PubMed Health⌕ Search

Biomedical subjects

G Mariotti

Publications and source records attributed to G Mariotti.

At least 19 recordsLinked to original sources
PubMed2006

New perspective in the management of neuroendocrine differentiation in prostate adenocarcinoma.

In this review, we will present some of the information that is known about neuroendocrine (NE) cells and differentiation in the prostate. We will then speculate on the potential role that NE differentiation in prostate carcinoma may play and how this differentiation may be clinically analysed and treated. The androgen-independent growth of prostate cancer can be caused by different mechanisms; one of these is receptor-specific paracrine or autocrine growth modulation of human prostatic cancer cells by neuropeptides secreted by NE cells. Our results affirm that different methods of androgen deprivation can influence the serum chromogranin A (CgA) levels to different extents in prostate cancer. In particular, bicalutamide produces a significantly lower increase in serum CgA compared with castration therapy. In the light of other evidence that supports a significant relationship between serum CgA levels, tissue CgA expression and NE activity, we hypothesise that bicalutamide may reduce the risk of NE cell hyperactivation in prostate cancer. It is important to determine whether increases in CgA levels and NE cell activation are associated with progression towards hormone-independent prostate cancer. We recently proposed as therapy of NE activation in hormone-independent prostate cancer, a combination of oestrogens and somatostatin analogues. The combination of ethinyl estradiol and lanreotide had a favourable toxicity profile, offered objective and symptomatic responses in patients with limited treatment options and refractoriness to conventional hormonal therapy strategies and, in particular, offered a median overall survival that was superior to the 10-month median survival in patients with hormone refractory disease. This combination therapy also sustains the novel concept in cancer treatment in which therapies may target not only cancer cells but also its microenvironment in combination, which can confer protection from apoptosis.

Adenocarcinoma↗
PubMed2005

Long-term prognostic impact of repeated measurements over 1 year of pulse pressure and systolic blood pressure in the elderly.

Systolic blood pressure (SBP) and pulse pressure (PP) have been identified in western industrialized countries as major predictors of cardiovascular events in the elderly on the basis of measurements taken at a single visit. Considering the wide variability of blood pressure (BP) in older people, this study set out to assess the prognostic significance of measurements of SBP and PP taken over several months according to a monitoring scheme mimicking routine care. A total of 444 Italian general practitioners enrolled a cohort of 3858 unselected elderly outpatients and followed them up for 10 years. BP was recorded at recruitment, 1 week later and at quarterly visits during the first year. The average BP of these six visits was used to define the patient's BP status. During the 10-year follow-up, 1561 participants died, 709 from cardiovascular diseases. Proportional hazard regression analysis, adjusted for all main prognostic factors including antihypertensive treatment, showed that for each 10-mmHg increment in SBP and PP there were, respectively, 5 and 9% increases in risk for total mortality (TM) and 9 and 13% increases in risk for cardiovascular mortality (CVM) (all P < 0.01). However, including both SBP and PP in the model, only PP showed an independent, significant relationship with TM and CVM. In conclusion, prognostic information based on repeated measurements of PP is stronger than that given by SBP and consequently should be recommended in the definition of cardiovascular risk in the elderly.

Aged↗
PubMed2004

Benign prostatic hyperplasia: what about a campaign for prevention?

OBJECTIVES: In an era when prevention is considered better than cure, is there a rationale for benign prostatic hyperplasia (BPH) prevention? MATERIALS AND METHODS: Medline and Current Content databases were searched for studies conduced in the last 10 years on BPH and the feasibility of prevention program. RESULTS: Some important criteria for promoting prevention can be found in BPH disease. The significant impact of BPH on the male population and on its quality of life is well established. Knowledge of the etiopathogenesis of this disease is rapidly improving. However, the use of PSA or other markers to select a population at higher risk for developing BPH and its clinical manifestations needs to be better established. More data are available for secondary prevention against BPH progression. Although the action of some natural and nutritional agents on BPH tissue has been demonstrated experimentally, data from prospective clinical trials are not available. Synthetic agents such as 5alpha-reductase inhibitors or COX-2 inhibitors may be effective, but clinical results for primary prevention of BPH have not been reported. CONCLUSION: At present, we propose a BPH prevention program as a basis for discussion and future work.

Health Promotion↗
PubMed2002

[Penile metastasis from bladder cancer. A case report].

Penile metastases from bladder cancer are unusual. A case of a man, 50 years old, with undifferentiated bladder carcinoma submitted to radical cystoprostatectomy and ileal conduit is presented. Twelve months after the primary diagnosis the patient presented metastases of the penis.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1998

[Diverticula of the female urethra. Comparison of imaging techniques].

BACKGROUND AND AIMS: Urethral diverticula is a rare pathology with an incidence varying between 0.3 and 6%. It is difficult to diagnose owing to the aspecificity of its clinical symptoms. The aim of this study was to evaluate the imaging techniques now available for its diagnosis. METHODS: The sample consisted of 19 female patients aged between 20 and 53 years old undergoing diverticolectomy owing to urethral diverticula between 1980 and 1996 at the 4th Division of the Department of Urology at "La Sapienza" University of Rome. All patients underwent preoperative X-ray examinations (micturitional cystourethrography and P positive urethrography). A retrospective study was performed in order to evaluate the accuracy of the individual methods. RESULTS: Micturitional urethrocystography showed a sensitivity equivalent to 77% of cases. P positive urethrography showed a 85.7% accuracy rate. Lastly, transvaginal ultrasonography, which always showed the diverticular sac in all patients in which it was used, also highlighting multiple and divided diverticuli which were not visible using traditional radiology. The latter method is easy to use and well tolerated by patients; moreover, it shows the spatial relations of the diverticulum and allows the characteristics of periurethral tissues to be evaluated. CONCLUSIONS: The authors affirm that transvaginal ultrasonography is the first method of choice for the diagnosis of urethral diverticula.

Adult↗
PubMed1997

Ureteral injuries during gynecologic procedures.

The reported incidence of iatrogenic ureteral injuries ranges from 0.05 to 30%. These injuries are particularly secondary to gynecologic surgical procedures. Simple abdominal hysterectomy has proved to be the most common procedure leading to such injures. Because some ureteral injuries may be symptomless, leading to silent kidney loss, the incidence may be too low, and a figure of up to 2.5% after gynecologic operations has been suggested. The incidence continues to be about ten cases during abdominal surgery for one case during vaginal surgery. Different risk factors may influence the ureteral injuries rate. An operation at the pelvic brim, distorted anatomy, removal of the adnexa or of ovarian neoplasm, may facilitate the occurrence of an ureteral trauma. The management of ureteral trauma is positively influenced by an early recognition of the trauma. Conventional technique or ureteroneocystostomy or end to end anastomosis with ureteral stent to treat the injury proved successful. Extensive reconstruction draws upon the entire therapeutic armamentarium of the urologist. Surgical options mainly include creation of bladder tubes and autotransplantation. The most important factor influencing the management of ureteral injury is the presence of associated complications. Blandy et al. sustained to attempt repair of these complicated iatrogenic injuries as soon the diagnosis has been made.

Female↗
PubMed1996

[Prognosis of shoulder calcifications after irrigation treatment and roentgen findings. A prospective study and literature review].

In 106 shoulder joints of 94 patients suffering from calcifying shoulder (calcifying tendinitis), needling and lavage were performed. Patients were prospectively investigated before and after treatment to examine if location, size, number and density of calcium deposits would predict outcome after the above-mentioned lavage. Excellent and good results were seen for subacromial calcifications and those situated near the tuberculum majus. Density and number of calcifications were without discriminating value, whereas large calcium deposits (> 1,5 cm) and fairly small calcifications (< 1,0 cm) responded very well to conservative treatment as described above.

Adult↗
PubMed1996

Physical map of the malaria vector Anopheles gambiae.

Random cDNA clones, cosmid clones and RAPD polymorphic fragments have been localized by in situ hybridization to the ovarian nurse cell polytene chromosomes of the malaria vector Anopheles gambiae. We thus established 85 molecular markers for 110 sites within the whole A. gambiae polytene chromosome complement. The cDNA clones analyzed were isolated at random, and their exact localizations were determined by in situ hybridization. For 15 of the cDNA clones, a partial nucleotide sequence has been obtained; for nine of them sequence searches in the GenBank database revealed high degrees of similarity with published sequences. The cosmid clones analyzed were obtained as the result of screening with a few of the aforementioned cDNA clones of particular interest, or taken from a small set of randomly isolated cosmid clones. The RAPD clones are polymorphic fragments, potentially diagnostic for the various chromosomal forms of A. gambiae that are currently being analyzed.

Animals↗
PubMed1994

[Erosive osteochondrosis is not spondylitis].

Technetium-99m-DPD and gallium bone scanning were concomitantly performed in patients suffering from either infectious spondylitis or erosive spondylopathy. This comparative study in 5 patients with spinal infections and in 7 patients with lumbar erosive intervertebral osteochondrosis shows a distinct enhancement of the isotopes used such that differentiation between infections and aggressive degeneration is possible. Combined scintigraphy may be a helpful diagnostic tool in such cases.

Adult↗
PubMed1994

X-linked mental retardation, microcephaly, and growth delay associated with hereditary bullous dystrophy macular type: report of a second family.

We report on 2 patients with mental retardation and bullous dystrophy, macular type. The observation of the condition in a male and his maternal uncle is consistent with recessive X-linkage. Due to the rarity of the condition, nosologic definition was difficult before the birth of the propositus. The clinical picture in the two patients described, characterized by mental retardation, dwarfism, microcephaly, alopecia, bullous dystrophy macular type, hypogenitalism, is very much like the one observed in the patients, all males, belonging to the only other family reported to date. The recent localization of the bullous dystrophy gene in the Xq24-qter segment opens the possibility of prenatal diagnosis.

Abnormalities, Multiple↗
PubMed1994

Antihypertensive efficacy and tolerability of different drug regimens in isolated systolic hypertension in the elderly.

The pharmacological treatment, mainly based on diuretics, of isolated systolic hypertension (ISH) has recently been shown to reduce the risk of stroke and coronary heart disease in the elderly. The purpose of this study was to compare the antihypertensive effect and tolerability of different drug regimens in elderly subjects with ISH (systolic blood pressure--SBP-- > or = 160 mmHg and diastolic blood pressure--DBP-- < 90 mmHg). A multicentre, randomized, controlled open trial was planned in the general practice setting. Four widely used treatment schedules were tested: hydrochlorothiazide 25 mg plus amiloride 2.5 mg (H+Am), nifedipine slow release 20 mg (N), atenolol 50 mg (At) and atenolol 25 mg plus chlorthalidone 6.25 mg (At+C). After a baseline evaluation, 308 patients (76.3% female, mean age 75.3 +/- 7.1 years) were randomized and followed up for 6 months. After 3 months the drug dosage was doubled if the systolic blood pressure goal (SBP < 160 mmHg and SBP reduction of at least 20 mmHg) had not been reached. Ninety-four subjects (30.5%) presented contraindications to beta-blockers. At the 3rd- and 6th-month visits all treatment groups, except At, showed a significant reduction in SBP compared to the control group; DBP showed no significant reduction in any group at any time. At the end of the follow-up the percentage of hypertensives who had reached the BP goal was 14.6% in the control group, 52.9% in H+Am, 54.8% in N, 28.6% in At and 52.2% in At+C.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1993

[Low-dose steroids in chronic polyarthritis: a basic therapy?].

The symptomatic and disease-modifying efficacy of low-dose corticosteroids in rheumatoid arthritis is explained. A possible therapeutic effect of low-dose corticosteroids is shown by long-term studies which include radiological evaluation. The safety and side-effects of low-dose corticosteroids are described. Steroid-induced osteoporosis in rheumatoid arthritis is discussed especially based on recently accomplished longitudinal bone density studies. Finally consequences in the management of rheumatoid arthritis are defined.

Adrenal Cortex Hormones↗
PubMed1992

Prevalence and variability of orthostatic hypotension in the elderly. Results of the 'Italian study on blood pressure in the elderly (SPAA)'. The 'Gruppo di Studio Sulla Pressione Arteriosa nell'Anziano'.

The prevalence of orthostatic hypotension (OH) in an elderly outpatient population was assessed according to the most common criteria given in the literature. Short-term OH variability and relationships between OH and its known risk factors were also analysed. A sample of 3858 elderly outpatients aged 65 years or more was randomly recruited by 444 Italian general practitioners. The patients' blood pressure (BP) and heart rate were recorded in both lying and standing positions at two visits 7 days apart. Three definitions were used for the identification of OH: (1) a decrease in systolic BP greater than 20 mmHg (SOH); (2) a decrease in both systolic (greater than 20 mmHg) and diastolic (greater than 10 mmHg) BP (SDOH); (3) any decrease in systolic BP associated with symptoms (SyOH). Prevalence figures for SOH were 13.8% at the first and 12.6% at the second visit, and respectively 5.3 and 4.8% for SDOH, 14.1 and 11.8% for SyOH. All the criteria were met by less than 2% of subjects at each visit. The diagnosis of OH was confirmed at both visits in 36.3% of cases for SOH, in 25.7% for SDOH, and in 43.9% for SyOH. Each different OH definition identifies a population subgroup characterized by different sets of risk-factors. The presence and prevalence of OH is difficult to define because different people may be identified by the currently accepted criteria or by the same criterion over a short time.

Aged↗
PubMed1992

Effects of long-term treatment with prazosin on left ventricular diastolic function in mild to moderate hypertension.

It is not well established if blood pressure control is associated with an improvement in diastolic function, whose impairment represents an early marker of cardiac involvement in systemic hypertension. The purpose of this study was to evaluate whether a prolonged treatment with an alpha 1-blocking agent can lead to a reversal of the abnormalities of left ventricular filling. Eleven never-treated patients with mild to moderate essential hypertension were examined before and after at least six months of treatment with prazosin. Cardiac function and left ventricular mass were measured by means of radionuclide ventriculography and echocardiography. Average blood pressure values significantly decreased during the treatment period: from 163.54 +/- 17.80 mm Hg to 146.81 +/- 13.14 mm Hg for systolic blood pressure and from 106.09 +/- 6.96 mm Hg to 92.90 +/- 8.93 mm Hg for diastolic blood pressure. All the indices of left ventricular mass showed a trend toward reduction, but the differences with respect to the baseline values did not reach statistical significance. Average value of ejection fraction was normal before treatment and did not change significantly after treatment. All indices of diastolic function were significantly lower than normal controls' values at the beginning of the study and tended to worsen at the end of the study. Our findings suggest that diastolic function is not consistently affected by the therapy with alpha 1-adrenoreceptor antagonists despite good blood pressure control.

Adult↗
PubMed1991

Hypomelanosis of Ito associated with chromosomal translocation involving Xp11.

We report on a 3-year-old girl with hypomelanosis of Ito (HI). She has typical skin lesions and mild CNS involvement characterized by impaired walking and borderline mental retardation. Cytogenetic investigation showed a 18/X translocation with breakpoint on Xp11. This is the sixth case of HI in which this breakpoint has been reported, underlining that this event cannot be considered coincidental. Further studies are needed to understand the etiologic and pathogenetic meaning of this finding.

Child, Preschool↗