Biomedical subjects
Publications and source records attributed to F Franco.
A case is presented that illustrates the unusual concurrence of both myasthenia gravis and recurrent retrobulbar optic neuritis. The association of optic neuritis with myasthenia gravis might support the idea that there is a disorder of immune function in optic neuritis.
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110 cases of conisation carried out in the Obstetric and Gynecological Clinic of the University of Padua between 1.1.74 and 31.12.82 have been considered. The operations were always performed on completion of diagnostic assertions comprising colpocytology, colposcopy and biopsy, this last undertaken upon indications from both colposcopic and colpo-cytological examinations. The comparison of the histological sample with the serial on the cone, with the cytological, colposcopical and bioptic ones, correspond in the importance of the lesion in almost 90% of cases. The reliability of the diagnosis by the three methods associated and then integrated by the conisation therefore approaches 100%. Prophylaxis carried out in this way allows a personalisation in the operation which, though respecting radicality, must be as non-demolitary as possible.
The Authors evaluate the percentage of vaginal delivery after previous cesarean section, in a group of 57 patients. Results show that 34% of the patients delivered spontaneously, and when recurring causes are excluded the percentage rises to 39%. The Authors conclude that a careful monitoring of labour can prevent unnecessary cesarean section in patients who underwent previous surgical delivery.
The Authors report the preliminary results of a study performed on patients submitted to radical hysterectomy according to Wertheim-Meigs for cervical-carcinoma, in order to evidence possible changes of the intestinal functionality, by means of a manometric investigation of the anal sphyncteres and measurement of the intestinal transit times. The manometric survey showed that no essential parameter was uniformly altered whereas the transit time measurement proved in some cases the slowing-down of the intestinal progression at the level of the ascending and transverse colon, and a normal transit in the descending colon as well as in the rectum in all examined cases.
The Authors analyse the correlations between clinical staging (FIGO) and surgical staging in 152 patients affected by cervical cancer who underwent primary surgical therapy at the Gynecologic Institute of Padua University between 1974 and 1982. In the examined series clinical staging agrees with surgical staging in 2/3 of cases. The error percentage of clinical staging does not change significantly, from a statistical point of view, when staging varies. In those cases in which the two systems disagree the overstaging figure tends to decrease as staging becomes more severe while the clinical understaging figure tends to increase accordingly. On the basis of these results the Authors advocate a rational resort to operative staging in cervical cancer so as to evaluate the real topography of the original focus more accurately and plan the most adequate treatment.
Primary surgical treatment in cervical carcinoma offers an unrepeatable chance to assess the biologic characteristics of the neoplasia by surgical staging and pathologic examination of the surgical specimen. The detection of factors of risk for locoregional diffusion, clinical staging being equal, can guide a subsequent target radio-treatment by identifying a group of patients at higher risk for relapses. The analysis of 155 cases of cervical carcinoma treated with radical primary surgery and pelvic lymphadenectomy at the Gynecologic Institute of Padua University has stressed the statistically significant correlation (P less than 0.05) existing between lymphatic diffusion and presence of neoplastic cells in capillaro-like spaces, degree of neoplastic cervical infiltration and parametrial diffusion. According to the Authors the presence of these features is a reliable basis to select patients eligible for post-surgery radiotreatment.
Two human cases of subcutaneous dirofilariasis are described in a 41 year-old woman and in a 14 year-old boy living in Venice Lido. In the first case, the development of a nodule at the left forearm had been preceded by generalized symptoms such as pruriginous urticarioid patches in various regions of the body, transitory swellings and 8% eosinophilia. From the nodule, an adult female of Dirofilaria repens was recovered with embryos visible in the uterus. In the second case, the parasite was localized in the scrotum, where it had caused an extensive oedema with the formation of a nodule having the size of a nut. An immature female specimen of D. repens was found. In both cases, the serological tests (Indirect Haemoagglutination and Bentonite Flocculation) gave significant titres specific for filariasis (1:256 and 1:20 in the first case, 1:128 and 1:5 in the second, respectively). A parasitological survey of blood samples from 145 stray dogs captured in the territory of the Venice municipality revealed the presence of D. repens in 8.3% of cases, D. immitis in 4.8% and Dipetalonema reconditum in 0.7%. This is the first time that the aetiological agent of human subcutaneous dirofilariasis was identified as D. repens in Italy.
Acetic acid derivatives of tricyclic systems, such as 6,11-dihydro-11-oxodibenzo[b,e]thiepin, 4,10-dihydro-4-oxo-thieno[2,3-c][1]benzothiepin, dibenzo[b,f]thiepin, dibenz[b,f]oxepin, etc., were synthesized and assayed for antiinflammatory activity. One of the compounds, 6,11-dihydro-11-oxodibenzo[b,e]thiepin-3-acetic acid (52), was chosen for evaluation in man on the basis of high antiinflammatory activity in both short- and long-term animal assays and a low gastric irritation liability in rats and dogs.
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Thyroid nodules are commonly found in clinical practice, and their detection by either the physician or the patients always gives rise to concern as to the possible existence of a malignancy. Technological developments have had a major impact on the study and treatment of thyroid nodules. The application of fine-needle aspiration biopsies (FNAB) and the availability of high-resolution thyroid ultrasonography have modified thyroid nodule management even if important differences of opinion remain. This article describes the progress as well as contemporary controversies in thyroid nodule diagnosis and considers the effect these advances have had on the treatment of patients with nodular disease. It includes a brief description of the clinical importance of thyroid nodules, of the use and limitations of imaging studies in thyroid nodule diagnosis and of the usefulness, limitations, and impact of FNAB on nodule management.
This study presents the analysis of the prescriptions given 2,782 clinical encounters. These clinical encounters were directly observed and recorded by trained observers in 164 health centers of the Federal District and nine states of the Mexican Republic. It was found that 70.9 per cent of the patients received a drug prescription. Sixty per cent of the compounds prescribed did not belong to the basic list of drugs. An strong influence of advertising by medical agents was detected in the use of some poly-drugs. Some specific needs for training and continued education of the physicians in the first level of care.
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