Biomedical subjects
Publications and source records attributed to L Frigerio.
A classification of stress incontinence is described. The stress test makes it possible to diagnose sphinctero-urethral incompetence and to identify the cases that are objectively negligible. Thus, surgical treatment can be limited to those who require it.
The data presently reported show that repeated exposure of rats to allyl alcohol, ethionine or alpha-naphthyl isothiocyanate (ANIT) impaired some plasmatic parameters mainly by means of different mechanisms which involve the liver function. In particular, four administrations of allyl alcohol, given every other day, increased glutamate oxaloacetate transaminase (GOT) for at least 48 hours from the last dose; ethionine reduced the bromsulphthalein (BSP) clearance even after 48 hours from the 1st, 2nd, or 3rd administration given on the 1st, 5th, or 12th day; ANIT, administered daily for seven days, increased glutamate pyruvate transaminase (GPT), alkaline phosphatase (AP), bilirubin, triglycerides (TG) and cholesterol (CH) while it decreased the body-weight and retarded growth for at least six to seven days after intoxication. Twice daily administrations of dihydroxy-dibutylether (DHBE), a strong choleretic agent, brought to normality the parameters impaired by the three hepatointoxicating agents even when the intoxication was already established. In fact, DHBE reduced the plasma GOT levels increased by allyl alcohol, improved the BSP clearance impaired by ethionine and tended to normalize the parameters modified by ANIT by lowering GPT, AP, CH, TG and bilirubin plasma levels and by enhancing body growth. The curative activity of DHBE does not seem to be related only to a membrane stabilizing action since silymarin, a known cell membrane stabilizer, does not significantly influence the parameters described above in all the experimental conditions. Even the choleretic activity of DHBE alone might not be sufficient to explain its hepatoprotective action since fenipentol (a known choleretic agent) is inactive at least after ANIT intoxication.
LR 19731 [4-p-chlorophenyl-5-beta-(N'-phenyl)piperazinoethyl-1,3-dioxolin-2-one] lowers the plasma cholesterol and triglyceride levels of rats in several experimental conditions after single or repeated treatments, while it is scarcely active on liver lipids. The compound is especially effective in reducing plasma cholesterol in a dose-related manner both in normolipemic and hyperlipemic rats. The minimal effective dose (after five oral treatments in 4 days to normolipemic rats) is as low as 3 mg/kg, the ED50 is 11.3 mg/kg, while the maximal effective dose capable of completely suppressing plasma cholesterol is 100 mg/kg. Surgical removal of the thyroid gland does not influence its activity. At its ED50 the compound does not cause hepatomegaly, accumulation of desmosterol in plasma and liver. Under the same experimental conditions clofibrate presents a poor dose-response correlation on plasma lipids and generally appears at least 10 times less active than LR 19731 on cholesterol but more effective on liver weight. The experiments of general pharmacology indicate that LR 19731 does not effect central and peripheral nervous functions, does not influence the cardiovascular system or cause skeletal muscle relaxation, hypothermia, analgesia, and does not possess anti-inflammatory properties up to a dose of about 100 mg/kg.
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One hundred twelve cases of female urinary incontinence were studied. The bladder was stable in 53 patients and detrusor instability was detection in 59 of the incontinent women. Cystometry performed in the supine position cannot be relied upon to be sufficiently useful in the complete evaluation of various forms of instability. Involuntary detrusor contractions occurring during one or more provocative tests represent an abnormal bladder behavior pattern. An isometric contraction develops when the stream is interrupted and stable incontinent women show only a small isometric rise in 35 cases (66%). Fifty-six patients with unstable bladders presented a large isometric detrusor contraction (95%). Urodynamic studies combined with voiding stop tests can increase the clinical information of female urinary incontinence.
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BACKGROUND: We investigated the effect of iodinated contrast medium concentration on increased neoplastic lesion enhancement and its direct relation to diagnostic efficacy in biphasic spiral computed tomography for detection of hepatocellular carcinoma. METHODS: A pilot, single-center, randomized, double-blind, crossover, comparative study was performed and included 22 participants. Each patient underwent two separate biphasic contrast-enhanced spiral computed tomographic examinations. Scans were performed with iomeprol containing 400 (iomeprol 400) or 300 (iomeprol 300) mg of iodine per milliliter (Iomeron, Bracco Imaging SpA, Milan, Italy) with a 2- to 12-day window scan; patients were given an equal total dose of 45 g of iodine at a fixed injection rate of 4 mL/s. Comparison included assessment of quantitative and qualitative parameters. RESULTS: Lesion density and lesion-to-liver contrast increased more markedly with the higher concentration of contrast medium during the arterial phase (p = 0.0016 and 0.0005, respectively). There was no significant difference in any parameter between the two concentrations during the portal phase. Number of lesions detected during the arterial phase increased from 37 with iomeprol 300 to 42 with iomeprol 400; in the portal phase, the respective numbers were 34 and 36. CONCLUSION: Even though a small number of patients was examined, our study suggests that, in patients with cirrhosis, an increased concentration of iodine improves liver-to-lesion contrast and may improve the detection of hepatocellular carcinoma.
Bowel obstruction is the most common complication in patients with ovarian cancer. Management of this situation is controversial. The aim of our retrospective study was to determine the best approach for managing bowel obstruction in recurrent ovarian cancer. A retrospective analysis of data on 47 patients with intestinal obstruction by ovarian cancer was performed. Twenty-seven patients were submitted to surgery, with 21 intestinal procedures performed, 2 gastrostomy tubes placed, and 4 patients deemed inoperable. Twenty patients were managed medically with Octreotide (mean dosage of 0.48 mg/day), of which 1 patient required a nasogastric tube. Age, performance status, diagnosis of tumor to occlusion time, obstruction site, previous chemotherapy or radiotherapy, presence of ascites, or palpable masses were the variables analyzed. Student's t-test and Pearson chi-square test were used to compare the two different groups of treatment (surgical vs medical therapy). Disease-free-survival curves were plotted according to the Kaplan-Meier method and analyzed by the log-rank test. Cox's proportional hazards model was used for multivariate analysis. Values less than or equal to 0.05 were considered significant. The mean age of the patients was 58.7 years. Perioperative mortality and morbidity were both 22%. All patients died with minimal distress. Performance status results were significantly different between the patients submitted to surgery and patients treated with Octreotide (P= 0.03). No significant differences were found in the other variables analyzed. In multivariate analysis, only type of treatment emerges as a strong predictor of poor outcome (P < 0.001). Both surgery and Octreotide therapy are able to control distressing symptoms in end-stage ovarian cancer. Survival was significantly longer in the surgical group, and surgical palliation should be considered first in patients with good performance status.
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We considered 49 patients suffering from urinary stress incontinence, operated from January 1984 to December 1989 by Marshall-Marchetti modified after Symmonds procedure. 13 patients had one or more previous surgical procedures. We made urodynamic preoperative tests and a stress test (after Ferrari) in all our cases. We obtained: complete recovery in 80% of our cases, improvement in 14% and failure in 6%; particularly the recovery percentage in our patients operated for the first time was the 97.2%; in the recurrences we had complete success in 46%, an improvement in 38.5% and surgical failure in 15.5%. Complications were observed in 1 patient affected by pubic osteitis, treated with medical therapy. Only 3 patients had an incomplete bladder emptying one year after the surgical operation, with value of the post micturitional residual volume of about 1/3 of the maximal cystometric capacity.
The aim of the study was the assessment of the efficacy and safety of Seaprose S in women out patients from the maternity ward with infiltrated surgical wounds subsequent to vaginal birth or caesarean section. The semialkaline proteolithic enzyme Seaprose S, available in 30 mg tablets was administered at a dosage of 3 tablets a day for a period of 8 days. Thirty-two puerpera with a mean age of 31 years +/- 0.9 SE were admitted to the study with an episiotomic wound in 13 cases and a laparotomic wound consequent on caesarean section in the remaining 19 cases. The clinical situation deriving from the surgical wound resolved on average on the 4th day, in particular the swelling and the congestion of the wound had already diminished in the first days of treatment (p less than 0.01). Safety of Seaprose S was good considering that in no cases were side effects attributable to the treatment observed. In conclusion, from the data obtained in this study one may confirm the validity of Seaprose S in the treatment of laparotomic and episiotomic wounds.
The authors have examined 20 patients with genuine stress incontinence and urogenital prolapse and 20 control subjects searching a difference between static and dynamic condition of the pelvic floor. They used a simple device to study the mean position of the perineal plane both at rest and under switch. In incontinent patients the perineal plane is always below the bituberal plane (+1.17 cm at rest and +1.32 cm straining). These values are on a higher plane in the control subject (-0.64 cm at rest and +0.48 cm upon straining). These differences have an highly significant statistical value (P = 0.0002 and P = 0.001).
In order to increase our knowledge of the physiopathology of urinary stress incontinence related to pelvic relaxation, the Authors examined 20 women suffering from SUI (Stress Urinary Incontinence) almost always characterized by concomitant slight or moderate urethrocystocele and 20 women without urological problems. They analyzed and compared the measurement of perineal descent with radiological and electromyographic parameters in order to detect if a suffering of some fibers of the pudendal plexus can be related to the pathology of SUI. They pointed out that patients affected by SUI show a perineal position, either at rest and under switch, below the ischial tuberosities plane. Furthermore the anterior angle at rest is always more than 30 degrees and electromyographic records are pathological in 90% of cases.
87 patients treated for epithelial ovarian carcinoma between 1975 and 1986 were evaluated intensively. In all cases the original operation was followed by surgical reassessment to evaluate the result of adjuvant therapy and to study the cases without apparent disease. The actuarial survival rate after 3 years, by Kaplan-Meier calculation, demonstrated 73.5% survival in patients with negative second-look versus 32% in presence of positive reassessment (P less than 0.01). Surgical reexploration and histologic study were negative in 34 cases (39%). Original stage, histotype, histological grading, peritoneal washing and age of patients were considered for prognostic evaluation of the tumor. The absence of residual tumor (RT) at first surgery resulted in complete response after adjuvant therapy in 70.8% of women, versus 25.8% with RT greater than 2 cm (P less than 0.01). Negative second-look appears the most important prognostic factor for the evaluation of epithelial ovarian cancer (P less than 0.001).
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