Biomedical subjects
Publications and source records attributed to G Bonanni.
The Authors deal with the immunosuppressive drugs administered to kidney-transplant receiving. The point out the complexity of the utilized pharmacological schemes, underlining the metabolic and immunologic iatrogenic effects brought about by this therapeutic iter, which should not neglect the clinical conditions of the patient.
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In order to evaluate the influence of physical exercise on the hypothalamic-pituitary-ovarian axis, we studied ten women in the early follicular phase (EFP), twelve in the late follicular phase (LEP) and nine in the luteal phase (LP). The test consisted of a 90-minute physical exercise on a motor driven treadmill at 55-60% of VO2max. Blood samples were taken before, during and after the test. Prolactin and cortisol did not increase in any phase. Estradiol showed a significant increase in LFP (from 361.5 +/- 110.6 to 472.7 +/- 138.9 pmol/L) and in LP (from 457.2 +/- 94.6 to 555.3 +/- 96.9 pmol/L) but not in EFP. Progesterone levels increased significantly only in LP (from 28.2 +/- 6.7 to 33.5 +/- 6.7 mmol/L): Luteinizing hormone (LH) levels decreased significantly in all phases: from 13.7 +/- 2.0 to 10.5 +/- 1.1 IU/L in EFP; from 14.6 +/- 2.1 to 11.5 +/- 1.9 IU/L in LFP and from 7.5 +/- 1.3 to 5.7 +/- 1.0 IU/L in LP, while follicle stimulating hormone (FSH) levels decreased only in LFP (from 8.1 +/- 0.5 to 6.7 +/- 0.6 IU/L). Our exercise protocol (prolonged, continuous and moderate) was able to cause a decrease in gonadotropins levels, and this phenomenon is not due to changes in the other tested hormones.
In view of the importance of the emotional stress in some gastrointestinal diseases pathogenesis among which anxiety and/or depression appear to play an appreciable role, the Authors have analysed a number of sensitive colon and duodenal ulcers whose psychopharmacologic treatment has resulted crucial in the resolution of these diseases.
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Computed tomography (CT) resulted in a diagnostic accuracy of 89.2% and 96.1% for medial and lateral meniscal lesions, respectively, in 109 patients who underwent surgery after a direct CT study of the knee joint for a clinically suspected meniscal lesion. The meniscal lesions were the only pathologic condition found in 59 patients, while in 35 patients they were associated with various lesions of the cruciate ligaments (31 cases) and collateral ligaments (15 cases) and with cystic bursitis (6 cases). In the remaining 15 patients, the menisci were normal, but in eight of these cases, lesions of other knee joint structures were present. If meniscal lesions are clinically suspected, direct CT study of the knee joint may be considered the elective radiologic diagnostic method, rather than the more invasive arthrography. It may also be helpful in selecting patients for diagnostic and therapeutic arthroscopy.
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A total of 63 twin pairs (22 MZ and 41 DZ), with one or both members affected by not organic stuttering and/or tics, have been drawn out of the Mendel Institute's twin file. Concordance of stuttering was observed in 10:12 MZ, but only in 2:19 DZ twin pairs; concordance of tics in 6:10 MZ and in 2:22 DZ twin pairs. Stuttering did not come out significantly associated either with other disturbances of language or with an IQ under the average; almost always it was possible to find out a precipitating factor. Significant relations between stuttering and tics could not be stated. Sex ratio, obtained regarding any affected subject separately, clearly turned in favour of males both in stuttering (32:12) and in tics (27:12). Stutterers and left-handers incidence in the families of stuttering subjects appeared significant in comparison with families of subjects with tics.
In 1973 the Mendel Institute, within the specialized services it offers to Italian twins, instituted psychopedagogic counseling for twins and their families. This service is carried out in the intermediate field between neuropsychiatry and social work. Cases involving family and social maladjustment were referring for counseling. During the academic year 1973-1974, the service examined 96 cases, of which 58 involved problems of school retardation and 38 involved family maladjustment because of changed parent-twin relationships. The counseling service aimed at achieving improved family and school relationships by means of various therapeutic interventions. The psychopedagogic counseling, besides the immediate therapy, has permitted deeper study of maladjustment by means of analyses of the twins' condition as a possible additional cause of the maladjustment itself. Analysis of the cases in this limited sample would seem to indicate an indirect incidence of the twin situation per se (couple effect), somewhat emphasized by the family and social environment.
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15 subjects with Hypogonadotropic Hypogonadism (HH) were treated with either gonadotropins (13 cases) or pulsatile subcutaneous Luteinizing Hormone Releasing Hormone (LHRH) (2 cases) for up to 42 months, to study the effects of therapy step by step. The following results were obtained: (A) In postpubertal HH (5 cases = Group A), therapy brought about onset of spermatogenesis within 3 months and its normalization within 6 months. In HH of prepubertal onset (10 cases = Group B), spermatogenesis started within 9 to 21 months and became normal in only 3 cases after at least 18 months. The best sperm counts were obtained in Group A in the third month of treatment (41.75 +/- 43.68 mil./ml) and in Group B in the 36th month (14.87 +/- 17.06 mil./ml). Sperm motility was normal in the majority of the cases in Group A from the beginning but did not become normal in Group B. (B) Seminal fructose and zinc were normal from the beginning of therapy in 66% of the cases in both groups. Zinc became normal in 100% within 3 months in Group A, in Group B within 18. Carnitine was normal in 50% of cases in both groups, contemporaneous with sperm appearance. Transferrin was normal in Group A after appearance of spermatozoa, but in Group B never became normal. (C) We hypothesize that the recovery of fertility passes through the following stages: (1) Functional recovery of Leydig cells, followed by seminal vesicles and prostate. (2) Recovery of epididymal function, which probably implies beginning of the tubular function. Recovery of Sertoli cell function occurs with more difficulty.
The paper examines the complex metabolic behaviour of patients undergoing hemodialysis and renal transplantation. It underlines the importance of the metabolic and nutritional status of these patients since inadequate nutritional therapy may result in the failure of hemodialysis and/or surgery. Given the complexity of the metabolic syndrome and its bronchopulmonary, cardiovascular and septic complications, it is necessary to monitor the various chemical and clinical parameters in these patients in order to guarantee an optimal recovery and satisfactory survival rate. Fortunately today, by replacing the use of Azathioprine, Cyclosporin--irrespective of its collateral and/or secondary effects--has replaced the use of corticosteroids whose immunodepressive action made it obligatory to start simultaneous prophylactic antibiotic treatment and/or chemotherapy in order to avoid the development of other chance disease. The paper also reports the findings of a retrospective study (1976-1986) which evaluated various physiopathological and metabolic parameters and compared them to data reported in the literature.
In spite of the current availability of new and more up-to-date methods of prevention, diagnosis and therapy, specific forms in general and the ability to perform rapid, efficacious and resolutory operations, a number of cases of subprimary or secondary tuberculosis still exist which are most probably the result of delayed diagnosis, contagious episodes or the failure to adhere to recommended treatment protocols and, often, less than optimum medical therapy. A rare case of adrenal tuberculosis diagnosed in a patient hospitalized for left renal calculosis is reported. Routine tests indicated a specific form of diagnosis, and during surgery for left renal calculosis the patient underwent left adrenalectomy. Histological tests confirmed the initial diagnosis. For 180 days after the operation the patient received pharmacological treatment directed specifically against Koch's bacillus.
The authors, keeping in mind their clinical, diagnostic and therapeutic experience on ulcerous gastric and duodenal pathology, underline the effectiveness of the traditional antacids as well as that of the modern up-to-date antisecretory and cytoprotective agents. After having put into evidence the causes that can provoke peptic ulcer not excluding that of iatrogenic and their probable aetiopathogenetic mechanism and having hinted at another pathology that uses the same therapeutic remedies, the gastro-oesophagus reflux, they discuss in detail the active principles used in the gastric or duodenal pathology, the possible side and/or secondary effects that in the long run are determined when using only the modern therapy with the usual antacids. Therefore, they hope that these therapies are used after carefully considering the general clinical and anatomicopathologic situation of the lesion that must be created.
Males affected by hypogonadotropic hypogonadism can be treated with androgen replacement therapy, if they do not wish fertility. In order to limit or avoid androgen toxicity on the liver, it is possible to use testosterone undecanoate (which is absorbed in the gut by lymphatic system) at the dose of 160-240 mg/die or testosterone esters administered intramuscolarly at the dose of 250 mg/month. Estradiol and DHT derived from testosterone catabolism can be in excess therefore they can be provoke toxic phenomena, even if slight, such as gynecomastia or prostatic diseases. If patients wish fertility, they must be treated with gonadotropins or pulsatile LHRH. Therapeutic effects are very different depending on the different origin of the hypogonadism. In postpubertal onset hypogonadotropic hypogonadism, the response is constant and rapid; sperm count normalization can be reached within 6 months with the only hCG. Prepubertal onset hypogonadotropic hypogonadal men need hu-FSH too and longer treatment (18-24 months); sperm count normalization can be reached in less than half case. Nevertheless fertility can be reached even in oligozoospermic stage. Negative prognostic factors are: pan-hypopituitarism, cryptorchidism, how old are the patients at the beginning of the treatment and small testis volume. It is not yet clear if pulsatile LHRH therapy is profitable in terms of therapeutic results.
Direct CT of the knee joint was performed on 45 patients who subsequently underwent surgery for clinically suspected capsuloligamentous lesions. It was possible to perform a complete examination on all patients, even those immobilized in a cast or with acute clinical symptoms. Computed tomography correctly differentiated 32 lesions of the anterior cruciate ligament, five lesions of the posterior cruciate ligament, 16 lesions of the collateral ligaments, and 43 associated meniscal lesions. In five cases surgery disproved the CT diagnosis. Our experience permitted us to identify direct CT signs that not only indicate the presence of a capsuloligamentous lesion but also determine its site, extent, and seriousness.
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