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Biomedical subjects

F Messina

Publications and source records attributed to F Messina.

At least 19 recordsLinked to original sources

Primary hyperparathyroidism related to a parathyroid adenoma: the dramatic clinical evolution of a misdiagnosed patient and its surgical solution.

Primary hyperparathyroidism is a clinical condition related to an excessive and abnormally regulated secretion of parathyroid hormone (PTH) from the parathyroid glands which is responsible for an alteration of the calcium and phosphorus metabolism. Parathyroid adenomas are the most important cause of primary hyperparathyroidism (80-85%). A case of parathyroid adenoma observed in a patient aged 47, admitted to the Emergency Medicine Department of our Hospital with a diagnosis of hypertensive crisis, cephalea, vomiting, and a clinical history of recurrent episodes of severe abdominal and renal pain, is presented. Lab data showed severe hypercalcemia and a progressive worsening of the renal function. A severe neurological involvement with stupor, derangement of mind, the arising of acute respiratory depression, lethargy compelled the colleagues to transfer him to the Intensive Care Unit; a neck ultrasonography showed a poor-echogenous area under the right thyroid inferior pole, with signs of vascularization. The suspect of a primary hyperparathyroidism related to a single adenoma of the parathyroid gland suggested a surgical treatment. A ''concise parathyroidectomy'' was performed. Our surgical approach was confirmed by the comparison of the preintervention and the post-intervention iPTH values: 2080 pg/mL (normal range: 12-65 pg/mL) before excision vs 101 pg/mL after the removal. The histologycal exam reported a parathyroid adenoma with large areas with haemorrage. Three days after surgery the patient was in good general conditions. Patients affected by primary hyperparathyroidism are often misdiagnosed because their clinical conditions can create differential diagnosis problems with other diseases. However the surgical option remains the gold standard treatment.

Adenoma↗

Substituted tetraazaacenaphthylenes as potent CRF1 receptor antagonists for the treatment of depression and anxiety.

Two isomers of the hexahydro-tetraazaacenaphthylene templates (1 and 2) are presented as novel, potent, and selective corticotropin releasing factor-1 (CRF1) receptor antagonists. In this paper, we report the affinity and SAR of a series of compounds, as well as pharmacokinetic characterization of a chosen set. The anxiolitic activity of a selected example (2ba) in the rat pup vocalization model is also presented.

Acenaphthenes↗

Beliefs and attitudes towards the consumption of sugar-free products in a sample of Italian adolescents.

OBJECTIVE: The objective of this study was to investigate beliefs and attitudes towards sugar-free products in a sample of Italian teenagers. DESIGN: A total of 10 secondary public schools in the county of Rome were randomly selected. The probability of being extracted was set proportional to the number of students. A random sample of teenagers was selected from the schools for participating in a food consumption survey. SUBJECTS: The sample included 233 adolescents, aged 15-21 y. A total of 224 adolescents agreed to participate in the study aimed at assessing beliefs and attitudes. INTERVENTIONS: Two questionnaires were completed at the first day of the last period of the 4-day food survey. The first questionnaire contained questions on attitudes and beliefs toward a healthy diet. The second questionnaire, aimed at assessing adolescents' attitudes towards the consumption of sugar-free products, was based in part on the social-psychological model of the Theory of Planned Behaviour. RESULTS: In general, the adolescents of this sample seemed to be quite uncertain in their responses. On average, they did not express an emphatic point of view with regard to the act of eating sugar-free products. The results of the assessment of relationships between the variables of the theoretical model revealed the lack of causal links among beliefs, attitudes, intention and consumption of sugar-free products. Perceived behavioural control was not a significant predictor of intention. CONCLUSIONS: The target of further studies aimed at investigating attitudes towards sugar-free products should be tailored according to the quantity of consumption of such products in order to represent a sample of frequent and high consumers of sugar-free products. SPONSORSHIP: European Commission Quality of Life and Management of Living Resources Fifth framework Programme. QLRT-1999-00155.

Adolescent↗

Bartonella henselae and inflammatory bowel disease.

Sustained fever and increased thickness of the distal ileum on ultrasound suggested Crohn's disease in an adolescent boy. Bartonella henselae infection was diagnosed by specific serology and the patient recovered. Ileitis could be related to B. henselae infection.

Adolescent↗

Widening of the clinical spectrum of Bartonella henselae infection as recognized through serodiagnostics.

UNLABELLED: The recently improved diagnostics have widened, in children, the spectrum of clinical manifestations recognisable as Bartonella henselae infection. We report here the clinical features of 20 (14 males) consecutive children with serologically proved B. henselae infection observed within 12 months in the Paediatric Department of the University of Pisa. The patients had a mean age of 7 years 4 months (range 1.1-14.1 years). All children but one had a history of contact with kittens. Clinical manifestations included regional lymphadenopathy in 14 patients, representing in five the only clinical manifestation at onset, infectious mononucleosis-like syndrome in six, erythema nodosum in three, and Parinaud oculoglandular syndrome in one. In five patients a severe disorder was first suspected: fever of unknown origin in two with multiple hepatosplenic granulomatosis in one; osteolytic lesion suggesting bone neoplasm, marked inguinal lymph-node enlargement, suggesting Burkitt lymphoma, and an acute encephalopathy in one each. Bartonella henselae IgG antibody was positive in all patients with a titre ranging from 1:128 to 1:8590. IgM antibody was present in all except one child with an IgG titre of 1:2048. All patients recovered, some spontaneously. CONCLUSION: Bartonella henselae infection is frequent in Tuscany and probably underdiagnosed due to the high frequency of atypical onset of the clinical manifestations. An accurate clinical history and a reasonably wide use of the serological test may allow a rapid and accurate diagnosis, reassuring the family of the patient and avoiding invasive and expensive diagnostic procedures.

Adolescent↗

Pseudoinfectious mononucleosis: a presentation of Bartonella henselae infection.

Six children presented during one year with clinical features of infectious mononucleosis, but with laboratory findings of leucocytosis with neutrophilia, increased erythrocyte sedimentation rate, and hypergammaglobulinaemia. Serology for Epstein-Barr virus, cytomegalovirus, adenovirus, and Toxoplasma gondii was negative, while anti-Bartonella henselae IgM with high IgG titre (>/=1/1024) was present in all. All children had contact with kittens. No specific treatment was administered and all recovered.

Bartonella henselae↗

Albendazole treatment of human hydatid tissue.

The effect of albendazole was studied in 12 patients with cystic hydatid disease (CHD) of the liver. Six patients received albendazole continuously for 6 months, while 6 patients received albendazole for 6 courses of 4 weeks with a 2 week drug-free interval between cycles. The continuous therapy proved successful, with stable involution at the follow-up at 24 months, while the patients treated with discontinuous therapy showed improvement or relapse. In our experience, continuous therapy was more effective and can be considered to be a suitable alternative or percutaneous therapy in uncomplicated hydatid liver disease, as an initial treatment.

Adult↗

[Neurological disorder associated to EBV: three case reports].

Epstein-Barr virus (EBV) is associated with a wide range of clinical manifestations. Neurological involvement (NI) during Infectious Mononucleosis occur in 1-5% of the cases, the only NI is more rare. From January 1995 to December 1996 three patients with NI and EBV infection have been observed in our department. The diagnosis were: meningoradiculitis (1 case), meningoencephalitis (1 case), aseptic meningitis (1 case). The diagnosis was based on the results of the lumbar puncture and on the serology: IgM VCA positive at the onset of the symptoms and a significant increase of the IgG VCA after three weeks. No other etiology was apparent. All the patients have been treated with dexamethasone, glycerol and acyclovir obtaining a complete remission of the disease. In these cases the NI has been the only clinical manifestation of the EBV infection. Therefore the authors believe that it is important recognize that EBV can cause a myriad of neurological illness with or without the stigmata of infectious mononucleosis and recommend the need to suspect this infection in any acute neurologic disorder.

English Abstract↗

S.C.S. effectiveness in patients affected by peripheral chronic arterial disease: our 5 years experience.

Spinal cord stimulation (S.C.S.) showed a valid clinical effect in the treatment of chronic obliterative arteriopathy of the lower limbs at an advanced stage (III-IV stages) and of phantom limb pain syndrome (P.L.P.S.). Secretion patterns of various biochemical mediators were evaluated and mechanism, by which analgesic and vasodilatator actions occur, were thus accounted for. There is not agreement on this subject. We report our experience on 60 patients (age range 28-91), observed over the period 1987-92. Blood values of some chemical mediators (beta-endorphins, Kinins, Serotonin, PGE) were determined before and after stabilization of the S.C.S. implant (from 2 up to 6 months) and compared with the objective clinical and TCpO2 data. Statistical significance was checked of variations obtained (Student's "t" test). High significant increase of TCpO2, beta-endorphins, PGE, (p < 0.01) and the Kinins (p < 0.05) was found but there were no significant alteration of Serotonin. Results are explained and an S.C.S. effect at the spinal cord metamer level with a cortical integration (pointed out by the increase of the beta-endorphins) is suggested. Analgesic effectiveness and vasodilatator action of S.C.S. implant is stressed as long as it is carried out only when a correct indication is established in the absence of contraindications or important risk.

Adult↗