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Biomedical subjects

A Silvestri

Publications and source records attributed to A Silvestri.

At least 19 recordsLinked to original sources
PubMed1993

[Evaluation of trisomy 21 risk by serial determination of chorionic gonadotrophin hormone and alpha-fetoprotein: results of a national pilot study].

Previous studies, as early as 1984, have demonstrated the efficiency of maternal serum markers to screen for Down syndrome. These markers were AFP, hCG, oestriol and beta-1-glycoprotein. A pilot study was initiated in France in 1990 to evaluate these markers. It lasted from May 1990 until April 1991. 22,410 pregnancies were monitored in total, and 19,407 for women between 30 and 37 years of age. The pregnancy outcome was known for 20,151 cases (86.6%). Sensitivity and predictive value of the test was calculated on 17,362 dosages which outcome was known. The sensitivity based on hCG only was 59.4% (38/64) for trisomy 21 and positive predictive value 1.65% (38/2,307). This test is a better marker than maternal age. In the pilot study it induced a 13.2% rate of amniocentesis. If the risk was calculated using both hCG and AFP results, the performances of the test were better. At equal rate of amniocentesis, the double test increases the sensitivity (+9.5% at risk 1/200, +7% at risk 1/250, +14.4% at risk (1/350). The strategy of double dosages decreases the number of amniocentesis for a given sensitivity rate. This decrease is more spectacular for high levels of sensitivity. This pilot study confirms already published results. Maternal serum markers are the best tools, combined with maternal age to evaluate the risk of trisomy 21.

Adult↗
PubMed1992

Gianotti-Crosti syndrome: a retrospective analysis of 308 cases.

BACKGROUND: There is no agreement as to whether papular acrodermatitis of childhood caused by hepatitis B virus can be differentiated from other papulovesicular acrolocated syndromes. OBJECTIVE: We attempted to establish whether such differentiation is possible comparing histories, signs, and symptoms of all patients who have been previously diagnosed as having papular acrodermatitis of childhood or papulovesicular acrolocated syndromes. METHODS: Files of 308 patients hospitalized in the past three decades were studied. Photographs were examined by a panel of experts to determine whether it was possible to distinguish between papular acrodermatitis of childhood and papulovesicular acrolocated syndromes solely on the basis of cutaneous signs. RESULTS: The retrospective analysis confirmed a significant overlapping of the two types of the disease. The blind survey of photographs of the patients revealed that a distinction between the forms was not clinically possible. CONCLUSION: Acrodermatitis is a self-limiting cutaneous response to different viruses; clinical differences are probably due to individual characteristics of each patient rather than the causative virus.

Acrodermatitis↗
PubMed1992

Heart involvement in AIDS: a prospective study during various stages of the disease.

The goal of our study was to evaluate the incidence of heart involvement in AIDS patients during various stages of the disease. Between January 1988 to September 1991, we conducted a prospective study in 114 anti-HIV positive patients. The patients, whose mean age (+/- SD) was 34.6 +/- 5.4 years (range 20 to 54), were divided into three groups: anti-HIV positive asymptomatic (n = 31; 27%), AIDS related complex (ARC) group IV-A (n = 11; 10%), and AIDS subgroups IV-C1 (n = 62; 54%) and IV-D (n = 10; 9%). Overall, 84 patients (74%) were i.v. drug abusers, 24 (21%) were homosexuals, and six (5%) were partners at risk. Zidovudine (AZT) was administered to 94 patients (82%). Opportunistic infections and/or secondary malignancies were detected in 72 patients (63%). Electrocardiographic changes were of little clinical relevance. Of 72 AIDS patients, 47 (65.2%) presented a cardiac involvement: 12 subjects (16.6%) were affected by a dilated cardiomyopathy, 13 (18%) by pericardial effusion, three (4.1%) by mitral valve prolapse, four (5.5%) by myocarditis, five (6.9%) by valvular bacterial endocarditis, and 10 (13.8%) by alterations of left ventricle regional contractility. During a mean follow-up period of 44 months, 29 AIDS patients (40.2%) died. Death was attributed to a cardiac event in four patients; autopsy could be performed in 24 of the 29 patients who died. Our results demonstrate that heart involvement is present in 45.6% of HIV-infected patients, but only in the end-stage of the disease (AIDS) and it is presumably due to opportunistic infections and/or secondary malignancies.(ABSTRACT TRUNCATED AT 250 WORDS)

AIDS-Related Opportunistic Infections↗
PubMed1992

[Warthin's tumor of the parotid. The signs of a case].

The authors report a case of Warthin's tumor associated with cat scratch disease placed in 2 nodes. Both arose at the same time and evolved rapidly. Diagnosis was made by histology after their removal. We underline the rarity of the pathology, the frequent diagnosis made after operation and recommend enuclouresection of neoplasm as the first choice, considering the benignity of the lesion and the modest aggression allowed.

Adenolymphoma↗
PubMed1991

[Lesions of the duodenum from closed abdominal injury. A case report].

Following a review of the literature, the paper reports a case of duodenal injury. This rare pathology most frequently affects the second half of the organ and may cause damage ranging from a simple hematoma to parietal laceration with peritonitis and/or retroperitonitis. Symptoms are often confusing and delayed, and together with chemical and instrumental tests do not always allow an early diagnosis to be made. Treatment varies according to the type of lesion and its location, and is often secondary to the general condition of the patient. Postoperative mortality appears to be limited to 11% if laparatomy is performed early (within 24 hours).

Abdominal Injuries↗
PubMed1991

The interaction of native DNA with dimethyltin(IV) species.

The reaction of aqueous native DNA (calf thymus) with the solvated organotin(IV) species [(CH3)2SnCl2(C2H5OH)n], as well as with [(CH3)2Sn(OH)(H2O)n]+ and (CH3)2Sn(OH)2 (i.e., the hydrolysis products of aqueous (CH3)2SnCl2 at pH approximately 5 and pH approximately 7.4 respectively), was investigated by 119Sn Mössbauer spectroscopy. The addition of [(CH3)2SnCl2(C2H5OH)n] to DNA yielded a solid product, possibly (CH3)2Sn(DNA phosphodiester)2, where the environment of the tin atom is trans-octahedral with linear CSnC skeleton, and the equatorial atoms may consist of oxygen or nitrogen from water as well as from the nucleic acid constituents. No interaction with DNA apparently takes place due to hydrolyzed dimethyltin(IV) species, which occur in aqueous phases at approximate physiological pH values. The reaction pathway is then assumed to require weakly solvated, easily dissociable species such as [(CH3)2SnCl2(C2H5OH)n], which would imply in vivo reactivity of cellular DNA with organotins from hydrophobic sites.

DNA↗
PubMed1991

[Noninvasive evaluation of left ventricular function in alcoholics before and after suspension of ethanol abuse].

It is known that chronic alcoholism causes morphological changes of the myocardium before the development of a specific dilated cardiomyopathy. We studied a group of chronic alcoholics, with normal arterial pressure and without clinical evidence of liver cirrhosis, to evaluate left ventricular function, both before and after withdrawal of ethanol. A M-B mode echo recording of the left ventricle and left ventricular inflow Doppler velocimetry with carotid pulse tracing was performed in each patient within 24 hours of the last alcohol consumption and after a period of abstinence at least 3 weeks. We analysed parameters of left ventricular systolic and diastolic functions, in comparison with a group of normal subjects well matched for age, body surface area and heart rate. The results showed that, in the group of alcoholics, a cardiac hypertrophy exists with increased left ventricular mass and normal parameters of left systolic ventricular function, but with altered ratio PEP/LVET. This last result is the consequence of an abnormal left diastolic ventricular function, as demonstrated from the analysis of the Doppler indexes of left ventricular filling (lower ratio E/A). Left ventricular inflow Doppler velocimetry showed different results in alcoholics and control subjects in the early diastolic flow velocity peak (61 +/- 12 vs 84 +/- 8) and in the peak flow velocity in the atrial contraction phase (62 +/- 10 vs 40 +/- 5.6). We have not observed any change of the echocardiographic parameters after the short period of alcohol withdrawal. We advance the hypothesis that there is an altered diastolic function depending, not only on the hypertrophy of the myocardium, but also on the myocardial interstitial involvement caused by ethanol.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Amoxicillin associated with clavulanic acid. Clinical efficacy and tolerance].

The Authors, after having analysed the problems involving the choice of an antibiotical therapy in the odontostomatological field, present a study concerning the evaluation of the clinical efficacy and tolerability of Amoxycillin associated with clavulanic acid. This drug has been orally administered to 154 ambulatorial patients. The results thus obtained in this clinical sperimentation show that Stacillin is a good and efficacious antibiotic in odontostomatologic affections, and that it is also well tolerated. These characteristics make it a first choice antibiotic in the odontostomatologic sphere.

Adolescent↗
PubMed1990

[Conventional and single-use burs. Cavity preparation comparison].

Our work's aim, was to value the wear of conventional and monouse burs, while preparing the cavity. Usually the conventional burs give better technical efficiency, but the monouse ones represent a notable progress both in technology and prevention.

Dental Cavity Preparation↗
PubMed1990

A double-blind comparison of mianserin and maprotiline in depressed medically ill elderly people.

A double-blind, randomized 4-week mianserin vs maprotiline trial was conducted in 48 depressed geriatric medical inpatients. The drug dosages were up to 90 mg of mianserin and up to 150 mg of maprotiline per day. Efficacy was measured by the Geriatric Depression Scale, the Hopkins Symptom Check List depression subscale and the Clinical Global Impression Scale. The overall dropout figure was 27% of the sample. Side effects were relatively similar in the two treatment groups and suggested a safety profile somewhat better than that of the first-generation antidepressants. Mianserin showed some advantages in efficacy over maprotiline, particularly by the 4th week of the trial, but the overall figures of treatment responders were rather small (Geriatric Depression Scale: mianserin 48%, maprotiline 30%). Clinical trials vs placebo are needed to clarify the role of antidepressant pharmacotherapy in depressed geriatric medical inpatients.

Aged↗
PubMed1989

[Surgical anatomy of the rectum: technical notes].

To have a good knowledge of pelvic and rectal areas is very important to avoid major complications of the rectal surgery. Important technical points are: posterior dissection in the pre-sacral space: this space can be easily demonstrated performing the separation immediately behind the superior rectal artery and then cutting the recto-sacral fascia. This is the correct procedure to avoid dangerous bleedings too; total dissection of the mesorectum for neoplastic disease; it is possible to apply this technique for benign diseases too with a minimal bleeding and without an increase of lesions of the nervous plexes; lateral dissection, that follows the posterior dissection, is performed very close to the pelvic wall for neoplastic diseases and very close to the rectum for benign diseases; anterior dissection, that is performed before the Denonvillier's fascia for neoplastic diseases and behind it for benign diseases.

Dissection↗
PubMed1988

Alopecia areata during lithium therapy. A case report.

A case of total Alopecia areata is discussed in a patient who has received lithium for 2 months. Recent literature is reviewed and several critical observations are made on the possibility of attributing this pathology to the use of lithium.

Alopecia Areata↗
PubMed1988

Personality factors in chronic gastric and duodenal ulcers: a controlled study.

The personality profiles, as evaluated with Cattell's 16 personality factors test (16 PF), were compared in 25 subjects with gastric ulcer, 25 with duodenal ulcer and 25 healthy controls. Subjects were matched for sex, age, education, geographical area of living and duration of illness (only for patients). The profiles of the gastric and duodenal ulcer patients were substantially similar and characterized by greater anxiety, dependence, introversion, low ego strength and greater adaptability as compared to the controls. Patients with gastric ulcer, however, seemed to be slightly more disturbed than those with duodenal ulcer.

Adult↗