Biomedical subjects
Publications and source records attributed to F Pentimone.
Chronic exposure to asbestos can induce malignant peritoneal mesothelioma (PMM) without pulmonary or pleural involvement (PIMM). The localization to the peritoneum depends on the different susceptibility of the two mesotheliums and, perhaps, on the length of asbestos fibers which can facilitate their direct translocation.
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Aim of this study was to evaluate the aging of aorta with respect to atherosclerotic modifications: abdominal aorta echotomography is the preferred approach for this study. In 354 elderly patients, 65 and over, we have evaluated the diameter and the course of the aorta, the presence of atherosclerotic plaques in the aorta and iliac vessels, and the presence of aneurysms. Two kinds of findings could be identified by echotomography: age-related physiologic modifications, represented essentially by an increase of the aortic diameter; pathologic changes, characteristic for atherosclerosis, of which aneurysms are the most dangerous complications.
Aging is a multifactorial process still incompletely known. The role of oxidative damage to cell membranes, as an important phase of the process, is underlined by the recent literature. We emphasize the value of vitamin E as an antioxidant agent supplied by suitable diets in middle age and by cheap tablets in the aged.
OBJECTIVE: To evaluate the causes of non-pathologic traumatic fractures in the elderly and their consequences on quality of life. DESIGN: A prospective trial. FOLLOW-UP: 12 months for the inpatients and 3 months for the outpatients. SETTING: Basal assessment in orthopaedic hospital; follow-up in geriatric unit. PATIENTS: Both inpatients and outpatients, 65 years and over, both sexes, both living in a nursing home and in their own home, admitted to an orthopaedic hospital because of a fall, with diagnosis of a subsequent fracture. Criteria of exclusion: patients with pathologic fracture. 121 patients were enrolled, 108 had a complete follow-up. SURVEYS: Health and functional status prior to the fracture, causes and concomitant causes of the fall, site of the fracture, complications and functional disabilities. RESULTS: The most frequent cause of fracture is an accidental fall, especially in younger elderly, other causes being acute cardiovascular and neurological diseases. Fractures occur more frequently in females. The most serious injuries affect frailer subjects, with advanced age, neurologic and multiple chronic diseases. Fracture of femur is the most frequent fracture and it has the highest risk complications, functional disabilities and death. CONCLUSIONS: Because of the high frequency of accidental falls, the authors emphasize the necessity of primary prevention, especially the removal of architectural barriers both at home and in public environment.
Normal aging does not induce impotence, but only modifies the physiology of the erection which, however, allows good sexual intercourse. Impotence, found in 55.0% of the over 75 men, is due to organic or psychogenic causes: above all, penile arterial insufficiency and the collateral effects of drugs for the diseases which often affect the elderly, are the main factors.
OBJECTIVE: To compare efficacy and tolerance of recombinant interferon alfa-2b in the treatment of anti-HCV-positive chronic active hepatitis (CAH) in subjects aged 65 years and above with those less than 65. DESIGN: A randomized controlled trial. SETTING: Outpatients in two hospitals. PATIENTS: 65 consecutive outpatients with anti-HCV-positive CAH for 1 to 30 years, having basal aminotransferase levels at least twice the normal value. Those 65 and over were randomized to an interferon group (A, n = 22) or a no-treatment group (B, n = 22). All those under 65 received interferon (group C, n = 21). INTERVENTION: Interferon at a dose of 3 mU 3 times a week for a 6-month period. A normalization of serum aminotransferase levels was considered a positive response to therapy. RESULTS: Response to therapy was positive in 62% of the treated elderly compared to 57% of the adults (P = 0.85). The two groups of responders showed a common highly significant reduction of aminotransferase (P < 0.001). Side effects were similar in elderly and young. Two untreated elderly showed spontaneous normalization of aminotransferase. CONCLUSION: Interferon in anti-HCV-positive CAH is useful in the elderly, allowing normalization of aminotransferase, improvement of the histology and remission of the disease in 62% of the cases. Side effects seem to be independent of age. Further studies are required to assess both duration of remission and usefulness of cyclic therapy in previous responders.
This is the case report of a forty-seven-year-old man with an ostium secundum atrial septal defect and a very high grade of pulmonary hypertension, associated with a large bilateral perinephric fluid accumulation. The fluid accumulation was remarkably reduced after eleven phlebotomies over a twelve-month period. A pathogenetic relation with the Eisenmenger's syndrome is discussed. No previous report of this association has been found in a survey of the literature.
The authors describe a case of Takayasu's arteritis in a twenty-five-year-old Italian woman, characterized by nonspecific symptoms (weakness, arthralgias, fever) and elevated erythrocyte sedimentation rate early onset of these symptoms at the age of about twenty-three years early diagnosis, only eighteen months after the onset of symptomatology absence of progression of the disease under corticosteroid therapy with a follow-up of three years uneventful pregnancy ending in cesarean section and birth of a baby without maternal and neonatal complications.
Ten elderly patients with heart failure and frequent hospital readmission within 12 months before the study, were submitted to clinical radiologic, electrocardiographic and echocardiographic evaluation in order to find the causes of readmission. The most frequent factors were found to be non compliance with drug prescriptions and therapy inadequate for the etiology of the heart failure and the kind of cardiac dysfunction.
The Authors examine the relationship between diabetes mellitus, lipid metabolism and atherosclerosis with particular emphasis on the role of insulin and on the therapeutic consequences. The results of a study on the efficacy and tolerability of simvastatin in the treatment of hypercholesterolemia in non insulin-dependent diabetic patients are reported. Simvastatin administration induce a significant reduction and increase in total and HDL cholesterol levels respectively contributes to the decrease of triglycerides without interfering with the metabolic control of diabetic condition.
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A 44 year old woman with upper limb skeletal malformations and endocardial cushion defect is described. This congenital heart disease was rarely reported in association with Holt-Oram syndrome.
In recent years, epidemiological and clinical patterns in infective endocarditis are changed: mean age of patients, sex, underlying cardiac diseases, source of bacteremia, availability of better diagnostic methods--specially two-dimensional and doppler echocardiography--and surgical options. The Authors report a paradigmatic case of a young man without cardiac disease, who developed a destructive endocarditis complicated by refractory congestive heart failure; the cause was an organism of low pathogenicity, Streptococcus sanguis, that entered the bloodstream after gastroduodenoscopy.
High total serum cholesterol and low HDL levels are major risk factors for cardiovascular disease before the age of 65. Currently in older populations their role has not yet been defined. In the elderly a low-cholesterol diet is therefore preferable to pharmacological treatment, in view of the absence of collateral effects. In this study 40 elderly patients with hypercholesterolemia were divided at random into two groups. They were respectively fed their usual diet and a legume-supplemented normal caloric diet for 8 weeks. Total serum cholesterol levels significantly decreased in the latter group from the 2nd week onward.
In dystrophia myotonica clinical evidence of cardiac involvement usually appears several years after the onset of neuromuscular symptoms. In more than 90% of cases there is damage to the specialized cardiac tissues and in about 7% of cases there are alterations to the myocardium. We report a case characterized by early and spread deterioration of the pump function developing into refractory congestive heart failure. The contemporary involvement of the smooth muscle of gallbladder and colon confirms the hypothesis that dystrophia myotonica is a pan-muscle disease.
Approximately one year after the onset of chronic myeloid leukemia, a 66-year-old patient had multiple recurrent blast crises with the morphological, cytochemical, and immunological features of lymphoblasts. The lymphoblastic eruptions proved always highly sensitive to small doses of vincristine only (1.5 mg), which at variable intervals, of at first 3 months and later 20 days, brought about the immediate disappearance of blast cells from the peripheral circulation as well as from bone marrow blood. Some variable clinical aspects of the case during the crises are described; the crises recurred until the patient's sudden death due to cardiac causes.
In 40 subjects, 15 mean age 70.7 +/- 5.6 with systolic-diastolic hypertension, 15 mean age 75.5 +/- 6.8 years with systolic hypertension and 10 mean age 73.6 +/- 5.1 normotensive control group we have analyzed with M-mode 2D echocardiography and echophonocardiography the following parameters: diastolic--EDD--and systolic diameter--SD--of left ventricle, diastolic thickness of septum--SSD--and posterior wall--SPPD--of left ventricle, left ventricular ejection fraction--EF--(Theicholtr. formula), radius posterior wall thickness--R/SPPD--, left ventricular mass--LVM--(Devereux' formula), and systolic time intervals (Q-A2, LVET, PEP and PEP/LVET). The differences between groups are: systolic-diastolic hypertensive patients have increased EDD, SPPD and LVM, reduction of EF and increased PEP/LVET ratio in comparison with B and C groups; systolic hypertension doesn't increase EDD; SSD and PEP/LVET increase, while the EF remains within normal limits. In the healthy aged subjects SSD, SPPD and LVM are normal.