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Biomedical subjects

G Belloni

Publications and source records attributed to G Belloni.

At least 37 records · Page 2Linked to original sources
PubMed1996

Hepatic glutathione deficiency in chronic hepatitis C: quantitative evaluation in patients who are HIV positive and HIV negative and correlations with plasmatic and lymphocytic concentrations and with the activity of the liver disease.

OBJECTIVES: Reduced glutathione (GSH) is decreased in patients affected by chronic hepatitis C (CHC) as well as in patients who are HIV positive. Because the liver is the most important source of plasmatic GSH, we measured the concentrations of GSH in the liver (H-GSH) of patients with CHC who were either HIV positive or negative, correlating it to the concentrations of GSH in plasma (P-GSH) and in peripheral blood mononuclear cells (PBMCs) (L-GSH), to the replication activity of hepatitis C virus (HCV) in PBMCs, to the activity of the liver disease, and to the state of immunodeficiency in patients who were HIV positive. METHODS: One hundred, five patients with serologically and histologically demonstrated CHC (55 HIV positive and 50 HIV negative) entered the trial. Fifty-one healthy individuals made up a control group for P-GSH and L-GSH concentrations. H-GSH concentration was determined by high performance liquid chromatography on liver specimens obtained by ultrasound-guided biopsy according to the method described by Reed et al. The concentrations of P-GSH and L-GSH were determined according to the method described by Suarez et al. The detection of HCV RNA strands in PBMCs was performed according to the method described by Qian et al. Histological findings and degree of fibrosis were scored according to the numerical scoring system proposed by Scheuer and by Knodell et al. RESULTS: H-GSH, P-GSH, and L-GSH were significantly reduced in patients affected by CHC compared with healthy controls (p < 0.001). H-GSH and particularly L-GSH were more significantly reduced in patients who were HIV positive compared with those who were HIV negative (p < 0.001), without significant correlation with the values of the T cell subset CD4+. The reductions in H-GSH, P-GSH, and L-GSH were significantly correlated to the replication activity of HCV in PBMCs (p < 0.001) and to the grade of activity of the liver disease assessed by the values of ALT (p < 0.001) and by histological and fibrosis scores of CHC (p < 0.001). In both groups of patients with CHC, H-GSH, P-GSH, and L-GSH were more reduced in patients addicted to drugs than in patients who were not addicted. CONCLUSIONS: In patients with CHC, particularly those who are HIV positive, a systemic depletion of GSH is present. This depletion may be a factor underlying the resistance to interferon therapy and, in patients who are HIV positive, to antiretroviral drugs, fostering HCV and/or HIV replication. This may represent the biological basis for GSH replacement therapy.

Adult↗
PubMed1995

Adjuvant therapy with essential fatty acids (EFAs) for primary liver tumors: some hypotheses.

Hepatocarcinoma is responsible for approximately 1 million deaths annually. It is usually discovered at an advanced stage and, if inoperable, has a poor prognosis. New therapies combining chemotherapy, hyperthermia, radiotherapy and immunomodulators have been recently attempted with various levels of success. Once the tumor is detected at an early stage, some possibilities of cure seem to emerge either by intratumoral percutaneous injection (PEI) of alcohol or by chemoembolization and interstitial hyperthermia. When the tumor volume is more than 5 cm, these therapies are less successful and radiotherapy can be used. All the techniques described have some limits; PEI, for instance, does not achieve a complete eradication of lesions > 3 cm and a non-homogenous alcohol distribution within the tumor leads to areas of necrosis. Radiotherapy, even if effective, is limited by dose-related radiation hepatitis. Another important limiting factor is the incomplete response to therapy and tumor recurrence. Essential fatty acids, especially gamma linolenic acid (GLA) and eicosapentaenoic acid (EPA) are discussed here for their ability to control primary tumor proliferation and increase response to chemotherapy, radiotherapy and hyperthermic treatment, thanks to their effects on cellular membranes (increased lipoperoxidation and modification of tumor stroma).

Animals↗
PubMed1995

Differential distribution of hepatitis C virus genotypes in patients with and without liver function abnormalities.

Hepatitis C virus (HCV) infection persists for an indefinite length of time in a major proportion of patients, inducing chronic liver lesions that evolve to cirrhosis and hepatocellular carcinoma (HCC) in approximately 20% of cases. We studied HCV viremia and genotypes by reverse transcription-polymerase chain reaction (RT-PCR) in 341 consecutive anti-HCV-positive patients. Of these, 167 patients had persistently normal or near normal alanine aminotransferase (ALT) levels (fluctuations < or = 5 IU above the upper limit of normal); the remaining 174 patients presented with elevated ALT and histological evidence of chronic liver disease. Seventy percent of patients with normal ALT values had circulating HCV RNA despite the absence of biochemical indicators of liver damage and mild histological forms of chronic hepatitis were detected in most patients who underwent liver biopsy. Isolated genotype III infection was significantly more prevalent in this patient group with respect to control patients with abnormal ALT values (70% vs. 39%; P < .001). Conversely, isolated genotype II was more frequently found in patients with elevated ALT values and evidence of chronic liver disease (45% vs. 23%; P < .01) and it was progressively more represented in advanced liver disease, such as cirrhosis and HCC. Virological features of HCV infection might be associated with different clinical manifestations, suggesting a potential prognostic significance on disease outcome.

Adolescent↗
PubMed1994

Percutaneous cervical diskectomy: preliminary experience.

We assessed the feasibility of percutaneous treatment of a cervical herniated disc. In the lumbar region, the surgical instrument for percutaneous diskectomy passes only through the paravertebral muscles, while in the cervical region there is considerable risk of nervous, parenchymal and vascular lesions. Moreover, open surgery for cervical herniated nucleus pulposus is a well-established, low-risk procedure, with little risk of epidural fibrosis, the main complication of lumbar open surgery; a percutaneous procedure should therefore have a low morbidity rate. A safe percutaneous approach to cervical discs could be useful for biopsy and for treatment of high-risk patients for general anaesthesia. We treated 15 patients with cervical herniated nucleus pulposus; all gave informed consent and refused or were not eligible for open surgery. We used the Nucleotome described for treatment of lumbar herniated discs; except for the first three cases, we used colour Doppler sonography to detect hazardous structures in the path of the probe. We had one complication, a cervical haematoma due to damage to the inferior thyroid artery, prior to the use of ultrasound.

Cervical Vertebrae↗
PubMed1994

Carotid pain during percutaneous angioplasty (PTA). Pathophysiology and clinical features.

Stretching of the internal carotid artery during percutaneous transluminal angioplasty (PTA) may be associated with transient neck, facial or cranial pain. We report a series of 53 cases who received PTA. Cervical pain occurred in 51% of patients, with a radiation to face and scalp in 33%. Analysis focused on: (a) description of pain intensity, quality, timing and location; (b) investigation about the role of individual and technical parameters that could influence the relative risk of pain onset during PTA; (c) comparison with other available data on pain syndromes related to the carotid artery. Intimal flapping on post-angioplasty angiograms, bradycardia during the procedure and previous history of AMI were associated with a higher risk of painful angioplasty. PTA may also serve as a tool to investigate carotid pain and may add further knowledge to the evidence available about the role of the carotid wall in the pathogenesis of facial and cranial pain.

Aged↗
PubMed1993

Large bowel perforations in war surgery: one-stage treatment in a field hospital.

Over a period of 14 months between 1990 and 1992, 73 Afghan war wounded with penetrating colon injuries were admitted and treated by a single surgical team in a field hospital of the International Committee of the Red Cross (ICRC). There were 67 males and 6 females, with a mean age of 23 years (range 6 to 80 years). Fifty six (77%) patients had multiple associated injuries; admission was delayed longer than 12 hours in 39 (44%); hypotension or deep shock was present at admission in 34 (47%) and 12 (16%) respectively. At laparotomy faecal contamination was limited to one quadrant in 58 (79.5%) cases and major in 15 (20.5%). Fifty-two (71.2%) patients underwent resection and primary anastomosis and 21 (28.8%) primary repair. Exteriorisation or diverting colostomy were never used. Four (5.5%) patients died and 11 (15%) had postoperative complications. Overall failure rate was 2.7%, including one faecal fistula conservatively treated and one colostomy raised as a precaution in a patient undergoing relaparotomy for intra-abdominal abscess. No primary repair leaked Deaths were significantly related to delay in admission and age, but not to surgical treatment. One stage primary treatment of large bowel injuries from penetrating abdominal wounds has low mortality, failure and colostomy rates suggesting its wider use regardless of risk factors.

Adult↗
PubMed1992

Carotid percutaneous angioplasty.

Clinical benefit from treatment of symptomatic severe carotid stenoses has been demonstrated recently. The safety profile of endarterectomy, however, justifies the development of alternative techniques as percutaneous transluminal angioplasty (PTA), at least in mild to moderate stenoses. Early results and follow-up data from our series of 44 carotid stenoses treated by PTA are reviewed in this paper, in comparison with other reports from literature. PTA may be beneficial as a therapy of symptomatic internal carotid stenoses, provided its cost/effectiveness has been evaluated by a valid method.

Angioplasty, Balloon↗
PubMed1992

Local intraarterial thrombolysis for acute stroke in the carotid artery territories.

We have tested the feasibility of local intraarterial thrombolytic therapy in ischemic stroke in the carotid artery territories observed within 5 h of the onset of symptoms. Only 5 of 615 consecutive patients were enrolled. They were 1 man and 4 women aged 50 to 75 years. Angiography disclosed occlusion of the M2 tract in one, of the M3 tract in one, of the carotid siphon in one of M4 tract in two. Intraarterial urokinase was infused at a mean dosage of 560,000 units close to the site of occlusion. Four of them had partial or complete recanalisation at early angiographic control and were independent at 6th month control. The one who did not demonstrate recanalisation was confined to a wheelchair. One patient, who had recanalisation, sustained a hemorrhagic transformation of the brain ischemia not interfering with outcome. Our experience, at the light of the low rate of enrollment, despite the results, suggest that intraarterial thrombolysis may be a therapeutic tool for selected patients with stroke in the carotid artery territories and not a routinary treatment for them.

Aged↗
PubMed1991

Percutaneous discectomy using Onik's method: 3 years' experience.

A total of 234 patients treated by percutaneous discectomy at 237 levels and followed-up between 11 months and 3 years 4 months showed an overall success rate of about 75%. In a subgroup of 112 of these patients rechecked for a second time, the clinical results remain consistently good even 24 months after surgery. In a special group of 28 patients who complained only of low back pain, percutaneous discectomy achieved a success rate of 85.7%. Complications consisted of one disc infection which cleared without clinical or radiological sequelae (0.26%).

Adolescent↗
PubMed1991

Alcoholic abstinence syndrome: short-term treatment with metadoxine.

The effects of metadoxine (pyrrolidone carboxylate of pyridoxine), a compound with central benzodiazepine-like properties, were evaluated in two groups of chronic alcoholics (inpatients) presenting a mild withdrawal syndrome. According to a double-blind study design 20 patients received metadoxine 900 mg twice daily eluted in 500 ml of saline infusion, while 20 (the control group) were given 500 ml of saline infusion twice daily with equivalent doses of pyridoxine (40 mg/die) every morning over a 10-day period. The results indicate that metadoxine treatment was able to control alcohol abstinence, thus allowing a reduction in the needs for standard benzodiazepine therapy. The central activity of gamma-aminobutyric acid of this compound might play a crucial role in the clinical effects demonstrated.

Adult↗
PubMed1989

[Echo-guided renal biopsy in patients with a medical nephropathy].

Ninety-five percutaneous renal biopsies under ultrasound guidance were performed on 89 patients with nephrologic diseases. Accurate diagnosis was reached in 93% of cases at the first biopsy, and the figure increased to 100% after a second biopsy. The use of 18 and 16 gauge needles allowed correct histological diagnosis in 95% of patients, and satisfactory histology in the extant 5%. US guidance and the use of 18 and 16 gauge needles reduced the complications related to renal biopsy: in fact, severe hematuria occurred in 2 cases only.

Adolescent↗
PubMed1988

Psychological distress in geriatric and adult medical in-patients.

Psychological distress was evaluated in two groups of medical in-patients, one composed of geriatric subjects (178), the other of adults (201). The instrument used for this purpose was the SCL-90. The predominant pattern of emotional response among the geriatric patients was depression; although this pattern was also present among the adult patients, reactions of an anxious type were more common in these subjects. Women of both groups of patients scored significantly higher than men on many of the subscales of the SCL-90. No significant differences emerged in relation to the type of organic disease among the adult patients, while among the geriatric patients, subjects with disorders of the CNS, muscular-skeletal system and blood scored significantly higher than those with other diseases.

Adult↗
PubMed1988

Treatment of anxiety with ketazolam in elderly patients.

In a multicenter, double-blind trial, 63 elderly patients who had experienced a generalized anxiety disorder for at least one month were randomly assigned to receive 15 mg of ketazolam (n = 31) or placebo (n = 32) daily for 15 days. At the end of this period, if their total scores on the Hamilton Anxiety Rating Scale had decreased by at least 25%, treatment was continued unchanged for a further 15 days. Patients who did not respond to treatment were given an additional 15 mg of ketazolam daily. During the initial 15 days, 83% of the ketazolam-treated patients and 43% of the placebo patients responded to treatment (P < 0.01). During the second 15-day period, the anxiety scores of the ketazolam-treated patients continued to decline significantly, whereas the placebo patients showed no improvement. According to the investigators' assessments of severity of anxiety and patients' ratings of treatment effectiveness, ketazolam was significantly superior to placebo.

Aged↗