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Biomedical subjects

G Villa

Publications and source records attributed to G Villa.

At least 19 recordsLinked to original sources

Pharmacokinetics of nicorandil in patients with normal and impaired renal function.

The pharmacokinetics of oral nicorandil 20 mg 12 hourly for 9 doses was evaluated in 21 hospitalized patients with angina pectoris due to coronary heart disease and with normal and impaired renal function. Patients were divided into 3 groups based on creatinine clearance (CLCr): GROUP I (n = 6) greater than 80 ml/min, GROUP II (n = 8) 20-80 ml/min, and GROUP III (n = 7) less than 20 ml/min. After the first dose, the total clearance of nicorandil (CL) value did not change with increasing renal failure and so was not dependent on creatine clearance. After the last dose CL was 51 l.h-1 in Group I, 44 l.h-1 in Group II and 56 l.h-1 in Group III, and it was not related to creatinine clearance. The percentage of the dose excreted in the urine was 0.4%. No significant difference was noted in any of the other pharmacokinetic parameters examined in the three groups, not even on comparing values obtained on the first and last days of treatment. The findings suggest that there is no need to change the dose of nicorandil in subjects with different degrees of renal failure.

Administration, Oral

Myometrial invasion by endometrial carcinoma: assessment with plain and gadolinium-enhanced MR imaging.

A prospective study was designed to determine the sensitivity and specificity of nonenhanced T2-weighted and contrast material-enhanced T1-weighted magnetic resonance (MR) imaging in assessing the depth of myometrial invasion in patients with proved endometrial cancer. In 56 consecutive patients with clinically determined early-stage disease, findings of the two MR imaging techniques were compared with results of histologic examination of surgical specimens. Myometrial invasion was classified as absent (stage IA), superficial (stage IB), or deep (stage IC). In the assessment of each tumor stage, the sensitivity and specificity of contrast-enhanced T1-weighted MR imaging were higher than those of non-enhanced T2-weighted MR imaging. In determining the degree of myometrial tumor invasion, the overall sensitivity of enhanced T1-weighted MR imaging was 87.5%, whereas that of nonenhanced T2-weighted MR imaging was 71.4% (P less than .05). The use of contrast material may improve the ability to assess, with MR imaging, the depth of myometrial invasion by endometrial cancer.

Adult

Recombinant human erythropoietin reduces free erythrocyte protoporphyrin levels in patients on chronic dialysis.

We studied the significance of free erythrocyte protoporphyrin (FEP) in relation to iron status, aluminum levels and anemia in uremic patients on chronic dialysis. All but 1 patient showed high FEP values closely related to the degree of anemia. Increased FEP levels are due to a defective heme synthesis, not related to iron deficiency or aluminum overload. Treatment of anemia with recombinant human erythropoietin reduced FEP values. We therefore hypothesize that recombinant human erythropoietin ameliorates an enzymatic defect in heme synthesis.

Aluminum

High prevalence of antibodies to hepatitis C virus in hemodialysis units using a second generation assay.

We studied the prevalence and significance of antibodies to hepatitis C virus (HCV) in patients and staff from 3 dialysis units, using a 2nd generation assay (2nd g.a.; Ortho HCV). Of 277 patients, 151 (55%) were positive by 2nd and 85 (31%) by 1st g.a. Significant associations with the anti-HCV carrier status were: blood transfusions, retrospective finding of elevated ALT and duration of dialysis treatment, independently of transfusions. Of the 74 staff members, 5 were positive by 2nd and 3 by 1st g.a. Our data suggest that the 2nd g.a. is more sensitive in detecting HCV exposure in dialysis units and that duration of dialysis is a significant factor in acquiring HCV infection.

Ambulatory Care Facilities

[The role of nuclear medicine in renovascular pathology of urologic significance].

The diagnostic contribution of the radiological techniques (intravenous urography, angiography, sonography, computer tomography) is well-known. On the contrary, in this field, the possibilities of the Nuclear Medicine are underestimated. Radiological methods have high detail recognition but are only suitable for assessing the functional significance of morphological changes in a restricted sense; in the last 25 years, nuclear medical renal diagnosis has achieved a differentiated development stage which permits new qualitative and quantitative tests. The radioisotopic methods offer morphological informations which surely are less exact than those given by radiological techniques, on the other hand they add irreplaceable parameters of functional significance; these parameters concern the perfusion and the accumulation and excretion constants of selected areas of interest in renal districts. This is made possible by a wide choice of radiopharmaceuticals, having a different dynamic pattern and biodistribution. The Authors consider scintigraphic imaging of different renal pathologies: trauma, characterized by hypoperfusion; hematoma and/or urinoma; pseudotumor and carcinoma. Nuclear medical techniques allow in nearly all the cases a rapid and exact diagnostic guidance. The AA. emphasize the absence of invasiveness, the simplicity and the good compliance of these methods in all patients, even if seriously ill, and the usefulness in follow-up and diagnosis of several pathological conditions. Finally, they underline the absence of an appreciable radiobiological hazard.

Diagnosis, Differential

[Use of 99mTc-HMPAO SPECT in the study of AIDS-correlated dementia].

AIDS dementia complex is a well-defined neurological manifestation of the HIV infection. Its anatomo-pathological pattern is cerebral atrophy, grey and white matter abnormalities and vascular changes, and the main symptom is progressive dementia. SPECT with Tc 99m HMPAO has proved to be an useful tool in studying Alzheimer and multi-infarct dementia, and its use has been recently proposed in AIDS-dementia. We studied with Tc 99m HMPAO 57 Pts (11 HIV+, 26 ARC, 17 AIDS) and control group of 7 drug-addicted seronegative Pts. We found positive results in 45% SPECT, 18% CT, 0% neurological tests of dementia in HIV+ phase, versus 52%, 41, 20% in ARC phase and 94%, 88% and 76% in AIDS phase, while all control Pts were negative. Control group is too small to exclude with all possibility of doubt cerebral blood flow impairment caused by drug damage but nevertheless we think that SPECT examination with 99 mTc HMPAO has an important role in assessing CBF changes in earlier stages of AIDS disease. These changes are probably forerunners of definitive cerebral damage and may be important markers of the advancement of disease.

AIDS Dementia Complex

[Accuracy of magnetic resonance (0.5 T) in traumatic lesions of the knee. Controlled 87 cases].

In this study the authors investigated the diagnostic accuracy of Magnetic Resonance (MR) imaging as a method to recognise traumatic disorders of the knee; in particular its capability to identify meniscal and cruciate ligaments tears was examined. The results have been compared with those from arthroscopy and/or surgery, which were considered the gold standard of the study. Eighty-seven consecutive patients with suspected traumatic injury of the knee were prospectively studied. All patients underwent MR examination (0.5 Tesla magnet, gradient echo sequences, slices thickness = 5 mm) and, within 15 days/1 month, arthroscopy or surgery. The high diagnostic accuracy (internal meniscus = 87.5%; external meniscus = 88.5%; anterior cruciate ligament = 93.1%; posterior cruciate ligament = 96.5%) has confirmed the good diagnostic capabilities of MR in assessing traumatic lesions of the knee.

Arthroscopy

Abnormal alanine aminotransferase activity reflects exposure to hepatitis C virus in haemodialysis patients.

Prospective studies have shown that the annual incidence of non-A, non-B (NANB) hepatitis may be high in haemodialysis patients. To assess whether hepatitis C virus (HCV), the major causative agent of post-transfusion and community-acquired NANB hepatitis, has a role in the pathogenesis of liver disease in dialysed patients, we have studied the prevalence and significance of antibodies to HCV in a cohort of patients with end-stage renal disease on chronic haemodialysis treatment. Seventy-four (30%) had circulating antibodies to HCV. Statistically significant associations with the anti-HCV carrier status were duration of haemodialysis treatment, blood transfusions, and the finding of abnormally elevated ALT on retrospective analysis. In contrast, only one of 103 dialysis staff members showed transient positivity for anti-HCV, suggesting a low risk of professional exposure to HCV. These findings suggests that HCV infection is relatively frequent in haemodialysis patients and may be responsible for a significant proportion of liver disease in this clinical setting.

Adolescent

[Hormone profile of hypothyroidism in an area of the Central African Republic with endemic goiter].

In the Ouham region of Centro African Republic, one of the present Authors (B.P.) described a severe goiter endemia due to marked iodine deficiency and high daily intake of manioc as staple food. In the present study serum TSH, T3 and T4 of 233 subjects were determined; 150 of them lived in rural villages (Group 1) and 83 lived in Bocaranga, chief town of the province (Group 2). The blood samples done contemporaneously to the epidemiological survey, were strictly randomized in the population examined. The subjects of each group were divided in 4 sub-groups: A) with TSH, T3 and T4 in normal range; B) with elevated TSH; C) with elevated TSH and sub-normal T4; D) with elevated TSH and sub-normal T3 and T4. An apparently euthyroid pattern of TSH, T3 and T4 was evident in only 60 subjects (19.3% from group 1; 37.35% from group 2); the remaining 173 (80.67% from group 1; 62.65% from group 2) were hypothyroid (subclinical in the sub-group B; mild in the sub-group C; overt in the sub-group D). The mean hormonal values of the apparently euthyroid subjects (sub-group A) in the villages and in the chief town, were significantly different (p less than 0.05) from the control values of our laboratory. More significant differences were clearly evident between the control values and the mean values of sub-groups B, C and D in each of the two groups (1 villages; 2 chief town).(ABSTRACT TRUNCATED AT 250 WORDS)

Central African Republic

[Thyroid hormone profiles in goitrous and non-goitrous subjects seen in an endemic goiter area of the Central African Republic].

In the present study T3, T4, TSH serum concentrations were measured in 166 subjects whose goiter grading was ascertained according to WHO classification; 39 of them had no goiter (grading 0), 127 were goitrous with a grading comprised between 1a and 4. The two samples were composed by Males and Females of various ages whose choice was strictly predetermined by random numbers. The median ages of 127 goitrous and 39 non goitrous subjects were respectively 23.5 years and 33.5 years; 30 Males and 5 Females were in the first group; 58 Males and 69 Females in the second. They lived in the Ouham region of Centro African Republic where some of the Authors ascertained a severe goiter endemia due to iodine deficiency and manioc consumption as staple food. All the values of T4 and TSH of the two group of subjects, were significantly different from the control values (p less than 0.01) excepting T3. Goitrous subjects had T4 value lower than non goitrous subjects (p less than 0.05). The subjects of each group were distributed in the four subsequent subgroups: A) with T3, T4, TSH in the normal range; B) with elevated TSH and T3 and T4 in normal range; C) with elevated TSH, subnormal T4, and T3 in normal range; D) with elevated TSH and subnormal T3 and T4. From fig. 1 it can be seen that the 79.5% of goitrous subjects had a supranormal TSH (subgroups B + C + D) and 40.7% of them had a subnormal T4 (subgroups C + D).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent