Phrenic nerve palsy treated by continuous positive pressure breathing by nasal cannula.
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Biomedical subjects
Publications and source records attributed to C Moretti.
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We measured beta-endorphin (BE) and beta-lipotropin (BLPH) plasma concentrations (by means of an HPLC-RIA coupled method) during attacks as well as during symptom-free periods in a group of 28 patients with immunochemical (21) or functional (7) Cl inhibitor deficiency. Thirteen patients suffering from chronic urticaria served as controls. Three orders of considerations prompted us to initiate the present study: the clinical relationship between stress and the onset of acute episodes, the possible effects of repeated stressful situations, as are the attacks themselves, on the patients' neuroendocrine system and the well-known existence of close links between the immune system and endogenous opioids. The results show that plasma BE (and, to a lesser extent, BLPH) is dramatically increased during the attacks. In symptom-free periods many patients show very high BE concentrations, often in the presence of slightly elevated concentrations of BLPH and of ACTH. These observations suggest that patients with hereditary angioneurotic edema show a modified pro-opiomelanocortin-synthesizing cell activity that can result in a massive release of BE from the readily disposable pool present in the pituitary and/or an increase in the turnover of the peptide as evaluated by the BLPH/BE ratio.
We measured peripheral blood mononuclear cells (PBMC) beta-endorphin (BE) in patients suffering from hereditary angioneurotic edema (HANE), a disease attributed to C1-esterase inhibitor (C1INH) deficiency inherited as an autosomal dominant trait. Two orders of considerations prompted us to undertake the study reported herein: the presence of elevated plasma BE concentrations in HANE and the demonstration of BE-immunoreactivity in human unstimulated peripheral blood leukocytes obtained from healthy volunteers. Our results show that patients suffering from HANE have a very high BE presence in uncultured, unstimulated PBMC and in unstimulated PBMC cultured for 48 h. At this time high BE concentrations are detected in the culture supernatants. These observations suggest that in HANE patients the same factor(s) involved in causing increased secretion and release of BE from the pituitary (and, in turn, increased plasma BE levels) can play a relevant role also in the determination of high BE presence in PBMC and BE release from the cells.
The South American Simaba cuspidata Spruce and North Indian Ailanthus grandis Prain were investigated as sources of potentially useful antineoplastic agents. Both of these Simaroubaceae plant species were found to produce 6 alpha-tigloyloxychaparrinone (4a) and the new quassinoid 6 alpha-tigloyloxychaparrin (3b). The latter structure was determined by interpretation of spectral data and oxidation to 6 alpha-tigloyloxychaparrinone (4a). While both glycol 3b and alpha-ketol 4a were found to significantly inhibit growth of the murine P388 lymphocytic leukemia cell line, only the alpha-ketol (4a) inhibited growth of the corresponding in vivo system.
Investigation of the leaf extract of Picrolemma pseudocoffea afforded a new antineoplastic quassinoid, 15-deacetylsergeolide (3), and two known quassinoids, isobruceine B (1) and sergeolide (2). The structure of 3, which displayed strong antileukemic activity in the P-388 test system, was established through the interpretation of spectral data and chemical correlation to 2.
Two new quassinoids, 13, 18-dehydro-6 alpha-senecioyloxychaparrin (4) and 12-dehydro-6 alpha-senecioyloxychaparrin (5), have been isolated from Simaba multiflora fruits. Their structures were deduced from spectral data. 1H-13C 2-D chemical-shift correlation nmr was applied to the structural elucidation of the antileukemic quassinoid 4.
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OBJECTIVE: To investigate the efficacy and safety of a combination therapy with methotrexate (MTX) and cyclosporine A (CyA) in patients with juvenile idiopathic arthritis (JIA) who were refractory to MTX as a single second-line agent. METHODS: Seventeen consecutive patients with JIA who had refractory polyarthritis despite a minimum of 6 months of MTX as a single second-line agent at the dose of 15 to 25 mg/m2/week were continued with MTX with the addition of CyA (4 mg/kg/day) for 6 to 30 months (median 10 months) were analyzed. The clinical response to therapy was assessed through the preliminary definition of improvement in JIA. RESULTS: At the end of the treatment, as compared to the time when CyA was added to MTX, 8 patients (47%) met the 30% definition of improvement; among them 5 (29%) met the 70% definition of improvement, and 2 (12%) achieved complete disease control. Seven patients (41%) experienced side effects: 4 gastrointestinal discomfort, 1 liver transaminase elevation, and 2 increase > or = 30% in the serum creatinine concentration. No patients was discontinued from combination therapy due to adverse events. CONCLUSION: In our JIA patients who were refractory to MTX as a single second-line agent, the addition of CyA was associated with a significant clinical improvement in roughly half of the patients.
Although respiratory syncytial (RS) virus is the major cause of bronchiolitis and pneumonia in young children, the factors that regulate the associated lung inflammation have not been defined. The levels of interleukin (IL)10, IL-12, and interferon (IFN) were determined in the nasal wash samples from 20 infants with a clinical diagnosis of bronchiolitis, seven with confirmed RS virus infections and 9 control children without respiratory illnesses. IL-10 levels were significantly higher in acute nasal wash samples (1-4 d post hospitalization) from RS virus-infected infants than in convalescent samples from these children (14-21 d post-hospitalization), from children with other forms of bronchiolitis and from control children. In contrast, only one RS virus-infected infant had detectable IL-12 in an acute nasal wash sample. IFN activity was not detected in any samples from RS virus-infected children. RS virus infection stimulates IL-10 expression but not IL-12 and IFN, possibly contributing to an ineffective cell-mediated immune response.
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After a review on osseous labyrinthine modifications in cochlear otosclerosis, the authors report their experience, based on four patients, in CT evaluation of the disease. CT high resolution programs detect demineralization centres, which are distinctive of cochlear otosclerosis, at an early stage. CT must be considered a more informative investigation than multidirectional tomography.
To evaluate incidence, clinical and laboratoristic values of patients with non organic failure to thrive (NOFTT), a retrospective study (January 1987-January 1991) among inpatient children of Department of Pediatrics of University of Padova was made. Thirty-six children (23 females and 13 males) aged 10 days to 22 months were selected. The incidence of NOFTT was 1.15% of total admission for the same age; it was more frequent in females than in males (F:M = 1.8:1) and it was more represented in children 0-3 months and 10-12 months aged. The main data have been: breast-feeding very frequent but early stopped (45% within the first month of life); administration of special formulas (soy milk, hydrolisate, hypoallergenic formulas) in 25% of cases. Specific symptoms in different ages: regurgitation, sucking problems and dysphagia more present in children less than 3 months, and inappetence and/or food refusal more represented in children more than 3 months. Ematologic and other lab values were totally normal.