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Biomedical subjects

E Orlando

Publications and source records attributed to E Orlando.

At least 19 recordsLinked to original sources
PubMed2003

[Adenoid cystic carcinoma of the anterior segment of the tongue].

The authors describe a rare case of adenoid-cystic carcinoma localized in the anterior tongue. The neoplasia is made up of epithelial and myo-epithelial cells, organized frequently in islands with cribriform aspect, was circumscribed by a thin fibrous capsule that was focally infiltrated in the proximity of the deep margin. At the physical examination no local regional lymph nodes were absent. The surgical excision and radiotherapy constituted the only therapeutic protocol. Absence of local relapse and/or distant metastasis after eight years from the operation confirm the low aggressiveness of the neoplasia when localized in the anterior part of the tongue.

Carcinoma, Adenoid Cystic↗
PubMed2003

[Desmoplastic ameloblastoma. Clinical and histopathological diagnostic criteria].

A rare case of desmoplastic ameloblastoma observed in a 62-year old man presenting a swelling in the anterior mandible area with abnormal mobility of 33, 34, 43, 45, is described. Diagnosis of desmoplastic ameloblastoma was based on: anterior localization, radiopaque appearance, severe desmoplastic stroma and increasing infiltrate pattern of the tumor. The authors suggest to consider the desmoplastic histotype as a different nosological entity defined "desmoplastic ameloblastoma" since these clinical and histopathological features are missing in the other histologic variants of common ameloblastoma. A radical surgical treatment is suggested for this neoplasia.

Ameloblastoma↗
PubMed2001

Sudden infant death caused by a ruptured coronary aneurysm during acute phase of atypical Kawasaki disease.

This article describe's a case of atypical Kawasaki disease (AKD) with lack of typical clinical signs and rapid fatal course in a 2-month-old infant, who 1 week before hospitalization demonstrated rhinitis, coughing without fever, and later conjunctival hyperemia and allergic exanthema on chest and arms. On admittance, labwork highlighted the following: leukocytosis, thrombocytosis, elevated sedimentation rate, and positive C-reactive protein. General conditions remained mediocre for 7 days until sudden death occurred. The autopsy confirmed death caused by cardiac tamponade caused by a ruptured inflammated aneurysm of the left anterior descending coronary artery. We believe that the currently accepted clinical diagnostics criteria for KD in infants 2 years of age or younger can cause missed in vita diagnosis of AKD. For such, any typical clinical sign of KD whenever associated with thrombocytosis and elevated indices of phlogosis, should led to suspicion of KD and permit cardiovascular examination, and thus early treatment.

Acute Disease↗
PubMed1998

Aspirin increases the bleeding side effects in essential thrombocythemia independent of the cyclooxygenase pathway: role of the lipoxygenase pathway.

Acetylsalicylic acid (ASA) is currently recommended as an antithrombotic for patients with essential thrombocythemia (ET) who are at an increased risk of thrombotic events. However, ASA is also associated with an increased risk of bleeding in these patients as compared to the risk of bleeding in other patients treated with ASA. Recent data suggest that while ASA inhibits platelet thromboxane A2 (TxA2) synthesis in all individuals, ASA has little effect or inhibits the lipoxygenase pathway (i.e., 12-hydroxyeicosatetranoic acid or 12-HETE synthesis) in some individuals, and enhances 12-HETE synthesis in others. These differential effects are associated with a pronounced prolongation of the bleeding time vs. no prolongation of the bleeding time, respectively, i.e., in ASA responders and ASA nonresponders, respectively. To determine if the increased risk of ASA-induced bleeding seen in ET patients is associated with an effect on 12-HETE synthesis, we compared the relative effects of ASA on the bleeding time, platelet TxA2 and 12-HETE synthesis, and platelet aggregation and adhesion in ET patients and healthy volunteers. ASA (300 mg, taken orally) prolonged the bleeding time in 82% of the ET patients but only 27% of the healthy volunteers although platelet TxA2 synthesis and ADP- and collagen-induced aggregation were inhibited significantly in both groups. In contrast, platelet 12-HETE synthesis was unchanged and platelet adhesion was decreased in those patients and volunteers whose bleeding times were prolonged by ASA, whereas platelet 12-HETE synthesis was increased significantly and platelet adhesion was unaffected in those patients and volunteers whose bleeding times were not prolonged, and in some cases shortened by ASA. These results confirm previous data that demonstrate that ASA has different effects on platelet 12-HETE synthesis and platelet adhesion in different individuals, i.e., inhibitory or no effect in ASA responders (in whom ASA prolonged bleeding) vs. enhancing effects in ASA nonresponders (in whom ASA did not prolong bleeding). These results also indicate that there is a greater percentage of ASA responders in patients with ET than that seen in the general population, a difference that is associated with an effect of ASA on the lipoxygenase pathway. This may explain the increased bleeding side effects seen in the ET patient population.

12-Hydroxy-5,8,10,14-eicosatetraenoic Acid↗
PubMed1995

Platelet adhesion to fibronectin in flow: the importance of von Willebrand factor and glycoprotein Ib.

We describe glycoprotein (GP) Ib as a mediator of adhesion to fibronectin, specifically in flow. A monoclonal antibody (MoAb) directed to the von Willebrand factor (vWF)-binding site on this receptor or the absence of this receptor on the platelet membrane, in the case of a patient with the Bernard-Soulier syndrome, reduced platelet coverage to fibronectin to approximately 30% of the control value. A MoAb directed to the GP Ib-binding site on vWF showed a similar effect. With washed platelets in the absence of plasma vWF, the inhibitory effect of the anti-GP Ib antibody was the same as with whole blood. No inhibition with the anti-GP Ib antibody was observed when we used blood from patients with severe von Willebrand disease (vWD) or from a patient with vWD type I (platelet low). Addition of vWF to vWD blood resulted in restoration of adhesion. Immunoelectron microscopy on platelets adhering to fibronectin showed that GP Ib was homogeneously distributed over the entire surface of the platelet. vWF was present at the central zone and the edges of the platelet and at the basal interface between the platelet and the fibronectin surface. No direct binding of vWF to fibronectin could be demonstrated. These data indicate that GP Ib-mediated adhesion to fibronectin fully depends on vWF and that normal levels of plasma or platelet vWF are sufficient for optimal adhesion to fibronectin. The data suggest that the presence of platelets during perfusion is a prerequisite for vWF to support platelet adhesion to fibronectin.

Antibodies, Monoclonal↗
PubMed1995

Giant cell tumor of the ovary. Immunohistochemical evidence of origin from stromal ovarian cells.

Giant cell tumor (GCT) of the ovary is a rare condition, found almost invariably in the context of a mucinous tumor and presenting a microscopic picture indistinguishable from GCT of bone. We describe a case of GCT in the wall of a serous cyst of the ovary. An immunohistochemical study was performed using a panel of antibodies to epithelial, mesenchymal and leukocyte antigens. Mononuclear and giant tumor cells were positive for vimentin; CD 68 and LCA were found only in giant cells whereas actin was only found in mononuclear tumor cells. The immunophenotypic profile of the stromal cells of the residual ovary was identical to that of mononuclear tumor cells. The presented data suggest that GCT of the ovary is probably a non-neoplastic lesion of the mesenchymal stromal cells that react against substances of the associated tumor or cyst.

Actins↗
PubMed1995

[Acute necrotizing capillaritis in an adolescent dying from a a Goodpasture-like pulmonary-renal syndrome].

In this report the authors describe a rare case of pulmonary/renal syndrome like-Goodpasture's disease characterized by a necrotizing acute capillaritis in the lung, kidney, liver, spleen and heart. In the heart the capillaritis was associated with a contiguous acute ischemic lesion. The clinical and pathologic findings of the case suggest that the presence of vasculitis should not exclude a diagnosis of Goodpasture's Syndrome and that the multisystemic capillaritis would demonstrate the organ-non-specificity of anti-glomerular/alveolar basement membrane antibody.

Acute Disease↗
PubMed1995

[Giant-cell temporal arteritis. Anatomo-clinical study of 2 cases].

The Authors describe two cases of giant cell arteritis in male and elderly patients 72 and 82 years old. In both cases the early symptoms and signs of disease (headache, fever, weight loss and sedimentation rate raised) were associated to classical histology of temporal arteritis (granulomatous inflammation with giant cells). In case 1 there was impaired vision, while in case 2 coexisted polymialgia rheumatica (pain and stiffness in the muscles of the neck, back and proximal portions of the limbs).

Aged↗
PubMed1994

Seasonal variation of trace metal concentrations in the digestive gland of the Mediterranean mussel Mytilus galloprovincialis: comparison between a polluted and a non-polluted site.

Seasonal changes in metal (Cu, Fe, Mn, Pb, and Zn) concentrations were observed in the digestive gland of the Mediterranean mussel, Mytilus galloprovincialis, from both a polluted and a non-polluted population. Digestive gland of mussels from the polluted site showed metal concentrations appreciably higher than in non-polluted organisms, especially for Pb (up to 160 micrograms/g d.w.), Mn (up to 300 micrograms/g d.w.), and Fe (up to 8,500 micrograms/g d.w.), whereas the two populations showed maximum mean values, respectively, of 34 and 20 micrograms/g d.w. for Cu and 170 and 120 micrograms/g d.w. for Zn. Over 1 year (1991), differences between maximum and minimum values were moderate only in the unpolluted organisms. During gametogenesis, while the metal concentrations (expressed as microgram/g dry weight) decreased in the digestive gland, the tissue burden (as microgram) in that organ remained nearly constant or increased slightly. The apparent decrease in metal concentrations was probably due to the penetration of gonadic tissues into the digestive gland during gametogenesis, which biologically diluted metal concentrations in mussels from both the polluted and unpolluted populations. The effect of mussel size on trace metal concentrations in the digestive gland was demonstrated during different stages of the reproductive cycle. Higher concentrations were found in smaller organisms; however, during the spawning period, due to the fact that this is not a synchronous process within a population, the organisms exhibit a high variability in digestive gland weight which can mask this relationship when digestive gland weight is used as a size-index and as a parameter of the trace metal digestive gland burden.

Animals↗
PubMed1994

Bioavailability of biologically detoxified lead: risks arising from consumption of polluted mussels.

The possible risk for human health arising from consumption of lead-polluted shellfish was suggested by experiments on the bioavailability for mice of a "biologically detoxified" form of the metal. In this work, young mice were fed with a mixed diet including mussels collected in a Pb-polluted area. Metal concentrations in blood, kidney, liver, urine, and feces and the activity of erythrocytic delta-aminolevulinic acid dehydratase were determined after 1, 2, and 4 weeks. Comparisons were made with mice treated with balanced diet, mixed diet including control mussels, and drinking water with lead dissolved as acetate. In mice fed polluted mussels, lead concentrations increased in blood, kidney, and liver, whereas no significant accumulation was observed in urine. Different responses in mice treated with Pb(CH3COO)2 in drinking water are probably due to the diversity of lead chemical form in the two treatments. Our results demonstrate the bioavailability of biologically detoxified lead that can be transferred to a consumer with possible consequences also for human health.

Animals↗
PubMed1994

[Treatment of traumatic injuries of the spleen. Retrospective analysis of 164 cases].

Increased awareness of the spleen's immunologic function and the risk of overwhelming post-splenectomy sepsis has aroused interest in methods of splenic preservation in patients with abdominal trauma. During an 8-year period, 164 patients with documented blunt splenic injuries were treated in accordance with an evolving therapeutic program. Definitive treatment included nonoperative management in 19 patients (group I, 11.6%), repair in 50 (group II, 30.5%) and splenectomy in 95 (group III, 57.9%). Mortality and morbidity were higher in group III (6.3% and 34.3% respectively) according to the Injury Severity Score (ISS 33.3 +/- 13). In group II one patient died from severe head injuries. Only one patient failed nonoperative management and required laparotomy with resultant splenectomy on hospital day 10. Observation without surgery has proved to be safe and effective in children (failure incidence less than 10%); success rates in adults would not parallel the experience reported in children because of differences in anatomy and mechanism of injury. Selective criteria, including hemodynamic stability after initial fluid challenge, normal level of consciousness, lack of peritoneal signs, transfusion requirements of less than 4 units of blood, CT demonstration of minor splenic lesion and exclusion of associated abdominal injuries requiring surgery, make eligible for nonoperative management 12 to 18% of adults with anticipated success in over 75%. Operative repair or partial splenectomy can be employed in many patients, both adults and children, with a 1% incidence of rebleeding necessitating reoperation.

Abdominal Injuries↗
PubMed1994

[Gastric carcinoma. Our experience].

This study analysed 66 cases of gastric cancer from 1985 to 1992. Twenty-seven patients (41%) has been treated with anti-H2 drug, either medical care or Jerkily "a la demande": 12 patients have been treated several years. Of the 66 patients: 52 (89%) were operated on while the other 16 received medical treatment because of the extension disease and their precarious condition. Long-term 35 (67%) patients (of the 52 operated) died four years later, independently of the stage and PKT of the first and the second level. The 27 patients treated with anti-H2 drug showed the most undifferentiated grading and 88% belong to the third and the fourth stage; moreover 81% underwent first diagnostic endoscopy notwithstanding a clinical and surgical history of gastric ulcer. Is it possible, therefore, that anti-H2 drug delay the diagnosis.

Adult↗
PubMed1994

[A double-blind study of neostigmine versus placebo in paralytic ileus as a result of surgical interventions].

A fully randomized double-blind study, stratified according to diagnosis, was carried out in order to assess the effect of endonasal neostigmine in the treatment of post-laparotic paralytic ileus. A total of 40 patients (16 M, 24 F), aged between 22 and 76 years old, were admitted to the study; of these 20 were cholecystectomized and 20 had undergone emergency surgery. According to a special randomization list, 10 patients from each pathological group were treated with 6% neostigmine en (1 puff = 5.4 mg) and the other ten were treated with placebo. Both treatments were administered at a dose of 2 puffs, one per nostril, at the end of surgery and then repeated every 4 hours up to a maximum of 6 puffs/day. Treatment was continued for 4 days or until canalization of feces and gas was achieved. The mean daily dose of endonasal neostigmine found to be efficacious was 4 puffs/day, equivalent to 24.7 mg in cholecystectomized patients and 23.5 mg in patients undergoing emergency surgery. In over-all terms the canalization of gas and feces was observed in 74% of patients treated with neostigmine and in 45% of those receiving placebo and the difference was statistically significant.

Administration, Intranasal↗
PubMed1994

[Lesions of the spleen caused by blunt trauma. Proposal of a classification based on CT and correlation with prognosis and treatment].

The use of CT scan has had a profound influence on the evaluation and treatment of closed abdominal injuries, enabling a progressive reduction to be achieved in the total number of emergency laparotomies. The authors review CT performed over the past two years in adult hemodynamically stable patients with traumatic splenic lesions. In 19 cases it was possible to commence non-surgical treatment which was successful in 18/19 cases. A simple and precise scoring system was elaborated on the basis of data obtained from CT by evaluating 4 parameters: extent of free intraperitoneal effusion, concomitant lesions to other abdominal organs, severity and site of splenic lesion. This classification gives a high degree of prognostic accuracy and provides a useful guideline in the choice of the most appropriate treatment.

Adult↗
PubMed1993

[Anomalous origin of the right coronary from the left sinus of Valsalva. A possible cause of juvenile sudden death].

Anomalous origin of the right coronary artery from the left sinus of Valsalva is a rare congenital anomaly classified as a "minor" anomaly of no clinical importance. Recently, manifestations of myocardial ischemia (angina pectoris, myocardial infarction, nonfatal ventricular fibrillation, sudden death) have been described in patients with this anomaly in the absence of atherosclerosis or other. Sudden death occurs frequently in symptomatic patients and rarely in asymptomatic patients (sudden unexpected death). In this study we report two cases of juvenile sudden death observed in asymptomatic patients with anomalous origin of the right coronary artery from the left sinus of Valsalva. In both cases the sudden death was exertion-related. In case 1 the coronary anomaly was the cause of death, since it was the only significant anatomic abnormality at necropsy; the microscopic findings revealed ischemic lesions only in the myocardium supplied by the anomalous right coronary artery. In case 2 the coronary anomaly was connected to other cardiac and non cardiac diseases (lymphocytic active myocarditis, chronic portitis, encephalitis, medullary adrenalitis). Since these morphologic lesions were extremely slight and there was no adrenal catecholamine damage in the myocardium, we consider negligible their possible role in determining death, which in this case was induced by the congenital coronary anomaly. The cardiac microscopic findings, also in this case, revealed ischemic lesions in the myocardium supplied by the anomalous right coronary artery.(ABSTRACT TRUNCATED AT 250 WORDS)

Abnormalities, Multiple↗
PubMed1992

Prolonged bleeding time in patients with lupus anticoagulant.

Platelet adhesion to collagen under flow conditions was studied in 18 patients with lupus anticoagulant, seven of which showed a prolonged bleeding time in the presence of a normal platelet count. The effect of patient plasma, IgG and purified anticardiolipin antibodies on platelet adhesion was also examined. We found a significant reduction of platelet adhesion in patients with lupus anticoagulant, which was more evident in patients with prolonged bleeding time. This platelet adhesion defect could be attributed to a plasma factor. In fact, patients' platelets regained normal adhesion when mixed with normal plasma, whereas controls' platelets showed abnormal adhesion in the presence of patient plasma. A causative role of antiphospholipid antibodies was demonstrated in experiments using purified immunoglobulins and anticardiolipin antibodies.

Adult↗
PubMed1992

Management of postoperative bile leakage with endoscopic sphincterotomy (EST) and a naso-biliary drain (NBD).

Between July 1987 and December 1990, 13 patients with postoperative bile leakage were treated with endoscopic sphincterotomy and a naso-biliary drain. All the leaks healed in two weeks, except for one (intrahepatic) that needed two months to heal in association with percutaneous management. The non-surgical treatment of bile leakage is the preferred approach on account of the superior safety, efficacy and cost-effectiveness as compared with surgical repair, which is associated with significant morbidity, mortality and costs. The treatment of choice has to be endoscopic, which is much easier and safer than the transhepatic approach, especially in the non-dilated duct, while another advantage over radiology includes the possibility for rapid definitive treatment of distal obstruction (e.g. residual stones). A leak from an extrahepatic duct heals rapidly, while a leak from an intrahepatic duct takes longer to heal and sometimes needs associated percutaneous drainage. Finally, the authors propose treating an extrahepatic bile leak merely with naso-biliary drainage without cutting the papilla, and an intrahepatic bile leak with endoscopic sphincterotomy, nasobiliary drainage and a bilio-duodenal endoprosthesis.

Bile Duct Diseases↗