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F Negro

Publications and source records attributed to F Negro.

159 records · Page 9Linked to original sources
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In situ hybridization: perspectives of its clinical application in hepatitis B and delta virus infections.

In situ hybridization is a sensitive and specific technique for detecting nucleic acids in cytological and histological specimens. Visualization of the target sequences by autoradiography or (immuno)histochemistry allows their precise subcellular localization and quantitation. The application of in situ hybridization techniques has contributed to the understanding of the complex replicative cycle of hepatitis B virus. More recently, hepatitis delta virus replication has also been studied by this technique. Although in situ hybridization is a powerful tool for the molecular biologist, its clinical significance in diagnosis and prognosis of human hepatitis virus infections has yet to be fully evaluated.

Hepatitis B↗
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Are there any subgenomic forms of hepatitis C virus RNA in the liver?

BACKGROUND: Hepatitis C virus has a single stranded positive RNA genoma. Although believed to replicate via semi-conservative transcription of a negative-stranded, genomic-length RNA intermediate, detailed steps of its replicative cycle are unknown. AIMS: To quantify some of intrahepatic hepatitis C virus RNA forms, as inferred from comparison with replication of other members of the Flaviviridae family. PATIENTS AND METHODS: Genomic and negative-stranded hepatitis C virus RNA were semi-quantitated by strand-specific reverse transcriptase-polymerase chain reaction at both their 5' and 3' ends in liver of 10 patients with recurrent hepatitis C after liver transplantation. RESULTS: Our data are consistent with the existence of hitherto unrecognized, very large amounts (up to approximately 10,000 fold the amount of the replication intermediate proper) of subgenomic hepatitis C virus RNAs of genomic polarity, starting in the 5' untranslated region, of unknown length. Similarly, subgenomic RNAs of negative polarity, starting in the 3' untranslated region, may also be produced, albeit to a less extent. We found no correlation between the amount of these forms and any clinical, histological or virological feature. However, the number of subgenomic RNA molecules of negative polarity tended to be inversely correlated with viraemia (r = 0.7, p = 0.058), suggesting their possible role in controlling rate of virion production. CONCLUSIONS: Hepatitis C virus replication results in transcription of huge amounts of subgenomic RNAs both of genomic and negative polarity, which may either regulate translation of excess structural antigens of hepatitis C virus, or play the role of defective RNAs interfering with viral replication. A revised model of hepatitis C virus RNA replication is proposed.

Biopsy↗
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Preoperative parenteral nutrition in the high risk surgical patient.

In order to assess the significance of malnutrition in determining surgical complications and the possibility of their reduction by preoperative nutritional support (PNS), a randomized controlled trial is being performed at our institution. The results relative to 100 patients who underwent major surgery for gastrointestinal disease, are presented here. In the treatment group 49 patients received 30 kcal/kg/day and 200 mg/kg/day of nitrogen for at least 7 days in the immediate preoperative period (nine patients were excluded from this group due to early surgery--seven cases; or refusal to accept PNS--two cases. Data analysis with their inclusion or exclusion showed similar results.) Fifty-one patients constituted the control group. The observed septic complication rate was, respectively, 30 and 35.3% (p:NS). When the analysis was restricted to the patients with abnormal instant nutritional assessment (INA), as defined by Seltzer et al (serum albumin less than 3.5 g/dl and/or total lymphocyte count less than 1500 cells/mm3), a statistically significant difference was observed in the incidence of sepsis between the two subgroups (21% vs 53.3%, p less than 0.05). Analogous results were obtained from the patients who underwent gastrectomy for gastric cancer: 16.7% of septic complications in the malnourished treated patients and 100% in the malnourished control ones (p less than 0.05). The occurrence of serious sepsis (sepsis score greater than or equal to 10, according to the scoring system developed by Elebute and Stoner) in the malnourished subgroups was 5.2% and 26.7%, respectively, (p = 0.09). The postoperative mortality rate was not significantly changed by the PNS (reduction from 3.9% to 2.5%, p:NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Clinical Trials as Topic↗
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Relationship between neonatal birthweight variation in respect to 50 degrees percentile and maternal education level in a high selected and homogeneous population.

BACKGROUND: To evaluate the influence of maternal education on exceeding and missing weight of newborns in respect to 50th percentile. METHODS DESIGN: observational study. Length: five years. SETTING: obstetric and Gynecology Division Care. Neonatology Division Care. SUBJECTS AND MEASUREMENTS: 66 male and 57 female newborns having birth weight of around the 50th percentile; missing or exceeding weight was evaluated in respect of the 50th percentile of the relative week of birth. Parents were selected on the basis of the following criteria: mother: age 30-35, BMI before pregnancy 20-25, no habit for smoking or alcohol, first pregnancy, urban living area, no hypertension, normal glucose tolerance, normal thyroid function, regular pregnancy course, Caucasian race, Italian nationality, regularly married; father: BMI 20-25, no habit for smoking or alcohol, urban living area, steady job, just higher, equal or lower education level than wife's. Mothers underwent OGTT, measurement of thyroid function and recording of blood pressure and educational level. RESULTS: No relationship was observed between mother's education and exceeding weight both in male and in female newborns, while negative relationship was found between mother's education and missing weight both in male and in female in respect of the 50th percentile (Linear regression). CONCLUSIONS: Our data show that low maternal education exerts an influence in reducing but not increasing birth weight.

Adult↗
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Gastric cancer in the elderly.

Nowadays an increased number of elderly patients undergo surgery for gastric cancer. The old age by itself does not seem to represent a prohibitive risk factor anymore. Two groups of patients operated on of gastric cancer at our surgical unit (Group A = 378 patients younger or as old as 65 years and Group B = 330 patients older than 65 year) were compared. There were not statistically significant differences between the two groups in terms of number of performed radical exereses (57.7% vs. 42.3% respectively), kind of resective operation (total gastrectomy or subtotal gastrectomy) and extent of lymphadenectomy (D2-D3 type: 64.7% vs 63.8% respectively). The location of tumor, the distribution by stage and the long term survival of radically resected cases were not statistically different in the two groups of patients. Five-year survival after radical resection was 56.8% and 54.0% respectively. We conclude that elderly patients in good clinical conditions affected by gastric cancer should undergo radical resection with lymphadenectomy such extensive as D2-D3 type.

Age Factors↗
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Colorectal cancer: obstruction is an independent negative prognostic factor after radical resection.

The rate of colorectal tumors causing large bowel obstruction is still high (about 16%). In our experience, 93 out of 985 patients (9.4%) affected by colorectal cancer required surgery because of large bowel obstruction. The comparative analysis between 64 (68.8%) obstructed and 738 (82.7%) non-obstructed radically resected patients showed that sex and age of patients, tumor site, tumor diameter, parietal infiltration, grading, lymphnode involvement, distant metastases, and staging were not significantly different. Post-operative mortality rates (1.6% vs. 0.5%) and morbidity rates (15.6% vs. 15.6%) were not significantly different as well. On the contrary, survival rate was different. Patients submitted to radical resections had a far poorer prognosis as compared with non-obstructed radically resected ones: the five-year survival was 41.2% and 78.9% respectively. Radically resected obstructed patients showed an higher and earlier ráte of local and distant recurrence with a disease-related death rate of 47.6% vs. 16.3% as compared with non-obstructed ones. The occlusive phenomenon by itself resulted to represent an independent unfavorable factor negatively affecting long term prognosis after radical resections.

Adult↗
PubMedDate not supplied

[Typology of defunctioning colostomy and state of art in the treatment of bowel emergencies].

BACKGROUND: A trend toward avoidance of a defunctioning colostomy at emergency large-bowel surgery has been placed in recent years. The surgical management of patients with acute colonic disease has been evolving from multiple to single operations with a reduced use of colostomy. METHODS AND RESULTS: One hundred four consecutive non-selected patients underwent surgery for left-sided large bowel emergencies between 1980-2003. Defunctioning colostomy was performed in 10 out of 58 resection-anastomosis procedures. Thirty-seven patients underwent Hartmann procedure, 9 received only diverting colostomy. Postoperative morbidity was 28.8%. Postoperative mortality 8.2%. Anastomotic leak occurred in 1 and 6 patients with and without defunctioning colostomy respectively. Four out of the 6 patients without colostomy needed reintervention, while patient with covering colostomy underwent conservative treatment. Six (10.5%) out 56 patients with colostomy experienced major stoma related complications and underwent reintervention. DISCUSSION: Although there is general acceptance of one-stage surgery for right-sided colon emergencies, the surgical management of left-side large bowel obstruction and peritonitis remains controversal. Risk of anastomotic dehiscence associated with large-bowel anastomosis in unfavourable circumstance must be balanced against the high complications and low closure rates of a temporary colostomy. CONCLUSION: Primary resection and anastomosis without diverting colostomy for left-sided acute obstruction and peritonitis may be performed in selected patients. Diffuse purulent and faecal peritonitis are contraindications to one-stage surgery being necessary a two- stage procedure with loop or end colostomy. Colostomy remain a valid surgical option when high risk of dehiscence is suspected.

Colectomy↗
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[Blood coagulation parameters in insulin-dependent diabetic children at onset of the disease and after 3 months].

Levels of factors II, V, VII, VIII C, VIII R:Ag, VIII vW, IX, X, PT, PTT, TT, TR, antithrombin III and fibrinogen were evaluated in 11 children with insulin-dependent diabetes mellitus (IDDM) at onset of disease and after 3 months and in 15 healthy age-matched controls. At onset of IDDM a significant increase was observed only in mean values of factor VIII C, VIII R:Ag and in VIII vW. After 3 months the levels of factor VIII C returned within the normal range whilst no variations of factor VIII R:Ag and vW were found. These data show that coagulation abnormalities are already present at onset of IDDM and that endothelial damage evidenced by high values of factor VIII R:Ag and vW may persist even in a phase of good metabolic control. Levels of factor VIII C seem to be related to the increased protein glycosylation of IDDM.

Blood Coagulation Factors↗
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[Amoxicillin and clavulanic acid suspension for children in the treatment of bronchopulmonary infections].

The present study has been tested on 30 children, 14 males and 16 females, average age 4.11 +/- 0.44 (range 9 months to 10 years), weight of 17.08 +/- 1.25 Kg, with infections concerning low respiratory tract (8 cases of broncho-pneumonia, 9 cases of acute bronchitis and 13 cases of lobar pneumonia). It has been used a chemotherapy composed of amoxycillin and clavulanic acid in pediatric suspension of 312.5 mg/5 ml (in the ratio of 4 to 1); the daily dosage, related to the children's weight has been of 43.91 +/- 1.21 mg/Kg in two daily doses. On the average the therapy has lasted for 6.43 +/- 0.19 days from a minimum of 4 to a maximum of 8 days. During the treatment the symptomatologic parameters (dyspnoea, cough), and the objective ones (pathological lung signs, rales, hypophonesis, bronchial breath...) have progressively improved till they have disappeared; morning and evening body temperature has promptly returned to normal. Both the physical and radiological exams of the chest confirm either the improvement or the regression of the infection in most of the cases. Side effects due to the antibiotic have not been registered and local and general tolerability was excellent. Considering the more or less fast and complete symptomatological regression, the evolution of the infective clinical picture and the tolerability, the final evaluations have been: excellent efficacy in 13 cases, good efficacy in 9 cases, fairly good in 5 cases and poor in 3 cases.

Amoxicillin↗
PubMedDate not supplied

[Technical aspects of neorectum: restorative proctocolectomy].

In the last decade, restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is considered as the procedure of choice in the surgical management of most patients with familial adenomatous polyposis and chronic ulcerative colitis. Beyond the attraction of this operation, which permit to completely remove disease-bearing mucosa, spare the anal sphincter, and avoid a permanent ileostomy, it remains a difficult procedure with not negligible complication rate. Correct operative technique is required: to the purpose, main technical aspects of IPAA are analysed.

Adenomatous Polyposis Coli↗
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Leiomyoma of the esophagus. (A case report).

Leiomyoma is the most common benign tumor of the esophagus. Its occurrence is fairly infrequent and in 50% of cases is asymptomatic. The case of esophageal leiomyoma (EL) which attracted our attention is of interest. The patient, a 44 years old women clinically assessed for cardiac rhythm disturbance with no compliant of dysphagia, had two locations of EL, demonstrated by x-ray, computed tomography and esophagoscopy. The treatment was performed in two phases, surgical and endoscopic, in relation to the non identification of the upper EL through the left thoracetomy. The various technical possibilities must all be evaluated in relation to every single case.

Adult↗