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Biomedical subjects

C Grossi

Publications and source records attributed to C Grossi.

At least 37 records · Page 2Linked to original sources
PubMed1989

Decreased salivary glucose secretory rate: usefulness for detection of diabetic patients with autonomic neuropathy.

In this study we investigated whether the presence of diabetic autonomic neuropathy (DAN) leads to an altered composition of saliva. DAN was evaluated in 33 normal subjects and 31 diabetic patients by means of the Valsalva manoeuvre, R-R variation during deep breathing, heart rate response to standing and lying down and blood pressure response to standing. Salivary flow (ml/h), salivary glucose levels (mumol/l) and salivary glucose secretory rate (mumol/h) were measured in each subject. Twelve diabetic patients were positive for DAN. Salivary flow (13 +/- 2 ml/h) and glucose concentration (330 +/- 50 mumol/l) were not significantly lower in patients with DAN than in normal subjects (18 +/- 2 ml/h, 500 +/- 50 mumol/l) and diabetic patients without DAN (16 +/- 1.9 ml/h, 500 +/- 40 mumol/l). The salivary glucose secretion rate was significantly lower (P less than 0.02) in diabetic patients with DAN (4.2 +/- 1.0 mumol/h) than in normal subjects and diabetic patients without DAN (9.0 +/- 1.0 mumol/h and 8.0 +/- 0.9 mumol/h respectively). The test had a good sensitivity and specificity, and appeared to be particularly indicated in discriminating patients without DAN. It is suggested that the measurement of salivary glucose may represent a simple, quick and inexpensive method for the screening of diabetic autonomic neuropathy.

Adult↗
PubMed1989

[Description of a case of Meckel's diverticulum and chronic anemia in a 4-year-old boy].

The case of a boy of 4 years 6 months suffering from Meckel's diverticulum (M.D.) and chronic anaemia is reported. The patient presented no evident sign of bleeding of the mucosa or of other sites. Admitted to the Paediatric Clinic for severe anaemia, he underwent numerous clinical and laboratory investigations that revealed the presence of a bleeding M.D. This was removed surgically and in a comparatively short time (about 3 months), the haematic picture normalized, with manifest benefit to the child.

Anemia↗
PubMed1988

Salivary immunoreactive insulin: a new entry in clinical chemistry?

The distribution of salivary immunoreactive insulin (S-IRI) and its relation to plasma insulin (P-IRI) and other clinical and metabolic variables were investigated in 93 nondiabetic subjects (60 males, 33 females, ages 11-70 y). S-IRI was measured by RIA, with monoiodinated insulin as labeled antigen and with standards consisting of serial dilutions in saliva of known amounts of native insulin. The sensitivity of the method was 12.1 pmol/L. The intra- and between-assay CVs were near 10%, and analytical recovery exceeded 93% for various insulin concentrations added to saliva. S-IRI, measured after overnight fast, showed a nonguassian distribution in males (skewness 1.18, kurtosis 1.41) and females (skewness 1.71, kurtosis 1.18); mean and median values were higher in males (14.3 and 12.1 nmol/min) than in females (12.1 and 7.15 nmol/min), but not significantly so. S-IRI was significantly correlated with P-IRI both in males (r = 0.75, P less than 0.0001) and females (r = 0.72, P less than 0.0001). These results, particularly the correlation between S-IRI and P-IRI, indicate the possibility of using S-IRI measurement in clinical practice.

Adolescent↗
PubMed1987

CD16+ NK lymphoproliferative disorders: cellular and molecular characterization.

We studied the mononuclear cells obtained from 2 patients with CD16+ lymphoproliferative disorders. In both subjects, over 80% of the circulating peripheral blood mononuclear cells were CD16+, CD2+, CD7+, CD3-, CD4-, and CD8-. In 1 patient, greater than 60% of the cells expressed HLA-DR and HLA-DQ gene products. Functional analysis of the natural killer (NK) cell activity of cells from this patient demonstrated 76% killing of K562 targets at ratios as low as 1:1 effector:targets. Karyotype analysis demonstrated a deletion on the long arm of chromosome 6, supporting the contention that the lymphocytosis in this patient was due to a clonally expanded population of cells. In additional studies, Southern blot analysis of DNA extracted from cells of this patient revealed that the beta-chain of the T cell receptor was of germ line configuration. This information supports the hypothesis that the clonally expanded NK population in this patient is of a lineage distinct from T cells and represents a true NK leukemia.

Aged↗
PubMed1987

[Emergency myocardial revascularization in acute evolving myocardial infarct].

Immediate coronary artery bypass for acute evolving myocardial infarction could be the elective therapy if provided on useful time, because myocardial salvage can be achieved by early reperfusion. Thirty eight patients had emergency coronary artery by-pass graft for acute evolving myocardial infarction during the early phase: 35 were male, the mean age was 51 years (34 to 74). The mean interval between the onset of symptoms and surgery in this series of patients was two hours and a half. This interval seems to be also the time limit in our experience to get a partial or complete recovery of ischemic area. Four patients died in hospital, but they were in severe cardiogenic shock before emergency surgery. Twenty nine cases were free of symptoms at a mean follow-up of 18 months (6 to 36) and two suffered for residual angina. Three patients died after discharge few months later: two during redo emergency vein grafts operations, one in deep left ventricular failure, while he was waiting for heart transplant. All these patients operated on as emergency developed acute myocardial infarction during their stay in hospital waiting for catheter study, surgical operation or during percutaneous transluminal coronary angioplasty. Saphenous vein grafts, were used in twenty nine patients, left internal mammary artery in nine cases, single in four and associated to saphenous vein in five, with an average number of anastomoses of 2.6 (1 to 6) for patient. ECG was found to be normal in 76% of the patients operated on within two hours and a half from the beginning of symptoms.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Granulocytic sarcoma with an indolent course and destructive skeletal disease. Tumor characterization with immunologic markers, electron microscopy, cytochemistry, and cytogenetic studies.

A 6-year-old girl with a granulocytic sarcoma (GS) of the left maxillary sinus that followed a uniquely indolent clinical course (3.5 years) and was associated with highly destructive skeletal disease is described. The tumor cells demonstrated an unusual hematogenous "homing" preference for bone and soft tissue sites. Tumor cell characterization with immunologic markers, electron microscopy, cytochemistry, and cytogenetic studies revealed that the tumor cells expressed OKM1 and MMA (Leu-M1), but not HLA-DR, B-, or T-cell markers. The cells were nonspecific esterase- and myeloperoxidase-positive, had ultrastructural features of promyelocytes, and were clonal. The laboratory characterization of the tumor cells in this clinically unusual case of GS illustrates the utility of monoclonal antibodies, applied in conjunction with cytochemistry and ultrastructural analysis, in establishing the specific diagnosis, cell lineage, and maturational stage of this tumor.

Antibodies, Monoclonal↗
PubMed1986

[Multiple anastomosis with the internal mammary arteries].

Between February 1984 and June 1985 90 consecutive patients underwent a surgical procedure of myocardial revascularization with multiple anastomoses, using one or both internal mammary arteries by single or sequential anastomoses. In 53 cases venous graft were also used. 86 cases had elective surgery and 4 had emergency surgery for unstable angina. Most of the patients had triple vessels disease; left main stenosis was present in 14. Left ventricular ejection fraction was less than 0.35 in 8 cases. A single internal mammary artery was used in 61 patients with sequential anastomoses; in 3 of these a triple sequential anastomoses was performed. In 29 patients both mammaries were used, 6 of these were anastomosed in double sequential way. Right mammary was always sewn on the marginal branch of the circumflex artery through the transverse sinus. The incidence of perioperative myocardial infarction was 2.2%. There was no hospital mortality. Reparative surgery to control immediate postoperative bleeding was required in 5 patients (5.5%). 5 cases presented a wound infection. 32 sequential anastomoses were restudied angiographically: 30 of these were patent and 2 malfunctioning. There were two late deaths: one 5 months postoperative, for gastric hemorrhage and the second one 6 months after surgery for inferior myocardial infarction. Mean follow-up of 10 months was complete in 88 surviving patients of whom 80 (91%) were asymptomatic, and 8 cases had residual angina: 5 only during exercise, 3 at rest. We conclude that the extended use of the internal mammary artery grafting, as single or sequential anastomoses, is technically feasible and provides adequate perfusion to the area of myocardium supplied by such grafts.

Coronary Artery Bypass↗
PubMed1986

L-ascorbatemia during biofiltration.

In a study of the intradialytic behaviour of l-ascorbatemia during acetate and bicarbonate dialysis we noted the paradoxical increase in l-ascorbatemia during the first hour of acetate dialysis. During biofiltration, the intradialytic curve of l-ascorbatemia is similar to that in bicarbonate dialysis, even though an acetate dialysis bath is used. Thus the paradoxical rise of l-ascorbatemia during acetate dialysis may be due to the relative acidosis of the first hour.

Acetates↗
PubMed1986

[The internal mammary artery in myocardial revascularization].

Internal mammary artery by-pass graft is a very usefull alternative to venous by-pass graft for myocardial revascularization. From February 1982 up to August 1984, 111 patients with coronarosclerosis have been operated on with left internal mammary artery. Right internal mammary artery has been also used in 2 cases. Left internal mammary artery has been used as a sequential graft 13 times. Vein grafts have been associated in more than 2/3 of the patients who had surgery with internal mammary artery and the mean of anastomoses per patient was 2.9. Five patients had a perioperative myocardial infarction and one an infarction shortly after the operation. Ten patients had immediate reoperation: 5 for postoperative bleeding, 2 for arterial graft anastomosis occlusion, 2 for sudden ST elevation and 1 for acute myocardial infarction. Only one patient died for acute myocardial infarction post-operatively, following coronary artery spasm. Eighty-six patients have been followed-up 3 to 31 months after surgery. Advantages and limits of this surgical technique are discussed.

Adult↗
PubMed1984

[Myoglobinuria secondary to hypokalemia during prolonged diuretic therapy].

Myoglobinuria secondary to hypopotassemia was noted in a hypertensive patient treated for a long period with diuretics (chlorthalidone and indapamide). The picture included hypokalemic myopathy, with myoglobinuria, an increase in serum enzymes related by rhabdomyolysis, and flaccid paralysis. In spite of reinstatement management with potassium chloride, hypopotassemia promoted a torsade de pointes, quickly followed by terminal ventricular fibrillation.

Aged↗
PubMed1984

Plasma amino acid and serum unesterified fatty acid deficits and the effect of nutritional support in chemotherapy treatment.

The deficits in plasma amino acids and serum unesterified fatty acids of cancer patients undergoing chemotherapy and/or radiation therapy were studied to delineate the special requirements of the patients and efficacy of our nutritional therapy. Seven general surgery patients and 13 patients treated by the Head-Neck Service had baseline levels measured as part of their nutritional evaluation prior to surgical treatment of their cancers. Fifteen chemotherapy outpatients maintained on their regular diets had fasting levels analyzed. Twenty-six patients who were admitted for their therapy had their intake of the regular hospital diet supplemented with a low-residue enteral diet formula (Vivonex High Nitrogen Diet); parenteral nutrition was used only if their oral intake was totally inadequate. Baseline and sequential measurements were made of plasma amino acid and serum unesterified fatty acid levels by gas liquid chromatographic techniques. Before operation the patients had normal levels of amino acids except for a significant deficiency of threonine and glycine observed in patients with head-neck tumors. Outpatients with and without hepatic metastases had significantly depressed levels of the essential amino acids valine, leucine, threonine, and methionine and the nonessential amino acids serine, glycine, and proline. The baseline levels of the patients admitted for treatment had similar deficiencies except for more evidence of lysine deficiency. Patients supported with total parenteral nutrition had rapid elevation of the amino acid levels. The patients whose intake was supplemented with the oral diets had improvement in their amino acid levels, but the deficiency in the leucine and threonine fractions persisted up to 4 weeks of therapy. Although the lysine levels were normal when first analyzed, significant differences developed in the patients without hepatic metastases after the start of chemotherapy with return to normal only after chemotherapy was discontinued. Fatty acid levels were not significantly different between the cancer groups except for preoperative elevated oleic acid levels noted in the general surgery tumor group; there were no deficiencies in the essential fatty acids. These studies indicate a need for enteral formulas with adequate branched-chain amino acids and enrichment with threonine and lysine for supplementing the nutrition of the cancer patient who is undergoing chemotherapy.

Amino Acids↗
PubMed1983

[Altered immunoregulation in chronic viral hepatitis. Deficiency of T-lymphocytes with membrane receptors for histamine].

To further characterize the defect of immunoregulation in chronic active hepatitis (CAH), we measured circulating T cells with membrane receptors for histamine (H + TLy), cells endowed with cytotoxic and suppressor functions, in a group of patients with viral CAH, in patients with non-immune liver disorders and in healthy individuals. Patients with CAH showed significantly lower mean numbers and percentage of H + TLy (p less than 0,001) than controls, while patients with non-immune liver disorders had H + TLy values which did not differ significantly from those found in healthy individuals. The lymphocyte alterations in CAH patients were independent of serum HBsAg, cirrhosis or steroid therapy, but correlated inversely with an in vivo index of plasma cell activity, i.e., serum gammaglobulin levels, and with the histological parameter of hepatic inflammation, i.e. portal and periportal mononuclear infiltration. The normal values of H + TLy in patients with non-immune liver diseases suggest that in CAH the decrease in circulating H + TLy is not secondary to the liver damage. The alteration of immunoregulation associated with CAH may have pathogenetic implications, although it is unlikely to represent the sole mechanism for the perpetuation and worsening of the disease process.

Adult↗
PubMed1982

Traumatic intracerebellar hematomas.

Seven patients with "isolated" traumatic intracerebellar hematomas due to closed head injuries are presented. Computerized tomography parameters useful in the correct management of these hematomas include: location (hemisphere or midline), size, and appearance of the posterior fossa cisterns (intact or obliterated). Three patients with hemispheric hematomas were treated conservatively and recovered. One patient with a midline hematoma was managed conservatively and died. Three hematomas (one hemispheric and two midline) were operated on. The immediate results of surgery were good, but two patients died later due to medical complications. The results of this study support the concept that large hematomas (3 cm or greater) generally need surgery and that hemispheric hematomas of limited size (less than 3 cm) may be treated conservatively. The clinical course of prognosis of midline hematomas is grave, and evacuation of accessible hematomas should be considered early in the course of the disease.

Adolescent↗
PubMed1979

Pathologic identification of poor prognosis stage I (T1N0M0) cancer of the breast.

Twenty to 40% of Stage I(T1N0M0) cancers of the breast recur in ten years. This is an attempt to identify those patients in whom the disease is likely to recur. On the basis of a study of the histologic changes in the tumor and treatment failures poor prognosis was associated with several histological characteristics: poor cytologic differentiation; lymphatic permeation; blood vessel invasion and invasion of the tumor into the surrounding soft tissue. This classification was then applied to 363 cancers of the breast seen over a five year period and followed three to eight years. There were 203 Stage I (T1N0M0) tumors in the group. Ninety-four of the 203 Stage I tumors had one to four of the above histologic characteristics; 109 had none. Among the 109 patients characterized as good risks there were two treatment failures (2%). In the group of 94 with any high risk histologic features there were 47 treatment failures (50%) which were statistically significant (p = 0.001). The histologic changes had a cumulative effect on the degree of malignancy of the tumor. Pathologic changes in the tumor identified those patients whose Stage I (T1N0M0) tumors were likely to recur.

Adenocarcinoma↗
PubMed1979

The absence of protein--sparing effects utilizing crystalline amino acids in stressed patients.

The protein-sparing effects of the peripheral infusion of crystalline amino acids (PAA) was studied metabolically in selected surgical patients subjected to various degrees of stress. Twenty-one patients (sixteen cancer patients receiving chemotherapy and/or radiotherapy, three with major abdominal traumatic injuries and four with paralytic ileus) were infused with 2 1/24 hours of a solution of 4.2% Travasol amino acids with only 5% glucose as a source of nonprotein calories. One-half of the cancer patients were also allowed ad libitum oral intake of a regular hospital diet or Vivonex-HN. The nutritional status was evaluated by measuring changes in body weight, serum albumin levels and nitrogen balance. Body weight decreased in only the trauma patients. When these solutions were the sole source of nutrients all patients were in negative nitrogen balance and had significant decreases in their serum albumin levels. Serum albumin levels were preserved only when extra sources of calories were provided. The infusion of the crystalline amino acids without adequate levels of nonprotein energy did not conserve protein in these stressed patients.

Abdominal Injuries↗