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Biomedical subjects

L Lepore

Publications and source records attributed to L Lepore.

14 recordsLinked to original sources
PubMed1992

Cryptogenic chronic liver disease and hepatitis C virus infection in children.

The clinical features of 'cryptogenic' chronic liver disease and the prevalence of antibody to hepatitis C virus (HCV) in serum have been investigated in 33 Italian children (mean age 5 years). The diagnosis was based on the persistence of increased alanineaminotransferase values for longer than 6 months after the exclusion of biliary diseases, of extra-hepatic causes of hypertransaminasemia, of infection with known hepatotropic viruses and of autoimmune or metabolic disorders. Five patients had been transfused early in life, three had undergone surgery and one girl's mother had had acute non-A, non-B hepatitis during pregnancy. The remaining patients had no history of overt parenteral exposure. At presentation only 11 patients were symptomatic, the others had been referred after a check-up for intercurrent diseases. Liver histology performed in 21 cases showed persistent or mild active hepatitis in 18 cases and severe hepatitis or cirrhosis in three cases. Anti-HCV antibodies were found in 48% of the cases, including 88% with obvious exposure and 33% of the remaining cases. During a mean follow-up period of 5 years (range 1-14 years) only 11% of the cases achieved sustained biochemical remission, although none developed signs of liver failure. There was no significant difference in the clinical features and outcome of the disease between anti-HCV-positive and -negative patients. The results of this study suggest that HCV is implicated in most cases of 'cryptogenic' chronic liver disease observed in Italian children with a history of parenteral exposure and in at least one-third of the cases without overt exposure.(ABSTRACT TRUNCATED AT 250 WORDS)

Alanine Transaminase↗
PubMed1991

One case of rotational subluxation of the carpal scaphoid.

The authors describe one case of perilunate dislocation. After reduction of the dislocation, there was a residual rotational subluxation of the scaphoid due to dorsal tearing of the scapho-triquetral and radio-scaphoid ligaments. The subluxation results in post-traumatic dorsal instability of the carpus. The authors report their clinical experience and conclude that clinical and radiographic diagnosis is not always easy and treatment, which is always surgical, must aim at joint stabilization and ligament reconstruction.

Bone Wires↗
PubMed1990

Traumatic lesions of some accessory bones of the foot in sports activity.

Six athletes suffering from different lesions of some accessory bones of the foot are reported. Four of them were treated surgically, with removal of the os trigonum, the os tibiale externum, and the os subfibulare, while in the other two cases, conservative treatment was effective. In caring for athletes suffering from these kinds of disorders, their degree of involvement in sports, the level at which they are playing, and their desire to take the shortest possible length of time off must be taken into account in planning a therapeutic program.

Adult↗
PubMed1990

Distal radio-ulnar joint dislocation, ulna volar in a female body builder.

A 23-yr-old female body builder injured her right wrist while training. A correct diagnosis of pure distal radio-ulnar dislocation, ulnar volar, was made, and reduction was successfully carried out. After removal of plaster, the patient complained of wrist pain and clicking. Surgical exploration revealed a ruptured triangular fibro-cartilage complex, which was partially excised. The need for proper physical examination and accurate radiographic positioning is stressed.

Adult↗
PubMed1977

[Aromatic polycyclic hydrocarbons in plants using bituminous materials].

In recent years bituminous materials have been frequently used in several industrial works for waterproofing, protection and insulation of many amterials such as paper, (asphalted) cardboard, wood, etc. Constant components of these materials are the polyciclic aromatic hydrocarbons (PAH), of which we know the biological activity and, for some of them, the cancerogenic effects. The aim of this work is to evaluated the possible risk from exposure to polycicilic aromatic hydrocarbons for workers in operations with bituminous materials. By an analytical method for the determination of PAH, we have examined the polycicilic aromatic hydrocarbons in asphalt, air-blown asphalt, tars and, then, in fumes from hot treatments of those materials. After analysing the fumes developed under controlled conditions, in laboratory, and those taken from work-environment, we have reported the results of our search.

Air Pollutants↗
PubMedDate not supplied

[Treatment with low-dose methotrexate in intractable juvenile chronic arthritis].

14 patients suffering from Juvenile Chronic Arthritis unresponsive to NSAIDS were enrolled in this open study. There were two patients with a systemic form, nine patients with polyarticular form. All patients received methotrexate administered orally in one or two divided doses; the dose was 0.3-0.5 mg/kg/week. Clinical improvement occurred in most of the cases; remission was achieved in 5 out of 9 polyarticular form, in one out of the two systemic form and in two out of the three pauciarticular form. All patients showed a significant improvement in the clinical parameters except one with a pauciarticular form (duration of morning stiffness, number of swollen joints and number of painful joints). The effects on laboratory indexes were a decrease in ESR and CRP in about 50% of the cases, an increase up to the normal value of hemoglobin in about 30% of the cases. Two patients experienced a transient gastrointestinal discomfort and 3 had a mild elevation of serum aminotransferase levels which were restored after a reduction of the drug. In conclusion our data confirm that methotrexate at low dosage is more effective than other second-line agents and has fewer side effects. In our opinion methotrexate can today be considered the first choice for Juvenile Chronic Arthritis unresponsive to NSAIDS.

Administration, Oral↗
PubMedDate not supplied

Fracture of the os tibiale externum in a decathlete.

The upsurge in popularity in sports activities has produced a large number of lower extremity injuries. This article describes acute fracture of the os tibiale externum in a 28-year-old decathlete. The injury was treated conservatively, and excellent functional recovery was obtained. This is the second case of traumatic fracture of this accessory bone of the foot described in the English literature. When dealing with the feet of an athlete, supernumerary bones must be taken into consideration as a possible cause of serious discomfort.

Adult↗
PubMedDate not supplied

Treatment and prevention of osteoporosis in juvenile chronic arthritis with disodium clodronate.

Osteoporosis is one of the most difficult problems in the management of Chronic Juvenile Arthritis (JCA). The available data suggest that bone loss results from multifactorial processes which lead to bone degradation through the activation of osteoclasts. Biphosphonates are synthetic factors that, once localized on the surface of hydroxyapatite crystals, do not allow either the production or destruction of the crystals. This activity seems to be due to cytotoxicity against osteoclasts and to inhibition of prostaglandin E2 synthesis. There is some evidence that these drugs are effective in the treatment of osteoporosis in several diseases. In an attempt to reduce or prevent osteoporosis in children affected by JCA we started a trial with disodium clodronate, a type of biphosphonate. Thirteen patients were enrolled in the study: 7 received disodium clodronate and 6 acted as control subjects. Before starting the therapy and after one year we performed a CT scan to evaluate the mineral bone density in all patients. The mean bone density increased from a bone mineral content of 129 mg/cc before treatment to 134 mg/cc after treatment (8% increase); control patients passed from 123 mg/cc to 115 mg/cc (7% decrease) in the same period. Only one child stopped treatment because of gastrointestinal side effects. The small number of patients enrolled in the trial does not allow any definite conclusions to be drawn, but the data are interesting and worthy of further study.

Arthritis, Juvenile↗
PubMedDate not supplied

[Septic arthritis].

Septic arthritis is a serious medical problem that should be promptly recognized and requires appropriate treatment to avoid permanent joint damage. The disease is caused by several different microorganisms but the most frequent in children and in adults is Staphylococcus aureus. Pathogenetic mechanism, general (antiblastic therapy, diabetes, rheumatoid arthritis) and local (intra-articular injections) promoting factors are discussed. Usefulness of laboratory and radiological investigations is debated. Finally indications for needle aspiration, adequate drainage as well as guide lines on general and local antibiotic therapy are reported.

Arthritis, Infectious↗
PubMedDate not supplied

[Neutropenia caused by low-dose trimethoprim-sulfamethoxazole in children with chronic pathology of the urinary tract].

Neutropenia is the most common hematologic abnormality detected as consequence of Trimethoprim Sulfamethoxazole (TMP-SMX) therapy. Its incidence is evaluated in 27 children affected by urinary tract anomalies and treated with low doses of TMP SMX (2 + 10 mg/kg/die) for more than one month. A slight neutropenia was detected in 8 children (6 of these were in their first two years of life). In all the 27 cases a supplementation of folinic acid was started: a significant increase of PMN count was noted in all cases. Neutropenia can also appear after low (prophylactic) dosage of TMP-SMX, and can be prevented by concomitant administration of folinic acid.

Adolescent↗
PubMedDate not supplied

[Compromised function of the masticatory apparatus in juvenile rheumatoid arthritis].

A clinical and epidemiological study was conducted on a sample of 30 J.R.A. patients in order to identify the signs and symptoms of masticatory dysfunction. Helkimo's indices were used to quantify the data obtained. The incidence of masticatory dysfunction was significantly high as was confirmed by comparison with a random sample of healthy adolescents. The most common signs were alterations in the quality of mandibular movement, pain on muscle palpation and joint crepitus. The symptoms included spontaneous pain during mastication and tension headache with obvious psychobehavioural implications. The importance of early orthognathodontic intervention to reduce the sequelae of the joint damage became evident as did the role of the dentist in the framework of a broader and more specific multidisciplinary approach.

Adolescent↗