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Biomedical subjects

G Pisani

Publications and source records attributed to G Pisani.

At least 19 recordsLinked to original sources
PubMed1998

[Psychosexual problems in menopause].

BACKGROUND: A case-control study about the evaluation of sexual disturbances during menopause considering the ways in which these are caused by neuro-endocrine disequilibrium, or by a psycho-social crisis during menopause. In addition, there is an evaluation of the efficacy of hormonal replacement therapy on sexual disturbances. METHODS: Two groups of 44 menopausal women. The first group was transdermically treated with 50 micrograms/day of estradiol for three weeks in a one month period with the association of MAP 10 mg administered orally for 10 days. The other group received a placebo. Both groups were studied for a period of six months with quarterly check-ups. We have identified the crucial symptoms using a series of interviews which consisted of questions regarding the classic symptoms of menopause. The intensity of such symptoms was classified on a five point scale. Specific questions were asked regarding the frequency of sexual intercourses and the presence and intensity of sexual desire. The same questions were consecutively asked to the subjects at three month intervals. RESULTS: The presence of crucial symptoms was distributed as follows: hot flashes and perspiration in 65%, anxiety in 60%, symptoms of depression in 50%, paraesthesia and asthenia in 40%, insomnia in 35%, varying degrees of memory loss in 30%, vaginal dryness and dyspareunia in 15% of the subjects in both groups (control and sperimental). Sexual desire was diminished or very diminished in 48%, unchanged in 31% and increased in 11.5%. The frequency of sexual intercourse was diminished or very diminished in 56.5%, unchanged in 25% and absent in 18.5%. For the vasomotor disorders, patients participating in the first group demonstrated only a slight persistence in 15% by the end of six cycles. Similar results were found with symptoms of insomnia. Only 10% of the patients mentioned slight symptoms of anxiety or depression. All of the patients with vaginal dryness and dyspareunia showed a total remission of the symptoms. Subjects participating in the control group noted a slight increase in vasomotor disturbances, while psychological symptoms decreased slightly. Vaginal dryness and dyspareunia remained unchanged. At the end of treatment, only a modest percentage of the subjects, from both groups, mentioned an increase in the frequency of sexual desire and intercourse. CONCLUSIONS: These results shows that the lack of estradiol is not the most important factor in deciding sexual behavior. Also, for the group of patients complaining symptoms connected to vaginal atrophy, only a small increase in sexual interest and practice was verified once the normal trophism of tissue was reestablished. The same data obtained from the control group is probably a result of a certain mental condition caused by the "pharmacological effect".

Adult↗
PubMed1997

[Proposed medical record to be used in rape cases. New diagnostic and medicolegal aspects].

The latest report of 1996 on human development in the UN development programme (UNDP) states that 130,000 women are raped every year in the industrialized countries. Illegal "violation" is defined as the sexual penetration of any orifice of the body without the victim's consent. The doctor's contribution is essential in order to ascertain this offence. It can be divided into two stages: precise and complete (... missing? ...) information regarding the sexual aggression which might have taken the form of rape. Management of a rape case represents an extremely complex undertaking for the doctor since it involves medical and legal aspects and requires a number of interventions that lead to a rational evaluation and appropriate treatment. In this context, the doctor's role is not only to protect the psychophysical integrity of the victim, but also to contribute, following an early diagnosis of sexual aggression, to the identification of the particulars of an offence which still risks remaining unpunished, owing to the difficulty of diagnosis and in spite of the recent enactment of Law no. 66 on 15 February 1996. The medical record proposed by the authors consists of a descriptive anamnestic part and a graphic part, thus making the evaluation of the victim more rapid and precise. The proposed medical record is subdivided into anamnesis, objective examination, psychological examination, laboratory tests, any consultancy requested and therapy.

Female↗
PubMed1996

Rat model of mild stenosis of the common bile duct.

Several techniques for developing incomplete obstruction of the common bile duct have been described but none of them properly represents a compression or constriction of the bile duct. In this study, a mild stenosis of the common bile duct was achieved in the rat by means of a double ligature including a cannula that could be easily slipped out of the ligatures. Sham-operated rats were used as controls. The studies, performed 7-10 days postoperatively, indicated that in ligated rats a duct constriction was produced, made evident by an increase of the biliary pressure, an upstream dilatation of the bile duct, an increase of the liver volume constituted by portal tracts, and ductular proliferation. Serum parameters were practically similar in ligated and control rats, except for a slight increase in serum bilirubin. Following intravenous injection of sodium taurocholate there were rapid increases of bile flow and bile salt output in both groups, but choleresis induced by sodium taurocholate was higher in ligated rats than in controls. The clearances of [14C]erythritol and [14C]sucrose suggested that ductular water contributing to bile flow and changes in biliary permeability were not involved in ligated rats. The limited repercussion of humoral effects and hepatic behaviour seen in ligated rats despite the morphological alterations induced make the mild stenosis of the bile duct a good model for the study of early stages of compression or constriction of the biliary tract.

Animals↗
PubMed1996

Chronic laxity of the subtalar joint.

Chronic laxity of the subtalar joint derives from the functional significance of the joint with the talo-calcaneal interosseous ligament as the articular "pivot." The laxity of the subtalar joint is usually associated with traumatic or degenerative pathology of the interosseus ligament. The characteristic pain is present along the sinus tarsi and at times also more proximally along the posterior subtalar joint. Radiographic examination is not significant; however, with arthrography, the normal synovial recess of the posterior subtalar joint corresponding to the sinus tarsi is not visualized. With magnetic resonance imaging it has been possible to document structural alterations of ligament. Reconstruction of the interosseus talo-calcaneal ligament has a reasonable expectation of success. The author presents the results of this treatment in 47 operations (44 patients, 3 bilateral) between January 1982 and June 1992.

Adolescent↗
PubMed1996

Rapidly progressive squamous cell carcinoma of the cervix in a patient with acquired immunodeficiency syndrome: case report.

Recent evidence suggests an association between cervical condyloma, dysplasia and HIV infection. However, the course of cervical cancer in immunodeficient patients has not yet been thoroughly researched. Cervical cancer presently amounts to 1% of the causes of death in AIDS patients. This percentage is bound to increase not only because an improved life expectancy has been obtained, but mainly because the virus is widely spreading among the female population. A 28 year-old AIDS patient, parity 1/0/1/1, underwent gynecological examination and colposcopy following an episode of vaginal bleeding. Biopsy revealed an invasive cervical carcinoma. The last gynecologic investigation, which included a Pap smear and colposcopy, was performed 14 months earlier and resulted negative. Cytologic reexamination of the specimen confirmed the previous Pap smear result. Proctoscopy and cystoscopy showed no mucose involvement. Urography was negative. The cat scan indicated minor spleen and liver enlargement but no signs of malignant abdominal spread were found. The neoplasia was classified as a stage IIB cervical carcinoma (according to the FIGO classification) due to the spread to the left cardinal ligament. In spite of radiation therapy, the disease rapidly progressed leading to a monolateral ureteral involvement which created a juxtavescical stenosis. The patient died three months later. Necroscopic examination revealed lung metastasis. Such a rapidly progressive form of cervical cancer could be related to the acquired immunodeficiency condition. Recurrent cytological and colposcopic examinations are to be considered mandatory in HIV patients.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Hysteroscopic features in postmenopausal uterine bleeding].

One hundred forty three patients underwent hysteroscopy for abnormal uterine bleeding from January 1993 through December 1994. Sixty patients were postmenopausal. All but 3 of the procedures were performed on outpatient with no significant complications. Three groups could be identified on the basis of endometrial features (color, vascularity, thickness, necrotic areas): 1) negative for cancer, 2) possible or suspect (low or high risk), 3) carcinoma. Biopsy indicated cancer in one of the 16 doubtful cases, and in all (5) of the hysteroscopically diagnosed cancers. Outpatient Hysteroscopy successfully substitutes D&C (dilatation and curettage) for early diagnosis of endometrial cancer.

Adult↗
PubMed1995

Recombinant expression of hepatitis A virus protein 3A: interaction with membranes.

The function of hepatitis A virus (HAV) protein 3A and its structural requirements were studied in vitro and in a bacterial expression system by comparing the polypeptide precursor 3AB derived from a cytopathogenic strain with that of an attenuated strain. Although the precursor polypeptides 3AB of both HAV strains bind to microsomal membranes after translation in vitro they differ in inducing membrane permeability when expression is induced in bacteria. Intake and release of macromolecules was dramatically increased when 3AB of the cytopathogenic strain was expressed. Amino acid sequence alignments suggest that membrane binding might be due to a hydrophobic stretch near the C-terminus of 3A found in all picornaviruses whereas the ability to induce permeability of E. coli membranes is determined by an amphipathic helix formed at the N-terminus of 3A of HAVFG.

Amino Acid Sequence↗
PubMed1995

Complete nucleotide sequence of a cytopathic hepatitis A virus strain isolated in Italy.

The molecular basis of the cytopathic effect induced in cell culture by some hepatitis A virus (HAV) strains and variants has not been determined. In order to assess the molecular mechanism(s) underlying this particular phenotype the genome of an Italian cytopathic isolate (strain FG) was sequenced from cDNAs obtained by RT-PCR. Sequence analysis revealed the presence of mutations common to either adapted or cytopathic variants of HAV. In particular, amino acid deletions in proteins VP1 and 3A were detected. Expression of protein 3A in E. coli showed that the N-terminal deletion renders this protein toxic to bacteria.

Amino Acid Sequence↗
PubMed1993

Hepatitis A virus identification in an outbreak by enzymatic amplification.

From April 28th to May 22nd, 1987, the Medical Authority identified 13 cases (6 symptomatic cases) of hepatitis A (HA) in a school and in a college of Rome. The principal risk factor was determined to be "full-time presence at the State school and boarders at the college". The distribution of HA cases suggested a person to person contact; anti-hepatitis A virus IgM were identified in 12 out of 13 cases with high levels of transaminases. During the disease epidemic, water samples were taken from the well of the college for bacteriological and virological analyses. The water was classified as undrinkable due to the presence of 16 total coliforms/100 ml and 35 total bacteria count at 36 degrees C. Fecal coliforms, fecal streptococci and sulfite reducing clostridia were absent. Two water samples of 100 liters were collected and concentrated by adsorption-elution method on electropositive membranes or by ultrafiltration using a Millipore apparatus. Infectious Hepatitis A virus was only isolated from samples concentrated by adsorption-elution method on electropositive membranes using tissue culture methods and subsequently HA virus was identified by other traditional methods (Elisa and immunofluorescence). In contrast, PCR test performed on the concentrated samples, was positive only for the ultraconcentrated sample. The positivity of the PCR test confirmed the presence of the Hepatitis A virus in the well water.

Adult↗
PubMed1993

Mutations in the 3A genomic region of two cytopathic strains of hepatitis A virus isolated in Italy.

Two strains of hepatitis A virus (HAV) were isolated in cell culture and found to induce a cytopathic effect at early passages. The nucleotide sequences of the 5' non-translated region (5'NTR) and of genes 2B, 2C, 3A and 3B were determined for these strains and found to contain mutations similar to those detected in cell-culture adapted variants of HAV strain HM175. In addition, gene 3A shows a deletion of three aspartic acid residues near the N-terminus of the polypeptide. In combination with variations in the 5'NTR and in genes 2B and 2C, the absence of an aspartic acid residue in position 4 of gene 3A of three cytopathic clones of HM175 suggests a possible role of the 3A protein in determining the cytopathic phenotype.

Aspartic Acid↗
PubMed1991

Bladder training in older women with urinary incontinence: relationship between outcome and changes in urodynamic observations.

The purpose of this study was to clarify the mechanism by which bladder training affects urinary incontinence. Urodynamic data and specific urodynamic diagnoses of 108 women with urinary incontinence were compared before and 6 months after treatment with bladder training. Before treatment, 76 women had sphincteric incompetence, 11 had detrusor instability, and 16 had both. After treatment, 33 women no longer fulfilled the urodynamic diagnostic criteria for either sphincter or detrusor dysfunction. Controlling for severity before treatment, the number of incontinent episodes post-treatment was not associated with change in urodynamic diagnosis. Only the first sensation to void, voided volume, compliance, functional urethral length, and flow time showed any significant changes between pre- and post-treatment evaluations; however, none were correlated with change in the number of incontinent episodes. Bladder training does not appear to affect lower tract urodynamic variables or specific urodynamic diagnosis, and it is likely that its mechanism of action reflects adaptive behavioral changes. Physiologic changes not detected with techniques and/or criteria used in this study may still occur.

Aged↗