristic skin manifestations. Although the disorder is rare, with a prevalence of one to 10 cases per million in adults and one to 3.2 cases per million in children, early recognition and treatment are important ways to decrease the morbidity of systemic complications. An association with other connective tissue disorders (overlap syndrome) and malignancy make this diagnosis particularly important to primary care physicians. Patient management includes careful evaluation for underlying malignancy and liberal use of physical therapy, antihistamines, sunscreen and oral corticosteroids. Poor prognostic indicators include poorly responsive disease, delay in diagnosis and the presence of malignancy. The therapeutic goal is to maintain function and prevent or minimize sequelae.

Adult↗
PubMed2000

Transcutaneous immunization: a human vaccine delivery strategy using a patch.

Transcutaneous immunization, a topical vaccine application, combines the advantages of needle-free delivery while targeting the immunologically rich milieu of the skin. In animal studies, this simple technique induces robust systemic and mucosal antibodies against vaccine antigens. Here, we demonstrate safe application of a patch containing heat-labile enterotoxin (LT, derived from Escherichia coli) to humans, resulting in robust LT-antibody responses. These findings indicate that TCI is feasible for human immunization, and suggest that TCI may enhance efficacy as well as improve vaccine delivery.

Administration, Cutaneous↗
PubMed1999

Variations of the pursestring suture in skin cancer reconstruction.

BACKGROUND: The pursestring suture (PSS) utilizes a circumferentially placed intradermal suture to decrease the size of a defect. Its primary application in dermatologic surgery has been to allow placement of a smaller full-thickness skin graft and to enhance secondary intention wound healing. OBJECTIVE: To present our experience with 3 variations of the PSS. METHODS: The oval defects resulting after surgical excision of cutaneous malignancies were managed with 3 variations of the traditional pursestring technique. These variations included (1) complete closure of the PSS-reduced defect by the placement of traditional interrupted sutures; (2) PSS with the Burow's triangle graft; (3) use of a PSS only part way around an oval defect to avoid distortion of a nearby free margin. RESULTS: In the 7 years of performing these variations of the PSS technique, we have consistently achieved favorable results. CONCLUSION: We report 3 simple-to-use variations of the PSS technique that have been extremely useful in the management of cutaneous malignancies.

Facial Neoplasms↗
PubMed1999

Evidence of exercise-induced myocardial ischemia in patients with primary aldosteronism: the Cross-sectional Primary Aldosteronism and Heart Italian Multicenter Study.

BACKGROUND: Primary aldosteronism (PA) is a disease associated with hypersecretion of aldosterone caused by an aldosterone-producing adrenal adenoma, bilateral adrenal hyperplasia, and, although rarely, by adrenal carcinoma. Arterial hypertension induces several cardiovascular alterations that yield a high cardiovascular risk. It has been shown that reduced myocardial perfusion at rest, assessed by thallium-201 myocardial scintigraphy, was greater in PA than in essential hypertension (EH). However, it is still unknown whether reduced myocardial perfusion at rest and/or regional function abnormalities are present during exercise-induced myocardial stress. PURPOSE: We addressed the impact of PA on myocardial ischemia and sought to identify signs of exercise-induced myocardial ischemia (assessed by MIBI-SPECT and echocardiography) in patients with PA compared to patients with EH. Patients with consistent signs of myocardial ischemia on all of the tests were studied by coronary arteriography. PATIENTS: We studied 72 patients with PA and an age/sex-matched group of 72 patients with EH enrolled in the cross-sectional Primary Aldosteronism and Heart Italian Multicenter Study (PAHIMS). METHODS: Regional function was detected from echocardiographic measurement of wall motion done at baseline and immediately after exercise. Myocardial perfusion was evaluated by SPECT imaging after injecting 99mTc-MIBI with the same-day protocol using the rest-stress sequence. RESULTS: Although the conditions of arterial pressure, duration of hypertension, and target organ damage were equivalent, the patients with PA had greater incidence of both reversible perfusion defects and abnormalities of regional function. Moreover, multiple regression analysis showed that the high plasma aldosterone level was highly predictive for SPECT ischemic score and wall motion index, suggesting that PA contributes to cardiovascular risk over and above that associated with ventricular hypertrophy. Exercise-induced myocardial ischemia in PA was not segmental but widely distributed suggesting that this phenomenon was not related to abnormal coronary perfusion. Accordingly, of the 38 patients with PA who underwent coronarography, there was no presence of significant coronary atherosclerotic lesions in 30 (78.9%) of the patients. CONCLUSIONS: The PAHIMS observed more exercise-induced moderate myocardial ischemic defects (co-detected by SPECT and echocardiograms and not segmental but widely allocated) in patients with PA than in patients with EH. This phenomenon occurred in a greater percentage of patients with PA without significant coronary lesions (78.95%, n = 38), which supports the possible presence of small-vessel intramyocardial disease.

Adult↗