[Leukemoid reaction in a case of severe acute alcoholic hepatitis].
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Biomedical subjects
Publications and source records attributed to G Natali.
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Cross-sectional studies of the lumbar spinal canal were performed by computerised tomography in asymptomatic subjects and in patients with myelographic and clinical findings suggestive of lumbar stenosis. In most cases stenosis was found to be developmental or combined in nature. Computerised tomography is a useful adjunct to myelography in the evaluation of lumbar stenosis as it enables an accurate assessment to be made of the type, degree and extent of narrowing of the vertebral canal.
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Visceral artery aneurysm account for up to 5-10% of overall artery aneurysm. Celiac artery aneurysm are reported in 4% of these patients. The most common etiologic findings are atherosclerosis and tunica media infective degeneration. The radiological imaging led to more accurate morphological and anatomical definitions of this pathology and improved elective and urgent surgical treatment of selected patients. The Authors report a case of celiac artery aneurysm.
In a group of 136 completely followed up patients with multiple myeloma, the prognostic significance of the immunological myeloma types, of 20 different single prognostic factors, of 15 clinical staging systems, and of 6 morphological classifications was retrospectively investigated by means of the calculation of mean survivals, survival curves, and responses to chemotherapy. A univariate analysis was employed in order to correlate each prognostic parameter at presentation with the survival in the whole group; a multivariate analysis according to the Cox's hazards regression model was used in order to select the most powerful prognostic variables. The patients were grouped according to the myeloma immunological types, to the mean value of each single prognostic factor, and to each stage of the clinical and morphological systems. Causes of death were also related to immunological multiple myeloma types. All single variables, except age and serum calcium, presented a significant relationship with the survival, even if at different significance levels. Cox's regression model selected among them, serum levels of beta 2-microglobulin, percentage of bone marrow plasma cells, hemoglobinemia, lytic bone lesions, and Bence-Jones proteinuria as the most significant factors related to survival. Each clinical and morphological staging system divided groups of patients with significant differences in mean survivals, or in survival curves, or in response to therapy. Multiple myeloma type IgA and micromolecular, with Bence-Jones proteinuria, and type lambda were associated with a poor prognosis, with low therapeutical response, and with the development of fatal renal failure. All these parameters, together with new prognostic factors, are useful in the prognostic evaluation, and, when applied in different steps of the diagnosis and the therapy, allow of studying the clinical course of multiple myeloma under different perspectives, in order to have a more complete picture of the disease and of the single patient.
After a short clinical classification of the various open-bite types, the Authors describe from the clinical and cephalometric point of view the main structural alterations responsible for the skeletal open-bite. Then they consider the orthodontic problems in the orthodontic surgical treatment of the skeletal open-bite. Finally they describe the combined orthodontic surgical treatment in two anterior skeletal open-bite clinical cases.
The prognostic value of the multiple myeloma (MM) immunological type, of 20 different single prognostic variables, of 11 clinical staging systems, and of 6 morphological classification systems was evaluated in 121 patients (71 males and 50 females, 75 MM IgG, 26 MM IgA, and 20 MM micromolecular), who were followed from diagnosis to demise. The values of the prognostic variables related to diagnosis were correlated with survival by means of univariate analysis; multivariate analysis according to Cox's model was employed to select highly-significant parameters correlated with survival among these variables. Every patient was retrospectively staged according to each clinical and morphological system. Mean survivals were computed for each group on the basis of immunological type, mean value of each prognostic factor, clinical and morphological stage. Survival curves were computed and compared. All prognostic parameters showed a significant relationship with survival, even though p-value differed. Multivariate analysis according to Cox's model has indicated the following variables as significantly correlated with survival: bone marrow plasma cell percentage, degree of lytic bone lesions, hemoglobinemia value, and serum levels of beta 2-microglobulin. Each clinical and morphological staging system, as well as immunological types and mean value of single prognostic parameters, have divided patients into separate groups with significant differences in mean survival and in survival curves. All of these factors could be taken into account for correct prognostic evaluation, and, if they were applied in different steps of diagnosis and therapy, it would be possible to study the MM patient under different perspectives, in order to have a more complete picture of the disease and of the patient.
Six voluntary, clinically healthy, non-smoking, male subjects were studied to estimate and eventually quantify the role of the circadian rhythm of atrial natriuretic peptide and of the renin-aldosterone system in the conditioning and genesis of the circadian rhythm of arterial blood pressure. After a week of standard life condition, during the span of a day, with the subjects in constant supine position, venous blood samples were drawn every four hours, while arterial blood pressure was measured every two hours. Plasma levels of atrial natriuretic peptide, renin activity, and aldosterone were determined by radioimmunoassay. The time-related values of each variable were analysed by the "cosinor" method. The cosinor analysis shows a statistically significant (p less than 0.05) circadian rhythm for all variables studied. These data suggest an inverse relationship between the circadian rhythm of atrial natriuretic peptide and that of arterial blood pressure, with a chronological sequence in the atrial natriuretic peptide-plasma renin activity-aldosterone axis.
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