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Biomedical subjects

D Tassinari

Publications and source records attributed to D Tassinari.

At least 55 records · Page 3Linked to original sources
PubMed1995

Atypical absorption of morphine sulphate through oral mucosa: an unusual case of acute opioid poisoning.

An unusual case of probable opioid poisoning due to atypical absorption of morphine sulphate through the oral mucosa is reported. A patient with advanced laryngeal cancer, who was unable to swallow, became stuporous, bradypneic, and cyanotic and had pinpoint pupils 1 hour after taking a controlled-release tablet of morphine sulphate 30 mg. Intravenous naloxone 0.4 mg induced prompt reversal of the clinical picture. The tablet of morphine, in advanced stage of decomposition, was found in the patient's mouth, the mucosa of which was inflamed and extensively ulcerated because of the long-standing stagnation of food residuals. Usually morphine is not amenable to transmucosal absorption, because of its low lipid solubility. In this case, the retention of the tablet of morphine in the mouth and the breakdown of oral mucosa integrity could have provoked a quick transmucosal absorption of the drug, with by-pass of hepatic first-pass metabolism. This may have induced a peak in drug concentration much higher than that usually resulting from the enteric absorption of controlled-release tablets of morphine.

Absorption↗
PubMed1995

Response to growth hormone therapy in patients with growth hormone deficiency who at birth were small or appropriate in size for gestational age.

OBJECTIVE: To determine long-term growth response to growth hormone (GH) therapy in patients with isolated GH deficiency who had been small for gestational age and in those who had been appropriate in size for gestational age. DESIGN: Longitudinal, case-control study. SETTING: Pediatric clinic, endocrinology center, University of Bologna, Italy. PATIENTS: Sixteen GH-deficient children, small for gestational age with unknown cause, and 16 GH-deficient children, appropriate in size for gestational age, who were matched for chronologic age, bone age, pubertal stage, and target height at the beginning of treatment and were treated for 36 months. INTERVENTION: Recombinant human GH given subcutaneously at a dose of 20 IU/m2 per week in six doses per week for 36 months. MEASUREMENTS: Growth hormone levels (fluoroimmunoenzymatic method), levels of insulin-like growth factor I (radioimmunoassay), and complete 36-months auxologic follow-up. RESULTS: Patients who were small for gestational age had a modest improvement in height for chronologic age but no increase in predicted final height. Patients who were appropriate in size for gestational age had significantly better improvement in both measurements (multivariate analysis of variance: F = 6.3 (p < 0.001) and F = 3.8 (p < 0.05), respectively). Catch-up growth was similar during the first year of therapy for the two groups, after which the linear growth velocity decreased more rapidly in the small-for-gestational-age patients (multivariate analysis of variance: F = 4.9 (p < 0.05)). CONCLUSIONS: The constitutional component of the statural deficiency of small-for-gestational-age children seemed to prevail over hormonal deficiency during treatment with GH. Further follow-up to final height is necessary to evaluate these different responses.

Case-Control Studies↗
PubMed1995

Usefulness of coagulation markers in staging of gastric cancer.

Thirty-six patients with nonmucinous adenocarcinoma of the stomach, candidates for surgical laparotomy, were studied to evaluate the presence and extent of coagulation disorders in gastric cancer. They were staged according to TNM cancer staging (T: extent of primary tumor; N: lymph node involvement; M: presence of metastases), and a blood sample was collected before surgery. Platelets, platelet factor four (PF4), beta-thromboglobulin (BTG), activated partial thromboplastine time (APTT), prothrombin time (PT), factors five (V) and seven (VII), fibrinogen, cross-linked fibrin degradation products (XDP), fibrinopeptide-A (Fp-A), and antithrombin three (AT III) were assayed. Only fibrinogen, Fp-A, PF4, and factors V and VII were increased in more than 50% of patients. Fibrinogen and Fp-A were positively correlated with T(r = 0.29, p < p < 0.05; and r = 0.35, p < 0.05; respectively), whereas the other parameters did not show any statistically significant relationship with T, N, and M. Considering the subgroups including only the patients with pathological values, Fp-A (31 patients) was positively correlated with N (r = 0.4, p < 0.05), PF4 (25 patients) showed a positive correlation with T and N (r = 0.42, p < 0.05; r = 0.46, p < 0.05; respectively), and a significantly higher median in the presence than in the absence of metastases (median in the M+ subgroup: 42.7 ng/ml, range 38.6 to 102.8; median in the M- subgroup: 33.7, range 20.3 to 85; p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenocarcinoma↗
PubMed1995

Swyer-James syndrome: bronchoalveolar lavage findings in two patients.

Swyer-James syndrome (SJS) is a rare constrictive bronchiolitis that appears to be the result of acute bronchiolitis in infancy or early childhood. In the present study the cytological and immunophenotypical profile of bronchoalveolar lavage (BAL) was studied in two patients with SJS who showed a different spectrum of clinical outcome. The total BAL yield was markedly increased in the patient with chronic cough and acute episodes of dyspnoea but not in the patient with decreased exercise tolerance and longer duration of disease. In the two patients, the differential cell counts in percentage were characterized by a significant increase of neutrophils and a slight increase of lymphocytes. The analysis of lymphocyte subsets showed a significant increase of CD8+ cells (T-suppressor-cytotoxic) in both cases, resulting in a decreased CD4/CD8 ratio. In addition, an increase of cells bearing a B-phenotype (CD19+ cells) was noted in the fluid recovered from the patient with chronic cough and acute episodes of dyspnoea. In conclusion, our data suggest that SJS is an active process with inflammatory characteristics. Further studies are needed to explain the mechanism leading to the expansion in situ of immunocompetent cells.

Adolescent↗
PubMed1994

Prevention of aspiration pneumonia during long-term feeding by percutaneous endoscopic gastrostomy: might cisapride play any role? An open pilot study.

The risk of aspiration during tube feedings has been reduced but not abolished by percutaneous endoscopic gastrostomy (PEG). This open study was planned to evaluate whether cisapride may play some role in preventing aspiration in long-term enteral feeding via PEG. A group of 29 patients, unable to swallow because of head and neck cancer (14 cases) or neurological disorders (15 cases) entered the study; 7 neurological patients, fed via nasogastric tube before PEG placement, had suffered from aspiration pneumonia during nasogastric feeding. All patients underwent PEG, and 10 mg cisapride was routinely given via PEG before each administration of enteral feeding and 6 h after its initiation when the feeding was continued for 12 h or more. Only 1 minor complication was observed during the acute hospital setting (ileus, spontaneously resolving after 36 h). After hospital discharge, the patients were followed for a total of 4935 days of feeding (range 47-508 days, mean time per patient: 170 days) and assessed weekly for the development of complications. No episode of probable/possible aspiration pneumonia was observed during the follow-up. Two neurological patients with involuntary movements had rupture of the feeding tube, which was replaced without complications. These results support the hypothesis that cisapride might play some role in the prevention of aspiration in patients fed via PEG, and justify the planning of some controlled, double-blind trials to verify such a hypothesis.

Adolescent↗
PubMed1994

Spontaneous growth and pubertal development in Turner's syndrome with different karyotypes.

We studied spontaneous growth and pubertal development in 205 girls with Turner's syndrome, aged 1 month to 28.16 years, according to different karyotypes: 45,X (52%), X-mosaicism (12%), X-structural abnormalities (36%). Data on height, weight, height velocity, bone age and pubertal development were collected yearly in a mixed longitudinal and cross-sectional mode. Pelvic ultrasonography was performed in 133 patients, 46 of whom had contact breast thermography. Standards for height and height velocity (1-20 years) showed no differences when compared with other studies. Some differences were found when these data were subdivided by karyotype. In fact, X-mosaicism subjects had a pubertal growth spurt between 8 and 12 years of age. The spurt observed in this group cannot be justified by the more frequent presence of residual ovarian activity alone. It also appears in patients without ovaries and confirms the influence of a genetic factor on the X-chromosome. In spite of this spurt, the greatest final height was reached by 45,X subjects. X-mosaicism girls had more frequent spontaneous breast development linked to a higher percentage of visible ovaries. In this group the age of the first pubertal signs was similar to that of normal subjects and occurred much earlier than in the other groups.

Adolescent↗
PubMed1994

Value and limits of pharmacological and physiological tests to diagnose growth hormone (GH) deficiency and predict therapy response: first and second retesting during replacement therapy of patients defined as GH deficient.

There is currently a debate about the use of pharmacological and physiological tests to define GH deficiency and predict response to GH therapy. In addition, a good response to therapy has also been described in subjects without GH deficiency. For further information, we reevaluated GH secretion during replacement therapy in a group of children defined as GH deficient and examined response to therapy in the subjects subdivided according to secretion. One hundred eighty four children (113 boys and 71 girls) initially diagnosed with GH deficiency by means of pharmacological (peak < 8 micrograms/L after arginine and L-dopa tests) and physiological tests (mean nocturnal concentration < or = 3.3 micrograms/L during sleep test) underwent the same tests 2.8 +/- 1.1 yr after start of GH therapy. Sixty eight patients were retested 1.5 +/- 0.4 yr after first retesting. At diagnosis 122 subjects had pathological pharmacological and physiological tests (group A), 30 subjects normal sleep test with pathological pharmacological tests (group B), and 32 subjects pathological sleep test with normal pharmacological tests (group C). At diagnosis 140 subjects were prepubertal and 44 pubertal. To evaluate response to therapy in relation to GH secretion at diagnosis and at both retestings, a number of auxological parameters were calculated during treatment. At first retesting, 107 subjects (58.1%) changed initial group of diagnosis, 34 of whom (18.5%) presented normal secretion in both pharmacological and physiological tests (group D). At second retesting, 31 of the 68 subjects reexamined (45.6%) changed first test results, and 33 (48.5%) reverted to the initial group of diagnosis; none of the 6 subjects of group D maintained normal secretion. Although the percentage of normalized subjects was higher in pubertal subjects (36.4%; P = 0.0003) than prepubertal subjects (8.9%), puberty did not prevent a reduction of secretion in some subjects. Response treatment during the first year of therapy was similar in the various groups. GH secretion seems to change in both prepubertal and pubertal children diagnosed with GH deficiency when pharmacological and physiological tests are repeated over time. Moreover, such tests may not represent a reliable tool for predicting response to treatment. GH secretion normalization at retesting may not necessarily represent the end of a transient secretory defect.

Adolescent↗
PubMed1993

Structural changes of duodenum brush border in lung cancer patients treated with cisplatin plus etoposide.

The effects of cisplatin plus etoposide chemotherapy (PE) on the structure of proximal intestine villi and brush border were investigated in 10 patients with lung cancer. The day before starting chemotherapy (time 1); 8 days after its initiation (time 2), and one month after the 3rd course of PE (time 3) they underwent esophagogastroduodenoscopy and three biopsies were taken from the descending duodenum. Intestinal villi were examined by light microscopy; brush border by transmission electron microscopy. No significant histological changes of villous pattern were observed at times 2 and 3. The height of microvilli was reduced in seven patients at time 2 (P < 0.05). Microvilli abnormalities (i.e. rarefaction and/or heterogeneity in their height) were present in nine patients at time 2 (P < 0.05). Brush border appearance at time 3 did not differ from that at time 1. PE chemotherapy seems to have short-term toxic effects on small intestine brush border, but does not cause chronic enteropathy.

Adult↗
PubMed1992

Clinical usefulness of estrogen receptor immunocytochemistry in human breast cancer.

We assessed the reliability of the immunocytochemical assay of estrogen receptor (ER-ICA) as a marker of clinical outcome. Relapse-free interval (RFI) and overall survival (OS) according to ER-ICA status were retrospectively evaluated on a series of 210 patients who had undergone surgery for primary breast cancer between January 1985 and December 1988. ER assay by the dextran-coated charcoal method (DCC) was also performed in 189 tumors. A significant positive correlation was found between the DCC and ER-ICA assays, with an overall agreement of 79%. ER-ICA status showed a prognostic predictive power with respect to OS and RFI in the whole series of patients and in the subset of node-positive patients. It was also a marker of outcome with respect to OS in the subsets of node-negative patients and patients with tumors < or = 2 cm in diameter. Moreover, the predictive value of the ER-ICA assay was higher than that of the DCC assay in the present study. These findings emphasize the clinical usefulness of the ER-ICA assay as a measure for prognosis.

Adult↗
PubMed1992

Serum and erythrocyte magnesium concentrations in solid tumours: relationship with stage of malignancy.

Magnesaemia is often decreased in solid tumours, but magnesium (Mg) is mainly an intracellular cation and serum levels do not reflect actual body stores. In this study serum Mg (SMg) and erythrocyte Mg (EMg) concentrations were measured in 40 healthy controls and in 108 patients affected by various types of tumour (50 lung cancers, 25 breast cancers, 18 ovarian cancers, and 15 oropharyngeal and hypopharyngeal cancers). EMg was higher (P < 0.05) and SMg lower P < 0.001) in neoplastic patients than in controls. All tumour types behaved in the same way, though in the lung cancer group the increase in EMg did not reach statistical significance in comparison with the control group (P = 0.05). The extent to which EMg was increased and SMg decreased was positively correlated with the advancement in the stage of malignancy. These results suggest that in neoplastic disease Mg requirement is not only increased in tumour tissue, but also in erythrocytes. The increase in EMg may derive from a change in the red blood cell membrane, facilitating intracellular concentration of magnesium for transport to the tumour. The concomitant decrease in SMg may be the consequence of the enhanced erythrocyte uptake of magnesium from the extracellular circulating pool.

Adult↗
PubMed1991

What will be the adult height of coeliac patients?

We studied three groups of patients with coeliac disease: group 1 = 95 adult patients with gastro-intestinal symptoms diagnosed after reaching adult height, 41 of whom had had symptoms during childhood; group 2 = 23 adult patients with classic coeliac disease treated before or during puberty; group 3 = 11 coeliac children with short stature and no gastro-intestinal symptoms diagnosed and treated before or during puberty. We evaluated the adult height in groups 1 and 2 and the growth during the first years of diet in group 3. Our study leads us to the following conclusions. Dieting leads to a modest increase (on average not more than 3 cm) of the final height of coeliac patients. Subjects with gastro-intestinal symptoms who have been treated before adulthood reach a mean height similar to the normal population and have a slightly better adult height than non-treated subjects. This difference seems to exist only in men and this might be related to puberty evolving more rapidly in women receiving treatment. Subjects without symptoms during childhood reach a normal final height even without treatment. In our patients, early treatment seemed to have no great effect on adult height.

Adolescent↗
PubMed1991

[CEA, GICA, TPA, fibrinopeptide-A, gamma-GT and gastric cancer. A contribution to the rationalization of a combined assay].

CEA, GICA, TPA, Fibrinopeptide-A (FpA) and Gamma-GT serum levels were evaluated in 312 patients affected by gastric cancer, to assess their effectiveness in diagnosis, evaluation of disease extension and follow-up of gastric cancer. In 204 patients neoplasia was limited to the stomach, in 108 liver metastases, ascertained by ultrasonography and/or TAC, were present. CEA was increased in 224 cases (71.8%); mean values were significantly higher in metastatic patients than in metastasis-free group (p less than 0.001), but overlap of values between the two groups was observed in about one third of cases. GICA was increased in 268 patients (86%) and TPA in 306 (98%), without significant differences between metastatic and metastasis-free group. FpA was increased in all patients; when metastases were present it was significantly higher than in metastasis-free patients (p less than 0.001), with negligible overlap of values between the two groups. Gamma-GT was normal in 202 metastasis-free patients (99%) and increased in 105 patients with liver metastases (97%). On the basis of these data CEA does not seem to have striking diagnostic sensibility nor reliability in differentiating presence from absence of liver metastases in patients with gastric cancer. Combined assay of TPA, FpA and Gamma-GT seems to be the most reliable serological approach in diagnosis, staging and follow-up of gastric cancer.

Adult↗
PubMed1991

Changes in serum, erythrocyte, and urinary magnesium after a single dose of cisplatin combination chemotherapy.

The changes in serum and erythrocyte Mg concentrations and in renal Mg excretion induced by a single dose of cisplatin (100 mg/mq body surface area) were investigated in 16 patients with lung cancer. Magnesuria increased significantly (P less than 0.001) the day after cisplatin administration, returned to basal levels in the following days, and increased again on the 7th day (P less than 0.05). Magnesaemia decreased gradually and after 7 was significantly lower than before treatment (P less than 0.05). Erythrocyte Mg decreased significantly on days 1 (P less than 0.05) and 2 (P less than 0.001) after cisplatin administration, began to increase on day 4, and recovered to pretreatment values on day 7. These results suggest that, besides the well known damage to tubular function with consequent increase in renal Mg wasting, cisplatin may also interfere with Mg metabolism at cellular and subcellular levels. The activity of the drug on nucleic acids and membrane transport systems, where Mg is abundant and exerts important stabilizing functions, could induce Mg mobilization and increased membrane permeability, with a consequent shift of Mg from cells into the blood stream. This would counterbalance the increase in magnesuria, and magnesaemia would decrease significantly only when intracellular Mg returns to pretreatment levels.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1990

Effects of sport (football) on growth: auxological, anthropometric and hormonal aspects.

There are very few data available on the relationship between sporting activities, endocrine levels and changes in anthropometric measurements during growth. In order to study these relationships, we have made measurements of growth, changes in physical conformation and the plasma levels of several hormones [cortisol, dehydroepiandrosterone sulphate (DHEA-S), testosterone, growth hormone, somatomedin C, insulin, glycaemia and haemoglobin A1C] in 175 boys, aged 10-16 years, who have played football at a competitive level and in 224 boys, severing as controls, who have never performed sporting activities regularly. The football players were divided into prepubertal and pubertal subjects (10-11.99 years, 12-13.99 years and 14-16 years, chronological and bone age groups). Our results showed no significant differences in the growth indices between prepubertal athletes and controls, but the plasma level of DHEA-S was significantly higher (P less than 0.05) in the athletes. Pubertal football players, however, were significantly taller than the control subjects, particularly at 14-16 years chronological age. There were no such significant differences when bone age was considered. The pubertal football players were also more advanced in all biological indices of maturity, i.e. pubic hair, testicular volume and bone age. The increase in DHEA-S in pubertal football players, already seen in prepubertals, was also combined with a significant increase in testosterone, growth hormone and cortisol levels. Thus, in football players the DHEA-S level is already higher during prepuberty. This increase thus precedes all other indices of growth and maturation associated with puberty. We hypothesize that, while not excluding the possible influence of selection, as ours is a cross-sectional study, adrenal hyperactivity may be mainly responsible for the earlier onset of pubertal growth and maturity in exercising males.

Adolescent↗
PubMed1989

Growth and sport.

In order to investigate sport's influence on growth during puberty, we examined 398 boys 10-16 yr old. 192 of these subjects had been playing football as a competitive sport, and 206 were considered as controls, having never practised sports regularly. Both groups were divided into prepubertal (with testicular volume less than or equal to 2.5 cc) and pubertal, with the latter further divided into the following chronological and bone age groups: 10-11.99, 12-13.99, 14-16 yr. In these subjects we evaluated auxological-anthropometric and biological maturity characteristics and endocrine parameters (cortisol, dehydroepiandrosterone sulphate, testosterone). No significant difference was found between prepubertal athletes and controls concerning anthropometric and biological maturation parameters, whereas testosterone basal levels were significantly lower (p less than 0.05) and DHEAS values were significantly higher (p less than 0.05). Pubertal football players were significantly taller than controls (particularly at 14-16 yr chronological age), with a greater biacromial diameter after 12 yr chronological and bone age and thinner skinfolds at 12-13.99 chronological and bone age. They were more advanced in all biological maturation parameters i.e. pubic hair, testicular volume and bone age, particularly those subjects playing football for the greatest number of years and training time. In pubertal football players the increase in DHEAS (p less than 0.05) already seen in prepubertals is also combined with a significant increase in testosterone (p less than 0.0001) and cortisol (p less than 0.05). Thus football players DHEAS is already higher during prepuberty and this increase chronologically precedes the advance in all the auxological-maturative parameters typical of our pubertal subjects.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗