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Biomedical subjects

G Martelli

Publications and source records attributed to G Martelli.

At least 37 records · Page 2Linked to original sources

Renal stone formation in patients with inflammatory bowel disease.

Kidney stones are more common in patients with inflammatory bowel disease (IBD) than in the general population. The main lithogenetic risk factors were evaluated in patients affected by Crohn's disease and ulcerative colitis. Our results show the presence of several factors, besides hyperoxaluria, in patients with IBD although their behaviour appears different in Crohn's disease and ulcerative colitis at pre- and post-operative stages. Before surgery in patients with Crohn's disease we found a decreased citrate (p < 0.001) and magnesium (p < 0.005) excretion together with a low urinary volume (p < 0.001) and pH (p < 0.005). After surgery patients with Crohn's disease showed a further reduction of magnesium and citrate. Patients with ulcerative colitis before surgery showed a reduced citrate excretion (p < 0.05) and a more acidic pH (p < 0.05) than healthy subjects. Surgical treatment of proctocolectomy with ileal pouch-anal anastomosis seems to increase the risk of stone formation; in fact, after surgery we observed a relevant decrease of urinary volume (p < 0.001), pH (p < 0.0001) and urinary excretion of citrate (p < 0.0001) as well as magnesium (p < 0.005). Patients with IBD seem to be at greater risk of stone formation than patients with idiopathic calcium lithiasis; in fact, they show a lower excretion of citrate (p < 0.001) and magnesium (p < 0.001) together with a low urinary pH (p < 0.001) and volume (p < 0.001). Urinary volume reduction is probably one of the major risk factors together with the decrease of small molecular weight inhibitors that is a constant finding in all patients with IBD.

Adult↗

Blood lactate accumulation in top level swimmers following competition.

The purposes of this study were to evaluate the significance of blood lactate values after competitions and the blood lactate-swimming speed relationship to swimming performances. Auricular blood samples (N = 421) were collected in 203 top level Italian swimmers (116 males and 87 females) at the end of competitions performed in a 25 m swimming pool. The distribution of all lactate values differed between males and females. The lowest lactate values occurred in swimmers performing the longest distances both in males (1500 m) and females (800 m). In swimmers performing freestyle events a relationship between V-4 mM (swimming speed at 4 mmol/l blood lactate value) and competition velocities was observed, in males, at 200, 400 and 1500 m and, in females, at 400 and 800 m. The predicted velocity corresponding to the competition lactate value assessed by the individual blood lactate-swimming speed relationship was found to be highly related to the actual competition velocity. Results suggest that blood lactate values in swimmers are a useful indication of individual aptitudes.

Adolescent↗

Treatment of breast cancer in elderly women: retrospective analysis of 111 wide lumpectomies performed in a day hospital regimen between 1982 and 1988.

Between 1982 and 1988, 111 elderly women with breast cancer but without clinical involvement of the axillary lymph nodes underwent wide lumpectomy in a Day Hospital regimen at the National Cancer Institute of Milan. The patients ranged in age from 70 to 92 years (median, 79). An adjuvant treatment was carried out in all but 9 cases: tamoxifen only in 84 cases, tamoxifen plus radiotherapy in 6 cases, radiotherapy alone in 12 cases. The median duration of follow-up was 44 months (range, 30-109 months). Four patients (3.6%) were lost to follow-up. In the remaining 107 patients, 10 local-regional relapses (9.1%) and 7 distant metastases (6.5%) occurred. Six patients died from the disease, 14 from unrelated conditions. This retrospective study showed that selected elderly patients with breast cancers can be treated successfully under local anesthesia on an outpatient basis. The treatment guarantees local control of the disease, meets the favor of elderly women and consequently improves their quality of life.

Actuarial Analysis↗

The role of fine needle aspiration in the diagnosis of thyroid nodules: analysis of 795 consecutive cases.

The utility of fine needle aspiration (FNA) and physical examination for selecting patients with palpable thyroid nodules for surgery was evaluated in 795 consecutive cases. Surgery was performed in 216 patients based upon the cytological diagnosis and clinical criteria. Excluding 42 patients who were lost to follow-up, the remaining 537 were regularly followed up (range, 2-10 years). Cytological findings were classified as malignant, histologic control recommended (suspicious), follicular tumor, benign, and unsatisfactory. Thirty-six aspiration biopsies were positive for malignancy and the diagnosis was confirmed histologically in 34 of them. In 65 patients with final histological diagnosis of malignancy, cytology was positive in 34, suspicious in 20, benign in 3 cases, and unsatisfactory in 8. All patients with cytological diagnosis of follicular tumor had a benign lesion at histology. There were two false positive and three false negative cytological results among the 216 histologically confirmed cases. Excluding unsatisfactory specimen sensitivity, specificity and the predictive value for a positive and a negative result were respectively 95%, 97.5%, 94.5%, and 97%. We conclude that FNA is a very reliable diagnostic test in the evaluation of thyroid nodules and is the best guidance in addition to clinical criteria for selecting patients to be submitted to surgery.

Adenoma↗

Changes in the exercise-induced hormone response to branched chain amino acid administration.

It was the aim of the present experiment to detect possible effects of branched-chain amino acids (BCAA) on the endocrine response to 1 h of continuous running. Blood samples were collected from 14 long-distance runners (age 24-42 years) in two different trials performed at 1-week intervals. In both trials (E and P) blood samples were collected at the following times: 9 a.m. (basal values sample), 10.30 a.m. (sample 90), 11.30 a.m. (sample 150), 12.30 p.m. (sample 210); the athletes performed 1 h of running at a constant predetermined speed between samples 90 and 150. Following the basal sample a mixture containing BCAA (E trial), or not containing BCAA (P trial) was ingested. In both trials no hormone basal concentrations, except insulin, were changed before exercise. In P trial, following exercise (sample 150), human growth hormone (HGH), prolactin (PRL), adrenocorticotropic hormone (ACTH) and cortisol (C) increased, while testosterone (T) decreased. In sample 210, after 1 h of rest, while ACTH, PRL and HGH had recovered to basal concentrations, C remained elevated and T displayed a further decrease. In the E trial a similar pattern of change was observed in sample 150 for HGH, PRL, ACTH and C; in sample 210 HGH and PRL displayed significantly lower values than in the corresponding P trial samples. The T was not modified by the running exercise and increased during the recovery period. It is, therefore, suggested that BCAA administration before exercise affects the response of some anabolic hormones, mainly HGH and T.

Adrenocorticotropic Hormone↗

Doppler flowmetry and the diagnosis of breast lumps.

The aim of the study was to ascertain the reliability of a Doppler signal in the diagnosis of breast cancer. Computerized blood flow analysis was performed on 117 patients who presented with a breast lump at the Division of Diagnostic Oncology of the Istituto Nazionale Tumori of Milan. The values of systolic peak and diastolic frequency were evaluated in relation to the histologic diagnosis. Ten patients had a spontaneous regression of the lump and were excluded from the study. The number of evaluable cases with histologic confirmation was 107: 69 carcinomas and 38 benign lesions. Systolic peak values for the 69 carcinomas ranged from 1500 to 7400 Hz, with a mean value of 3243.4 Hz; diastolic frequency ranged from 200 to 3700 Hz, with mean value of 1413.9 Hz. No diagnostic signals were found in 4 breast cancers (false negatives). Twenty-three of 38 benign lesions (60.5%) and 65 of 69 malignant nodes (94.2%) were correctly diagnosed. The Doppler signal with computerized spectral analysis in addition to more specific ultrasonographic parameters could be considered a useful tool in the diagnosis of breast cancer.

Adult↗

Diagnostic efficacy of physical examination, mammography, fine needle aspiration cytology (triple-test) in solid breast lumps: an analysis of 1708 consecutive cases.

The clinical-radiologic-cytologic triplet was used for diagnostic evaluation in 1708 women over 30 years old with a breast lump. All the lumps were subjected to surgery except for 258 cases in which clinical resolution took place within 1-2 months. Seven-hundred and ninety-three out of 1450 nodules removed were cancers. Sensitivity of the clinical, mammographic and cytologic examinations was 82%, 73% and 68%, respectively. It increased to 95% when they were associated. Specificity was 63%, 80% and 97%, respectively. The predictive value of positive results of the triple test was 100%. No patient with malignant cytology was subsequently shown to have benign disease. The systematic use of the triple test in solid breast lumps for the early detection of cancer is recommended as a routine procedure. However, participation of experienced radiologists and pathologists as well as physicians skilled in fine needle puncture is required.

Biopsy, Needle↗

Hormonal changes after supine posture, immersion, and swimming.

This study was undertaken to evaluate the effects of the supine posture, immersion, and swimming on hormones involved in the regulation of hydrosaline equilibrium. Plasma levels of atrial natriuretic peptide (ANP), arginine vasopressin (AVP), plasma renin activity (PRA), and aldosterone (ALDO) were measured by radioimmunoassay in eight untrained young subjects (five males and three females). Blood samples were collected on different days: control morning samples in a relaxed standing posture before each test; after 20 min in a supine position; after 20 min of horizontal immersion in water at 28 degrees C; after 20 min of backstroke swimming (speed about 1 m/s). No changes occurred in AVP levels after each test. ALDO and PRA increased significantly only after swimming and were directly correlated. ANP increased significantly after immersion, but no further increase was observed after swimming. The hematocrit, which increased after swimming, was inversely correlated with ANP levels in the post-exercise samples. These data show that while ALDO and PRA increase only in response to swimming, even at moderate intensity, ANP probably requires more prolonged and intense exercise to reach a significantly higher level than in immersion.

Adult↗

Anaerobic threshold in runners and cyclists.

Two different noninvasive procedures have been used to determine the anaerobic threshold (AT) in 15 long distance runners and in 6 cyclists. The AT values obtained by ventilatory methods (on treadmill for runners and on cycloergometer for cyclists) and the AT values obtained by a field test were significantly correlated.

Adult↗

Fine needle aspiration cytology in superficial lymph nodes: an analysis of 266 cases.

The results of fine needle aspiration cytology of superficial lymph nodes in 275 patients are discussed. Nine cases were lost to follow-up. Of the remaining 266 aspirates, 152 were classified as cytologically malignant, 79 as benign, three as suspicious for malignancy, and 32 as unsatisfactory owing to scanty cellularity. The sensitivity of cytology for metastatic cancer was 96.5%. The results of aspiration biopsy from lymphomas were less accurate (67.5% sensitivity). There were no false positives and nine (11.3%) false negatives. Open biopsy of three suspect lymph nodes proved them to be malignant. The aspiration procedure is easy, safe and reliable. The diagnosis of benignity cannot, however, be determined without an open biopsy, particularly for lymphomas.

Adolescent↗

Localized mastalgia as presenting symptom in breast cancer.

The importance of breast pain as a presenting symptom of breast cancer was assessed in 200 women with localized mastalgia but negative physical examination and in 478 women with operable breast cancer. In the first group, mammography detected five cases of subclinical breast cancer at the site of pain. In the second group, 86 patients (18%) reported localized pain as presenting symptom, followed, at different intervals, by the detection of a breast lump. Localized pain can be considered a presenting symptom of breast cancer thus requiring a careful physical and mammographic examination, especially when risk factors are associated.

Adult↗

Ultrastructural modifications of the platelet plasma membrane in vascular diseases and the effect of a carbochromen derivative as studied by freeze-fracture and computer measurement.

A high surface density of the openings of the surface connected canalicular system (SCCS) has been observed in the freeze-fractured plasma membrane of circulating platelets in rabbits fed an atherogenic diet and in hypercholesterolemic type IIa patients. In vitro tests have revealed a correlation between the increased surface density of the SCCS openings and the initial steps of platelet activation. 8-Chlorocarbochromen, a new drug which enhances the in vivo release of prostacyclin from the arterial wall, has been found to be effective in reducing the high surface density of SCCS openings in platelets of rabbits on an atherogenic diet. The present study shows that circulating platelets from patients with peripheral vascular disease present a high surface density of SCCS openings compared to that observed in control subjects. After a single oral administration of 8-chlorocarbochromen, a reduction of the high number of these openings has been observed. Likewise, beta-thromboglobulin levels were found to be high in the patients and to be significantly reduced after oral administration of the drug. This study shows ultrastructural modifications of platelets in conditions related to atherosclerosis and includes data on the effectiveness of 8-chlorocarbochromen in reducing the platelet activation of these patients.

Administration, Oral↗

Hormonal and metabolic effects following a football match.

Hormonal and metabolic parameters were studied for two teams after a football match. Blood samples were collected before the start, at half-time, at the end, and 45 and 90 min after the end of the game. In the first team, ACTH, cortisol, and lactate levels increased significantly during the whole match to resume basal levels in the fourth sample (45 min after the end of play). HGH, prolactin, and blood glucose were found to be increased only at half-time. The second team had an intense and long warm-up period before the match and the lactate concentrations were already elevated in the first sample. All the other parameters, except ACTH and glucose, displayed a pattern similar to that of the first team. The differences in the time courses of the hormonal and metabolic values are discussed.

Adrenocorticotropic Hormone↗

Androgen levels following a football match.

In 18 trained football players, blood samples were collected before a football match, at half-time, at the end, and 45 and 90 min after the end of the match. The testosterone (T) level showed a decrease in the rest period. Dihydrotestosterone (DHT) increased during the match, but returned to initial levels in the last samples. The T/DHT ratio decreased, reached the minimal value at the end of the exercise, and returned to basal levels in the rest period. Cortisol and androstenedione levels increased during the match, but returned to control levels 45 and 90 min after the end of the match, respectively. It is suggested that during this type of exercise anabolic and catabolic hormones may be simultaneously activated.

Adult↗

On the role of meteoritic impacts in the formation of organic molecules.

It is suggested that the UV radiation, and shock and plasma phenomena which accompanied the hypervelocity impacts of solid bodies (meteorites and comets) onto the surface of the young Earth may have contributed to the synthesis of prebiotic organic molecules in the primitive atmosphere in a larger amount than was thought previously. The mechanisms responsible for this synthesis are discussed using information obtained from recent experimental and theoretical work on macroscopic hypervelocity impacts.

Earth, Planet↗