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Biomedical subjects

L Barletta

Publications and source records attributed to L Barletta.

At least 19 recordsLinked to original sources

[Encephalitis lethargica].

We report the case of a 34-year old patient who first complained of fever, confusion and transient ophthalmoplegia and then developed akinetic mutism, frontal lobe, pyramidal tract and extrapyramidal signs. Clinical and electrophysiological data support a diagnosis of encephalitis lethargica. Magnetic resonance imaging showed hyperintensive lesions in various brain regions. The patient responded to corticosteroid treatment. Two years after the onset of the first clinical signs he had recovered completely and today, after 5 years, he shows no sign of disease.

Adult

Molded arthroplasty and transfer of the extensor hallucis brevis tendon. A modification of the Keller-Lelievre operation.

The Keller-Lelievre technique for hallux valgus correction was modified by detaching the extensor hallucis brevis tendon from the proximal phalanx, and reattaching it on the medial sesamoid. Thirty-five consecutive patients were assigned randomly to 1 of 2 groups. Patients in Group 1 received the modified operation, and the original Keller-Lelievre technique was used for the control group. The only significant radiographic difference at 6 months was the distance between the first and the fifth metatarsal heads. There were only slightly significant differences in function and in pain relief between the 2 groups at the 6th postoperative month. At 3 years, these differences were greater, with the group treated by the modification described herein, retaining significant correction and showing better functional results.

Aged

Myelin basic protein purification in non denaturing conditions.

The utilization of denaturing methods for protein purification causes the irreversible loss of quaternary and tertiary structure together with consistent changes in the secondary structure. These modifications reflect on protein antigenicity. MBP is a myelin protein which is bound to membrane-phospholipids. Its tertiary structure is specific for this kind of interaction which determines its native conformation. MBP was obtained in two forms: denatured and non denatured. The latter has been purified using the non-ionic detergent beta-octil-D-glucopyranoside which is able to preserve protein tertiary structure separating it from the bilayer phospholipids. Non denaturated MBP could be useful in antibody and/or lymphocyte activity detection studies in various human pathological processes.

Animals

A case of parietal atrophy: etiopathogenetic evaluation.

We report on the case of a patient presenting a muscle atrophy of the right hand and a left parietal neoplastic lesion rapidly progressing. EMG findings showed no signs of denervation nor sensory-motor conduction impairments. Parietal lesions might interrupt sensory control mechanisms of motor activity.

Brain Neoplasms

Risk of invasive cancer in women with lobular carcinoma in situ of the breast.

100 women underwent wide resection for palpable or mammographically detected breast lesions (1 woman had bilateral lesions). Histology excluded invasive cancer, but one or more foci of lobular carcinoma in situ (LCIS) were observed. There have been no recurrences in the 20 women who underwent total mastectomy. In the 12 patients who had a subsequent wide excision and the 68 who received no other treatment 5 presented with an invasive cancer in the same breast at some distance from the LCIS site (median follow-up 58 months). The (observed/expected) rate per 1000 per year is 10.3 for an untreated LCIS. LCIS is therefore a risk factor for invasive carcinoma. Nevertheless this risk does not indicate the use of mutilating procedures and a wait-and-see policy is appropriate.

Adult

A clinical study on the use of codeine, oxycodone, dextropropoxyphene, buprenorphine, and pentazocine in cancer pain.

The authors report a prospective study on 944 cancer pain patients treated with one of the following opioids: codeine, oxycodone, dextropropoxyphene, buprenorphine, and pentazocine. Level of analgesia, duration of treatment, side effects, and drop out were evaluated for each drug. Twenty-four percent of the patients still benefitted from treatment at the fourth week of study, even if high drug dosages were not used. Pentazocine did not show an evident analgesic effect during the first 2 wk of treatment. The other opioids were found to be valid therapeutic instruments for chronic cancer pain control in a limited number of patients.

Adult

Use of monoclonal antibody MBr1 to detect micrometastases in bone marrow specimens of breast cancer patients.

Bone marrow specimens obtained from 121 breast cancer patients immediately after surgery were examined by an immunofluorescence method with monoclonal antibody MBr1 to detect tumour cells undetectable by other diagnostic procedures. 80 women were node-negative and 41 node-positive. In no case could conventional histology demonstrate tumour cells, whereas MBr1 was positive in 20 (16.5%) of the 121 cases. No difference was observed in MBr1 positivity between node-negative and node-positive cases (17% vs. 15%). With regard to clinical outcome (median follow-up 48 months) 27 women relapsed, including 6 of 20 MBr1-positive and 24 of 101 MBr1-negative patients. First distant metastases or death from progression of disease were taken as end-points. Multivariate analysis showed that the additional contribution of MBr1 positivity, after making allowance for other prognostic factors, was negligible.

Adult

Pain treatment in cancer of the pancreas.

Pancreatic cancer remains an important cause of suffering among oncologic patients. Due to the current poor response to specific therapies, a palliative approach represents the main treatment for this kind of tumour. The authors present the results of a prospective study performed on 41 patients treated according to the World Health Organization guidelines for cancer pain relief; 21 of them were treated by neurolytic coeliac blockade as well. Results, even if not comparable between the two groups, show that this neurolytic technique can play an important role in palliative treatment, on condition that it is part of a multimodal continuing care system.

Adult

Clinical observations on controlled-release morphine in cancer pain.

The authors report the data from two studies on the use of controlled-release morphine sulphate tablets for cancer pain relief. This preparation allows just two administrations per day, in comparison with immediate release oral aqueous morphine solution. The first study, a randomized trial carried out on 70 patients suffering from advanced cancer pain, evaluated the analgesic efficacy and side effects of this drug. The second, an open study of 113 patients, assessed analgesic efficacy, incidence of side effects, and the effects of age on dose. The analgesia provided by controlled-release morphine administration proved to be superimposable to those of the oral aqueous morphine solution. Moreover, the use of controlled-release morphine was associated with a statistically significant reduction of some side effects. Ninety-one percent of patients needed controlled-release morphine every 12 hr, while 9% required it every 8 hr.

Adolescent

Psychological aspects of testis cancer therapy: a prospective study.

We examined the impact of testis cancer and its curative therapies on the outlook of life, working activity, partner relationship and sexual function in 31 consecutive patients 18 to 51 years old (mean age 29.3 years, median 28 years) who already had undergone orchiectomy. Of the patients 13 subsequently were treated with chemotherapy alone, 6 with retroperitoneal lymph node dissection alone, and 7 with chemotherapy and an operation, while 5 seminoma patients were treated with radiotherapy. The patients were examined 3, 6 and 18 months after orchiectomy. Each patient was required to fill out a questionnaire to gather information relative to their work activities, emotional relationship with the partner and sexual life. The patients also completed an assessment form on the quality of life (Spitzer QL-Index) and a series of horizontal analogues to evaluate anxiety, mood, nausea, weakness and general health status. The statistical analysis of the linear and quadratic components for the variables under study was done with the general linear model for block design. Psychosocial adaptability of these patients, regardless of the treatment they underwent, in time became progressively less problematic and the development of psychosocial problems during the long-term adjustment was low. Only 2 patients reported worsening of the emotional relationship with the partner after treatment: 1 underwent chemotherapy and an operation, and 1 underwent radiotherapy. With regard to sexual life, no serious dysfunction was noted apart from the loss of ejaculation in 11 of 13 patients who underwent retroperitoneal lymph node dissection. Of our sample patients who had lost ejaculation only 2 suffered from a high state of anxiety. The anxiety scores on the last completed linear analogue were 2.6 and 4.1, whereas at the same time the mood scores were 1.9 and 4.4. Therefore, it is important for the clinician to assess the psychogenic aspect of this side effect when this type of operation is proposed.

Adaptation, Psychological

Osteogenic sarcoma arising in an old burn scar.

An osteogenic sarcoma arising in an old burn scar on the right thigh of a 70-year-old woman is described. Salient features of this rare cutaneous tumor were: a large pinkish exophytic mass, spindle and oval cells, multiple foci or osteoid formation, atypical osteoblasts and multinucleated giant cells.

Aged