Biomedical subjects
Publications and source records attributed to L Volpe.
Hypervitaminosis A in a one-year-old child resulted from overfeeding of daily vitamin supplements by a caretaker. Most cases of chronic hypervitaminosis A are the result of self-medication or health food faddism. The signs and symptoms of overdosage of vitamin A are reviewed.
Results of personal experience of the application of enteral nutrition in a group of patients (21) submitted to surgery for gastric cancer are reported. Enteral nutrition proved easy to perform, provided a significant improvement in some of the parameters considered in the study, was without significant complications and presented acceptable management costs.
Two cases of fibroadenoma phyllodes examined in the senological outpatient department of the Infermi Hospital, Biella between june and october 1987, described and diagnosed by senography and echography and confirmed by histological examination of the operating piece are presented.
An unusual case of an aneurysm on the splenic artery diagnosed as an accessory spleen on the basis of sonographic examination triggers a discussion of sonography, CT and angiography in the diagnosis of splenic aneurysms, which though rare in absolute term constitute a real threat to the patient's life giving her [correction of him] a high percentage of spontaneous ruptures when they do occur.
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Personal experience is reported of the latest instrumental techniques used to diagnose ruptures of the spleen following a closed abdominal trauma. Particular interest was taken in patients with unclear clinical symptoms who were given a series of surgical and/or non-surgical tests in order to diagnose ruptured spleen in the asymptomatic phase. Tests analysed included: peritoneal injection-douche, laparoscopy, angiography, scintiphotography, echography and CAT scanning.
Reference is made to an experimental and clinical investigation of single-layer intestinal anastomoses. The techniques of Gambee, D'Onofrio, Lembert, Halsted Connel were applied in six groups of 10 rabbits. The survival and weight data, gross and microscopic inspection, and the stenosis index showed that the best results were obtained with Halsted's, D'Onofrio, and Gambee's techniques. An account is also given of a clinical series of 124 patients in which Halsted's technique was employed.
Personal experience with 132 galactographic examinations carried out on all types of breast secretion is reported, in 7 patients in the absence of secretion. Radiology showed 38 endoductal productive lesions which did not always reveal themselves with loss of blood from the nipple. Features of the ductal lesions in relation to the type of secretion are compared. No complications connected to the examination were ever encountered even in cases in which the contrast medium spread.
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Complex though integrated hormonal and metabolic changes characterize pregnancy. In the face of progressive decline in insulin action, glucose homeostasis is maintained through a compensatory increase in insulin secretion. This switches energy production from carbohydrates to lipids, making glucose readily available to the fetus. This precise and entangled hormonal and metabolic condition can, however, be disrupted and diabetic hyperglycemia can develop (gestational diabetes). The increase in plasma glucose level is believed to confer significant risk of complications to both the mother and the fetus and the newborn. Moreover, exposition of fetal tissues to the diabetic maternal environment can translate into an increased risk for development of diabetes and/or the metabolic syndrome in the adult life. In women with previous gestational diabetes, the risk of developing type 2 diabetes is greatly enhanced, to the point that GDM represents an early stage in the natural history of type 2 diabetes. In these women, accurate follow-up and prevention strategies are needed to reduce the subsequent development of overt diabetes. This paper will review current knowledge on the modifications occurring in normal pregnancy, while outlining the mechanisms. In this paper, we will review the changes of intermediary metabolism occurring during pregnancy. In particular, we will outline the mechanisms responsible for gestational diabetes; the link between these alterations and associated maternal and neonatal morbidity will be examined.
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We measured by RIA the serum and urinary digoxin-like immunoreactivity (EDLF) in 8 subjects with severe obesity and in 10 healthy, non-obese individuals (as a control group), to evidentiate whether circulating and urinary levels of EDLF are increased in obesity. For each individual, we measured the mean EDLF on two sera collected consecutively on two successive mornings, between 8-9 a.m. and the daily urinary EDLF excretion. Every subject collected his/her 24 hour urine in 5 different timed fractions. For each urine fraction, we measured the excretion of EDLF, electrolytes (Na and K), and creatinine. In obese people, the mean serum digoxin-like immunoreactivity (no. 8, 27.3 +/- 8.7 ng/L de) was significantly higher (unpaired t test, p = 0.0002) than in the controls (no. 10, 12.0 +/- 7.3 ng/L de), whereas control and obese subjects had superimposable 24 hour EDLF urinary excretion. Urinary excretion of EDLF significantly changed throughout the day in normals, but not in obese people. In a multiple stepwise regression analysis, urinary K+ and Na+ significantly (p less than 0.01) contributed to the regression with urinary EDLF (EDLF = 76.9 + 0.67 K+ - 0.24 Na+; R = 0.601, no. 40) in obese individuals. The in vivo kinetic and metabolic pathways of EDLF are conceivably different in obese and normal subjects. A difference in the production rate, binding to plasma proteins and/or removal mechanisms could explain the findings of higher circulating levels with normal EDLF urinary excretion in obese persons.(ABSTRACT TRUNCATED AT 250 WORDS)
Three subjects with tubal ectopic pregnancy were treated with intravenous administration of methotrexate followed by oral administration of folinic acid. The treatment was effective in obtaining the resolution of ectopic pregnancies in all cases. Tubal patency was also preserved.
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