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Biomedical subjects

G Balzano

Publications and source records attributed to G Balzano.

54 records · Page 3Linked to original sources
PubMed1994

Bone metabolism changes after transdermal estradiol dose reduction during estrogen replacement therapy: a 1-year prospective study.

Twenty-four surgically menopausal women were randomly allocated to one of two transdermally-administered estrogen replacement therapies (ERT): Group A was administered Estradiol (E2) TTS 0.05 mg/day for 6 months and 0.025 mg/day for the following six months and group B, E2 TTS 0.10 mg/day for the first 6 months and 0.05 mg/day for the following 6 months. For both groups, the treatment regimen was based upon the twice-weekly application of transdermal patches to the lower abdomen for three weeks a month. Serum E2, alkaline phosphatase (AP), osteocalcin (BGP) and urinary hydroxyproline (OHP) excretion levels were measured before the operation, at the beginning of ERT and after 6 and 12 months of treatment. Bone mineral density (BMD) in the distal regions of the forearms was measured by single photon absorptiometry at the start of the study and after 6 and 12 months. In Group A, both mean cortical and trabecular BMD had increased by, respectively, 1.53% and 2.17% after 6 months of therapy; after the second 6 months a significant decrease was observed in both parameters (2.40% and 3.62%, respectively). In Group B, mean cortical and trabecular BMD increased by 1.50% and 2.10%, respectively (significant increase in trabecular bone) after the first 6 months of treatment; after the following 6 months, these values persisted (+0.15 and -0.03%, respectively). Mean AP, OHP and BGP serum levels rose after the operation. In Group A, AP and OHP showed a significant decrease after the first 6 months (-34.90% and -30.90%), followed by an increase at the last evaluation of 22.50% and 35.50%, that reached statistical significance only for OHP.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Cutaneous↗
PubMed1994

Age-related risk factors for ischemic stroke in Italian men.

We evaluated the age-related stroke risk factors in 164 Italian male patients with a diagnosis of first-ever ischemic stroke. Based on the age, we divided the patients into two groups: 42 patients ranging in age from 40 to 55 years, and 122 patients ranging in age from 56 to 75 years. For each case, an age-matched control without a history or symptoms indicating vascular disease was randomly selected from hospital patients. Information were obtained on the various risk factors. Univariate analysis showed that for the younger patients high systolic blood pressure, diabetes mellitus, hypertriglyceridemia, smoking and family history of ischemic stroke were significantly related to stroke. In the older patients, high diastolic blood pressure and smoking had a strong association with stroke. Multivariate analysis showed that high systolic blood pressure, hypertriglyceridemia, smoking and family history of stroke remained significantly and independently associated with stroke in patients up to the age of 55 years. Among patients 56 years or older, only high systolic and diastolic blood pressure, and smoking were significant predictors of stroke. In conclusion, the sets of factors associated with the risk of stroke among young and old male patients appear to be different.

Adult↗
PubMed1994

[Personal experience in surgical resection of pancreatic carcinoma].

The period 1981-1993, 124 patients underwent resection for pancreatic cancer; they represented 30.8% of all patients observed in that period. Surgical procedures were a pancreatoduodenectomy (PD) in 100 cases, a total pancreatectomy (TP) in 3 cases and a distal pancreatectomy in 21 cases. PD was performed by the injection of Neoprene into the residual pancreatic stump, rather than of pancreatojejunal anastomosis; in 37 cases a pylorus-preserving PD was performed. Adjuvant treatments were given in addition to resection in 75 patients: 47 underwent intraoperative radiation therapy, following a PD in 41 cases, a TP in 1 case and a distal pancreatectomy in 5 cases. Overall operative mortality was 2.4%, overall morbidity 26.6%. In the 103 patients undergoing PD or TP mortality was 2.9% and morbidity 29.1%. Postoperative diabetes occurred in 12.8% of patients undergoing PD with Neoprene injection. Overall median survival was 16 months. Survival was significantly related to UICC staging distribution, to the radical nature of the operation or to adjuvant treatments. No relationship was found between survival and the type of resection (PD versus distal pancreatectomy) or the pylorus preservation. Pancreatic resection, whenever technically possible, represents the treatment of choice of localised pancreatic cancer, in association with adjuvant treatments.

Adult↗
PubMed1992

Effect of azelastine on the seasonal increase in non-specific bronchial responsiveness to methacholine in pollen allergic patients. A randomized, double-blind placebo-controlled, crossover study.

Azelastine, a phthalazinone derivative, is a new potent, long acting, orally active anti-allergic compound with particularly strong H1-histamine receptor antagonistic effects which has been proven to possess in vitro and in vivo a number of anti-inflammatory properties. The aim of the present study was to investigate whether azelastine would be able to prevent and/or reverse the seasonal increase in non-specific bronchial responsiveness to methacholine in pollen allergic patients. Twelve atopic patients (5 males, mean age 31 years), skin positive exclusively to grass and/or Parietaria pollen extract, with rhinitis and mild asthma occurring in the spring for at least two years previously, were studied. After a 2 week run-in period, oral azelastine, 4 mg twice daily, or placebo, was given for 2 weeks from the start of the pollen season, according to a randomized, double-blind design. After 2 weeks, the treatments were crossed over. During both the run-in and study periods, patients recorded rhinitis and asthma symptoms, additional antihistamine and bronchodilator drugs taken and peak expiratory flow measurements. A methacholine inhalation test was carried out on four occasions in each patient: before the run-in period, before the start of the treatment, and at the end of the two 2 week treatment periods. Azelastine significantly reduced rhinitis symptoms and the need for antihistamine drugs, whereas asthmatic symptoms, use of bronchodilator drugs, peak flow recordings and bronchial responsiveness to methacholine were unaffected by the treatment. Compliance level and adverse side-effects were not significantly different between active treatment and placebo. In the final subjective evaluation of the two treatments, eight out of 12 patients preferred azelastine.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Oral↗
PubMed1989

Intrasubject between-day variability of PD20 methacholine assessed by the dosimeter inhalation test.

The intrasubject between-day variability of the methacholine inhalation test (MIT) was estimated in a group of 30 patients (15 males, mean age 29 yr), representative of a wide range of degrees of nonspecific bronchial responsiveness (from normal to severely increased). In each patient, an MIT with the dosimeter method was carried out on three separate occasions within one week, keeping as constant as possible both the technical and patient-related factors (FEV1 within +/- 5 percent, no recent airway inflammation) and independently from operator-related factors (three tests, three different operators blinded with regard to previous MIT results). On each occasion, twofold increasing doses of methacholine were given from 6.25 to 3,200 micrograms as cumulative doses, at five-minute intervals by means of a dosimeter Me.far MB3 (nebulization time 0.8 +/- 0.2s, output 5 +/- 0.2 microliters/puff). The FEV1 was measured initially and 1.5 and 3 minutes after each inhalation. The test was continued until either a fall of 20 percent or more in FEV1 was obtained or the last dose was reached. The results were expressed in terms of PD20, ie, the dose of methacholine producing a 20 percent fall in FEV1. Under these carefully controlled conditions, the 95 percent confidence intervals (as based on a single determination) corresponded to +/- 0.22 on a log10 scale or, in a more meaningful way, +/- 1.66 fold-difference in PD20 from one visit to the other.

Adolescent↗
PubMed1989

Treatment of reversible chronic airways obstruction with doxofylline compared with slow-release theophylline: a double-blind, randomized, multicentre trial.

A multicentre, double-blind, randomized trial was carried out in 11 Italian Pneumologic Clinics to investigate the therapeutic efficacy and tolerability of doxofylline compared with slow-release theophylline in 139 patients (86 males, 53 females) aged 17-77 years suffering from reversible chronic airways obstruction. The two groups of 69 patients on doxofylline and 70 patients on theophylline did not differ in their baseline clinical and functional parameters. After one week of wash-out, the two drugs were administered orally at a dose of 400 mg twice daily of doxofylline and 300 mg twice daily of theophylline. The treatment and follow-up lasted 28 days. Inhaled salbutamol on demand was allowed in the wash-out week and throughout the trial. The average serum levels at day 14 and 28 were: doxofylline 7.5 and 8.5 micrograms/ml; theophylline 10.4 and 7.95 micrograms/ml respectively. Both drugs significantly increased spirometric parameters (p less than 0.001 for all tests) and significantly reduced salbutamol consumption (p less than 0.001 for both drugs). Doxofylline was better tolerated than theophylline considering either the number of unwanted side-effects: (doxofylline 12; theophylline 37) or number of drop-outs due to side-effects (doxofylline 5; theophylline 10). From these results doxofylline seemed to be a good alternative to theophylline in the treatment of reversible chronic airway obstruction in view of its better safety profile.

Adolescent↗
PubMed1986

Evaluation of non-specific bronchial hyperreactivity in different respiratory diseases.

Bronchial hyperreactivity (BHR) has been observed in respiratory disorders other than asthma but asthmatics usually show BHR to differing degrees. The presence and degree of BHR in asthma was evaluated and compared with that in other respiratory disorders. High BHR was observed in asthma (84%, with no difference between atopics and non-atopics), recurrent or persistent cough (36%), laryngeal spasm (50%), Kartagener's syndrome (66%) and cystic fibrosis. BHR was low in patients with allergic rhinitis but no asthma and was absent in patients with unexplained dyspnoea (100%) and in healthy controls (91%).

Adolescent↗
PubMed1983

Evaluation of protective effect of fenoterol in allergen-induced bronchospasm.

The purpose of this study was to determine the intensity and duration of the protective effect of fenoterol (200 micrograms) in allergen-induced bronchospasm and to compare its effect with that of DSCG (20 mg). Twelve atopic-asthmatic patients, with ages ranging from 10 to 41 years, participated in the study. At the time of the study their symptoms were well controlled without the use of anti-asthmatic drugs and their FEV1 was greater than 80% of predicted and did not vary by more than 10% on each study day. The study was a double-blind cross over trial. Each drug was given separately at 1 week intervals according to an appropriate random plan. During the treatment the patients were given two puffs of metered dose aerosol and a capsule of inhalation powder. Each patient was given aerosol with test drug and placebo aerosol alternately, according to the double-blind method. The allergen was given 90 min after the administration of the drugs, and parameters of the respiratory function were controlled over a period of 6 h. Subsequently, the protective effect of 200 micrograms fenoterol administered 4 h before the allergen was studied openly, and showed that fenoterol possesses a protective effect in allergen-induced bronchospasm. This effect, although slightly reduced, persists even when the allergen is administered 4 h later.

Adolescent↗
PubMedDate not supplied

Nocturnal mechanical ventilation improves exercise capacity in kyphoscoliotic patients with respiratory impairment.

BACKGROUND: Patients with severe kyphoscoliosis, with or without stable respiratory failure, frequently experience oxyhaemoglobin desaturation during sleep, exercise, or both. Nasal Intermittent Positive Pressure Ventilation (NIPPV) applied during sleep has been demonstrated to be able to control nocturnal desaturations and also improve diurnal respiratory failure, if this is present, in this group of patients. The aim of this study was to evaluate the effect of a seven-day treatment with nocturnal NIPPV on exercise tolerance in a group of 6 patients with severe kyphoscoliosis and significant nocturnal and exercise-induced oxyhaemoglobin desaturation. METHODS: NIPPV was applied each night for a week by means of a volume cycled pressure ventilator set in assisted/controlled mode. In each patient lung function, daytime arterial blood gas analysis, overnight non invasive recording of arterial saturation, and 6-minutes walking test were carried out initially and at the end of the NIPPV course. RESULTS: During nocturnal NIPPV, as compared to baseline, the percent of night time spent below 90% of oxyhaemoglobin saturation significantly fell from 20 +/- 12.8 to 2.3 +/- 1.9 (Student t-test: p = 0.017). The 6-minute walking distance significantly increased from 244.7 +/- 132.2 to 340 +/- 122.3 m (p = 0.0097). Spirometry, daytime arterial blood gas analysis, and exercise-induced oxyhaemoglobin desaturation were unaffected by treatment. CONCLUSION: A one-week course of treatment with nocturnal NIPPV improves exercise capacity in patients with severe kyphoscoliosis.

Adult↗
PubMedDate not supplied

Pancreatic carcinoma: MR assessment of tumor invasion of the peripancreatic vessels.

OBJECTIVE: Our goal was to determine the value of MRI in the assessment of vascular invasion in the preoperative staging of pancreatic carcinoma. MATERIALS AND METHODS: In 53 consecutive patients with an established diagnosis of pancreatic ductal adenocarcinoma, SE T1-weighted and breath-hold gradient echo images at 0.5 T were obtained before and after bolus injection of Gd-DTPA. Major peripancreatic vessels were evaluated for the presence of (a) no tumor invasion, (b) contiguity with tumor, and (c) tumor encasement. All patients subsequently underwent surgery. Results of unenhanced and contrast-enhanced MRI studies were compared with the histologic findings in the resected specimens in 34 cases and with the surgical findings in 19 nonresected cases. RESULTS: In six patients, pathologic examination showed the presence of tumor confined to the pancreas with no vascular invasion. With MRI, five of these cases were correctly evaluated; in the remaining case, tumor-vessel contiguity was erroneously diagnosed. In 21 patients, tumor contiguity with adjacent vessels was found at pathologic examination. At MRI, 16 of these cases were correctly assessed, and 5 were understaged as tumors confined to the pancreas. Of the remaining 26 patients, 7 had vascular encasement by tumor at pathologic examination of the resected specimen; the other 19 patients had unresectable tumors encasing the adjacent vessels at surgical evaluation. MRI detected vascular encasement in 21 of these 26 cases; in the other 5, tumor contiguity was incorrectly diagnosed. The overall accuracy of MRI for determining vascular invasion was 79%. CONCLUSION: MRI is a helpful method for preoperative assessment of vascular involvement due to pancreatic carcinoma.

Adenocarcinoma↗
PubMedDate not supplied

Prevention of postoperative deep vein thrombosis in cancer patients. A randomized trial with low molecular weight heparin (CY 216).

Sixty-one consecutive patients were enrolled in a randomized, controlled trial of thromboprophylaxis with a low molecular weight heparin (Seleparina, CY 216) in major abdominal oncological surgery. Thirty patients received 2 x 3,825 anti-Xa international units of CY 216 subcutaneously on the day of surgery followed by a single daily 3,825 anti-Xa international units injection for 7 days; thirty-one patients did not receive any form of prophylaxis. The occurrence of deep vein thrombosis (DVT) was detected by 125I-labelled fibrinogen leg scan. Postoperative DVT developed in 2 patients in the CY 216 group and in 11 patients in the control group (6.8% vs 35.4%, p < 0.01). Although there was a higher postoperative transfusional requirement in the group receiving CY216 (p < 0.05), the total number of patients transfused was similar in the two groups (14 vs 13). On day 1 after surgery, the two patients who later developed DVT in the CY216 group had plasma anti-Xa activity significantly lower (p < 0.01) than the remaining patients. As a good relationship was found between plasma anti-Xa activity and body weight, adoption of a personalized dosage schedule might improve efficacy of CY 216 prophylaxis.

Abdomen↗
PubMedDate not supplied

[Diagnostic-therapeutic protocol in orthodontic surgery].

The authors describe the diagnostic-therapeutic protocol of orthodontical-surgical treatments of Angle-class I, II and III used by the Oral and Maxillo-Facial Surgery Department of Second University of Naples. They also present a personal survey.

Adult↗
PubMedDate not supplied

[Dento-skeletal recurrence in cases of surgical treatment of dysmorphism].

The purpose of the present study is to investigate the factors contributing to skeletal relapse after surgical correction of mandibular prognathism. Postoperative follow-up after mandibular setback is carried out to clarify the timing and causes of the relapse. The subjects are mandibular prognathism patients. The etiology of relapse is discussed.

Adult↗
PubMedDate not supplied

[Treatment of the pancreatic stump after cephalic pancreatoduodenectomy].

Pancreatico-jejunal anastomosis still represents the main source of postoperative complications after pancreatoduodenectomy. In this study our experience on the occlusion of the residual pancreatic stump instead of pancreatico-jejunal anastomosis is reviewed. Between March 1981 and December 1995 we performed 223 pancreatoduodenectomies using Neoprene injection into the Wirsung duct for pancreatic carcinoma of the head (123 cases), ampullary carcinoma (36 cases), distal bile duct cancer (23 cases), islet cells carcinoma (17 cases), chronic pancreatitis (11 cases), duodenal carcinoma (5 cases), miscellaneous diseases (8 cases). Neoprene is a fluid, synthetic glue which polymerized and hardens when in contact with the pancreatic juice, inducing a fibrosis tissue which spares the endocrine component. We observed a 4.9% operative mortality (11 patients): 5 abdominal sepsis, 1 DIC, 1 aortoiliac thrombosis, 1 pulmonary embolism, 1 stroke, 1 hepatic failure, 1 cardiac failure. Overall morbidity was 44.8% (100 patients): in 25 cases (11.2%) a major complication requiring reintervention occurred. In 38 patients (17%) pancreatic fistula was detected: median duration was 43 days, with a mean output of 5.3 ml/day; in all cases a spontaneous solution of the fistula was observed. In conclusion, intraductal injection of Neoprene after pancreatoduodenectomy is a safe procedure, it represents an useful alternative to pancreatico-jejunal anastomosis.

Adult↗
PubMedDate not supplied

[Intraoperative radiotherapy as adjuvant treatment for resection of carcinoma of the pancreas].

Local recurrence is the most frequent site of failure after resection for pancreatic cancer. We reported our experience in term of tolerance, local control and survival obtained by the association of resection and intraoperative radiation therapy (IORT). Between January 1985 and July 1996 152 resection for pancreatic cancer were performed at the authors' institution. For 77 patients, IORT was added to resection (group 1), whereas the other 75 patients underwent resection alone (group 2), because of either the unavailability of the linear accelerator or the patient's refusal. In group 1, radiation doses from 12.5 to 20 Gy, with electron beam energies between 6 and 12 MeV, were delivered. Extension of the disease, percentage of radical resection and postoperative chemotherapy were similar in the two groups of patients. Operative mortality and overall early postoperative complications were respectively 1.3% and 31.2% in group 1 and 4% and 32% in group 2. The median survival was 17 months in group 1 and 15 months in group 2 and the median disease free survival was 12 months in group 1 and 8 months in group 2. A local recurrence was detected in 31% of patients in group 1 and in 49.3% of patients in group 2 (p < 0.1). The results suggest a better local control in patients with pancreatic cancer undergoing adjuvant IORT.

Carcinoma↗