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Biomedical subjects

E M Zardi

Publications and source records attributed to E M Zardi.

14 recordsLinked to original sources
PubMed2006

Subcellular shift of the hepatic growth hormone receptor with progression of hepatitis C virus-related chronic liver disease.

AIMS: To evaluate the cytoplasmic and nuclear expression of hepatic growth hormone receptor (GHR) in different stages (S0, S1, S3 and S4, according to Knodell's classification) of chronic liver disease (CLD) and in hepatocellular carcinoma (HCC). METHODS AND RESULTS: Liver specimens from 31 patients with hepatitis C virus-related CLD, five patients with HCC and nine controls were examined for expression of hepatic GHR by immunohistochemistry with MAb 263. Cytoplasmic and nuclear staining were evaluated as a percentage of positively stained cells. The cytoplasmic expression of GHR was comparable between normal liver and S0 hepatitis, while it progressively decreased in S1, S3 and S4 CLD (P < 0.01). Conversely, nuclear GHR showed increased expression in S3 and S4 CLD (P < 0.05). No differences were observed between HCC and normal liver in terms of GHR immunoreactivity. CONCLUSIONS: This is the first study to show that the subcellular expression of hepatic GHR changes with the progression of CLD. The increase in nuclear expression of GHR with advanced stages of CLD suggests that GH may act directly at the nuclear level to promote hepatocyte proliferation/regeneration.

Adult↗
PubMed2006

Surgical complications after resection of adrenal carcinoma.

A 76-year-old woman with a history of dyspnoea, weight loss and abdominal pain, was admitted to our Hospital. Sonographic and tomographic examinations showed the presence of a large adrenal gland tumor and the promptly performed adrenalectomy and splenectomy proved that the lesion was an adrenal gland carcinoma infiltrating the spleen. One month after surgical treatment, the patient's general condition dramatically worsened due to development of perirenal abscess and renal infarction; finally, the patient died. In accordance with literature, we decided to only perform adrenalectomy and splenectomy that are the treatment of choice in these cases. In fact, complications are unforeseeable and avoiding the resection of the kidney surely offered the patient a better life quality.

Adrenal Cortex Neoplasms↗
PubMed2005

Treatment of cryptosporidiosis in immunocompromised hosts.

The most important species of Cryptosporidium in humans, C. parvum and C. hominis, cause severe and chronic life-threatening gastroenteritis in immunocompromised patients. Despite a certain efficacy shown by passive immunotherapy or by some chemotherapeutic agents (e.g. paromomycin and nitazoxanide), no significant benefit has been demonstrated. The use of highly active antiretroviral therapy (HAART) in persons with the acquired immunodeficiency syndrome drastically reduces the prevalence of Cryptosporidium infection. This result seems to be due to aspartyl protease inhibitors of the human immunodeficiency virus included in HAART, which directly interfere with the life cycle of the parasite. The identification of the C. parvum proteases involved in the host-cell interaction could lead to new therapeutic approaches using specific parasite protease inhibitors in immunocompromised persons.

Animals↗
PubMed2004

The role of ribavirin in the combination therapy of hepatitis C virus infection.

Ribavirin is a very broad-spectrum anti-viral agent used clinically to treat infections by Lassa fever virus, respiratory syncytial virus (RSV) and, in combination with Interferon-alpha (IFN-alpha), hepatitis C virus (HCV). Although it was originally synthesized over 30 years ago, the precise mechanisms of its therapeutic activities are still not fully understood. Ribavirin was shown to possess both direct and indirect action mechanisms against several DNA and RNA viruses. These include direct inhibition of viral RNA-dependent RNA polymerases, inhibition of the host inosine monophosphate dehydrogenase, modulation of the host immune response and inhibition of viral capping enzymes. More recently, ribavirin was demonstrated to be able to act as an RNA virus mutagen, increasing mutations in the RNA virus genome and reducing their infectivity. Still the real challenge is to identify which of its biological properties is responsible for the observed clinical efficacy on specific infections. Under this aspect, renewed interest results from its synergistic enhancement of interferon-alpha (IFN-alpha) therapy, which could open the way to develop more powerful anti-HCV compounds. This work purpose is to provide a broad overview of all the recognized ribavirin action mechanisms against HCV, which can possibly also explain its synergistic behavior with IFN-alpha. An overview on the corresponding HCV treatment clinical observations is also provided in the second part of this work.

Antiviral Agents↗
PubMed2002

Myiasis of a perineal fistula.

We report a case of myiasis of a rectocutaneous fistula in a subject suffering from bone metastases after surgical resection of a neoplastic bladder. The fistula was infested by maggots identified as third-instar larvae of flies belonging to the family Sarcophagidae, genus Sarcophaga. The infestation was neither intestinal nor pseudointestinal; it was probably caused by a fly ovipositing on the fistula of the patient while having wound care at home, even though the possibility that the infestation might have occurred during hospitalization cannot be ruled out.

Animals↗
PubMed2001

Doppler sonography measurement of portal blood flow velocity after glucagon injection in patients with chronic HCV infection.

Doppler sonography measurement of portal flow velocity (PFV) after glucagon injection was performed in 45 patients with chronic hepatitis C virus (HCV) infection. Patients were divided into three groups: group 1 = no or mild liver fibrosis; group 2 = moderate to severe liver fibrosis, and group 3 = liver cirrhosis. All patients were examined using a Doppler ultrasound (US) multipurpose equipment and a convex 3.5-MHz probe, 10 min before (baseline), as well as 5 and 10 min after, IV administration of 1 mg of glucagon chloride. No significant differences were found in mean baseline PFV among group 1 (19.4 +/- 2.4 cm/s), group 2 (20.1 +/- 3.6 cm/s) and group 3 (17.5 +/- 3.7 cm/s). Five minutes after glucagon injection, all three groups showed significantly increased values of mean PFV (25.6 +/- 4.8, 23.7 +/- 4.0 and 19.5 +/- 5.0 cm/s, respectively; p < 0.05 vs. baseline). The mean increase of PFV above baseline was significantly higher in group 1 (7.9 +/- 3.7 cm/s) than in group 2 (4.5 +/- 3.9 cm/s) (p < 0.05) or in group 3 (2.7 +/- 2.3 cm/s) (p < 0.05). A significant inverse correlation was found between individual values of fibrosis score and of individual increase of PFV. In patients with chronic HCV infection, Doppler sonography measurement of PFV after glucagon injection could be useful in assessing the severity of liver histological damage.

Adult↗
PubMed1997

[Subcutaneous human dirofilariasis].

After a short review of the literature, starting from the last decades of the past century, the current classification of the Dirofilaria genus is shown with its two subgenera: D. immitis and D. nochtiella (repens, tenuis and ursi). The first case of subcutaneous and pulmonary dirofilariasis caused in Italy by D. repens is then shown as well as a research on dog populations in which D. immitis is prevalent. The fact that D. immitis has not yet been isolated in humans, in Italy, is probably due to D. repens vectors being more anthropophile. Finally, the latest cases of dirofilariasis from D. repens reported in Italy are taken into consideration along with the one isolated by the Authors, complete with illustrations. The case presented has been diagnosed on the basis of the histological examination carried out on a soft nodule detected in the right pectoral region; furthermore, eosinophilia and an elevated value PRIST were present.

Adult↗
PubMedDate not supplied

Correlation between a psychometric test and biochemical indices of hepatic encephalopathy in alcoholics.

BACKGROUND/AIMS: In alcohol abusers an alteration of responses to psychometric tests has been reported, even when clinical symptoms of hepatic encephalopathy (HE) are absent. Our research was intended to individualize a simple psychometric test, easy enough to be performed also at the patient's home, able to reveal an impending encephalopathy and, consequently, to facilitate earlier treatment. METHODOLOGY: Twenty-six consecutive male alcoholics were engaged and, after informed consent, the following schedule was applied: administration of a psychometric test, followed by a drawing of blood for the determination of many blood parameters. After 15 days of treatment to detoxicate patients, psychometric tests and blood examinations were repeated. RESULTS: The results confirmed that common blood examinations are not useful to monitor brain damage in chronic alcoholism, that a psychometric test is able to demonstrate a therapeutic improvement and that a positive and significant correlation has been observed between BBCA/AAA ratio and WAIS Score. CONCLUSIONS: These preliminary results suggest that it is possible to suspect dangerous biochemical changes by means of a simple psychometric test.

Adult↗
PubMedDate not supplied

Liver focal lesions and hepatocellular carcinoma in cirrhotic patients: from screening to diagnosis.

This short review aims at pointing out the role of ultrasonography (US) as a valuable means for an early detection of liver focal lesions in cirrhotic patients. Among these lesions which may be benign and malignant, hepatocellular carcinoma (HCC) finds its place with an incidence in cirrhotic patients becoming higher as the time passes from the onset of cirrhosis. US is of fundamental importance in the regular screening of subjects with viral cirrhosis because of its sensitivity in evaluating focal lesions (79-82%); however, it is not yet the most valuable method for the diagnosis of HCC for which other diagnostic techniques are needed such as CT (Computerized Tomography), MR (Magnetic Resonance) and the US-guided fine-needle biopsy. In fact, the echo-structure of HCC varies with its dimensions and may mimic that of one of many other liver focal lesions. Lately, some new sonographic techniques have become available that can allow a more accurate investigation of HCC. Among them, the "Tissue Harmonic" and the "Pulse Inversion Imaging" techniques provide a better definition of the grey-scale image thus improving the conspicuity of focal lesions. Color and Power Doppler techniques, while allowing an accurate observation of the lesion vascularization, integrate the sonographic appearance of HCC. The enhancement of the US color Doppler signal obtainable by using echographic contrast agents, represents a further progress for a detailed observation of the focal lesions' micro-vascularization and, thus, for the HCC identification. Further advancements in terms of improvement of the image quality and characterization of the focal lesion are to be expected from the use of "Tissue Harmonic" and "Pulse Inversion Imaging" techniques associated with echographic contrast agents. However, the diagnosis of HCC still rests on the incontrovertible histological evidence obtained by echo-guided fine-needle biopsy.

Carcinoma, Hepatocellular↗
PubMedDate not supplied

[Multiple cerebral tuberculomas resistant to conventional therapy in an immunocompromised subject].

A 33 years old immunocompromised woman was admitted for a fever of unknown origin during the last five months. She referred a body temperature up to 38.3 degrees C, headache, weakness. The physical examination revealed right homonymous hemianopia, hyperreflexia and Babinski on her right side. A TC scan and a following bioptic specimen showed multiple cerebral tuberculomas. A conventional therapy was started but no significative improvement was observed. She was finally treated with interferon gamma and GM-CSF in addition to the therapy with an important regression of the lesions and significative improvement of the fever and neurological findings.

Adult↗